Health

NHS cancer wait times drop to a 10-year low, 'extremely worrying' figures reveal


NHS cancer waiting times are the worst in 10 years with a 20,000 suspected patients not seen within 14 days of an urgent GP referral.  

Some 87.8 per cent of 170,000 patients in England suspected to have the disease had a consulation within two weeks of their doctor referring them — the lowest since records began in October 2009. It means 12.2 per cent had to wait longer. 

Referrals are still nowhere near where they were before the pandemic struck, despite repeated pleas, and were around 31,000 lower — 15 per cent — in August compared to the year before.   

A GP makes a referral if they are concerned about a patients’ symptoms, such as a lump, blood in the urine or stool or persistent illness. It leads to a cancer diagnosis in around seven per cent of cases.

Therefore, cancer charities fear more than 2,000 cancer patients in England (seven per cent of 31,000) may have missed out on a diagnosis in August.

Macmillan said the implications of thousands of people missing out on tests and treatment for the disease is ‘extremely worrying’.

It comes after Matt Hancock made ‘deeply concerning’ comments on Tuesday that cancer patients may only be guaranteed timely treatment if Covid-19 stays ‘under control’. 

The NHS figures released today also revealed more than 110,000 patients have waited longer than a year to start routine hospital treatment – another 10-year high.

The data also shows: 

  • Some 1.96million people had waited more than 18 weeks for treatment in August – triple the figure in the same month last year;
  • Overall, the waiting list, including the 111,026 patients who have waited more than a year for treatment, stood 4.22million in August;
  • Nearly half a million patients in England had been waiting more than six weeks for a key diagnostic test in August;

The NHS data today is another reminder of the sheer impact Covid-19 has had on treatment for other diseases. 

Cancer treatment has become one of the largest calamities of the pandemic, with experts previously warning the fall-out could last for years.

HOW CANCER PATIENTS ARE BEING DELAYED 

Macmillan Cancer Charity pointed out the NHS England data today revealed:

  • LOWER GP REFERRALS: The number of people in England being seen by a specialist for suspected cancer following an urgent referral by their GP was 169,660 in August 2020. This is around 30,700 lower than it was the same time last year, a drop of 15 per cent.  
  • FEWER SUSPECTED CANCER PATIENTS SEEN IN TWO WEEKS: 87.8 per cent of those who saw a specialist did so within two weeks of their initial urgent referral – this is the worst result on record in England for this cancer waiting times target.  
  • 22% FEWER PATIENTS STARTING TREATMENT: 20,177 patients started treatment for cancer in August 2020. Under normal circumstances, this figure would be expected to be around 25,800 – a reduction of 22 per cent and 5,600 people. 
  • 9% FEWER PATIENTS HAVING SURGERY: The number of people having surgery as a subsequent treatment for cancer was around 4,000 in August 2020. This is lower than last month’s figures and a nine per cent drop than what would be expected compared to previous years.
  • 18% FEWER PATIENTS STARTED TREATMENT AFTER REFERRAL: Under normal circumstances, around 13,700 people in England start treatment for cancer following urgent GP referral for suspected cancer specifically every month (i.e. excluding those diagnosed through other routes, e.g. cancer screening). In August 2020, this figure was 11,197, which means the number of people starting treatment following an urgent GP referral for suspected cancer is around 2,500 lower, a drop of 18 per cent.
  • 82% FEWER PEOPLE TREATED LOWER CANCER SCRENINGS: 82 per cent fewer people in England started treatment for cancer following a cancer screening appointment in August 2020 compared to August 2019. Just over half of these people (56 per cent) started treatment within 62 days of their screening appointment, against a target of 90 per cent. 

The latest data shows a record low numbers of patients are being seen for their first consultant appointment after being referred urgently by their GP for suspected cancer.

An ‘urgent referral’ means the patient should be seen by a specialist within two weeks to investigate symptoms, such as a lump in the breast, testes, further. The time frame target does not exist in Scotland, Wales or Northern Ireland.  

It is important to be checked rapidly because the earlier cancer is diagnosed, the better chances of getting life-saving treatment early.  

In August 2020, 87.8 per cent of the 169,660 referrals were seen within two weeks. It means some 20,698 had to wait longer. 

The figure is down from 89.4 per cent in August 2019 and lower than the target of of 93 per cent. It is also lower than the average of 94.1 per cent.

But the actual number of people seeking a referral because they have concernig symptoms is lower as well, the figures suggest.

Around 30,700 fewer people were referred to a specialist by GPs in August 2020 (169,660) compared with August 2019 (200,317) – a 15 per cent drop.  

Given that under normal circumstances, around seven per cent of people who are seen by a specialist for suspected cancer following an urgent GP referral will go on to be diagnosed with cancer, Macmillan say 2,000 people in England who would have been diagnosed with cancer this August are instead unaware they have it.

The figure is even worse for breast cancer; 9,498 urgent referralls were made in August 2020, down 28 per cent from 13,220 in August 2019. Data was not given for other cancer types. 

It suggests patients are still not going to their GP after the national lockdown reduced face-to-face appointments. 

This is despite cancer charities warning of a walking timebomb of diagnoses, and Prime Minister Boris Johnson himself urging people to keep using the NHS amid the coronavirus crisis.    

However, the rates of urgent referrals have increased again after plummetting during lockdown – in April just 79,573 were made. 

Cancer treatments have also been affected by the Covid-19 pandemic. The NHS data shows 82 per cent fewer people in England started treatment for cancer following screening appointment, such as for breast or cervical cancer, in August 2020 compared to August 2019. 

More than half of these people (56 per cent) started treatment within 62 days of their screening appointment, against a target of 90 per cent.  

Sara Bainbridge, head of policy at the charity, said: ‘Disruption to cancer diagnosis and treatment is having a traumatic impact on cancer patients’ lives.

Many patients with suspected cancer were not seen by doctors - either because they didn't go or they struggled to get appointments - when the NHS had to all but shut down to prepare for an influx of people with Covid-19 (Pictured: A temporary Nightingale Hospital in London)

Many patients with suspected cancer were not seen by doctors – either because they didn’t go or they struggled to get appointments – when the NHS had to all but shut down to prepare for an influx of people with Covid-19 (Pictured: A temporary Nightingale Hospital in London)

Pictured: The percentage of cancer patients seen within two weeks of an urgent referral over the last decade. In August 2020, 87.8 per cent of referrals were seen within two weeks. It means some 20,698 suspected patients had to wait longer. The figure is down from 89.4 per cent in August 2019 and lower than the standard of 93 per cent over the past decade

Pictured: The percentage of cancer patients seen within two weeks of an urgent referral over the last decade. In August 2020, 87.8 per cent of referrals were seen within two weeks. It means some 20,698 suspected patients had to wait longer. The figure is down from 89.4 per cent in August 2019 and lower than the standard of 93 per cent over the past decade

‘Today’s data shows that, six months from the start of the pandemic, there were still thousands fewer people being tested or treated for cancer than the same time last year, meaning that the backlog of patients continues to grow.

110,000 HAVE WAITED MORE THAN A YEAR FOR A ROUTINE OP 

The NHS data released today showed the number of people waiting more than a year to start hospital treatment is at its highest level since 2008 — 111,026 patients. 

In August 2019, the figure was 90 times lower, at just 1,236.

Those affected are patients waiting for planned, non-urgent surgery such as hip and knee replacements, cataract surgery or kidney stone removal. 

Waiting times are expected to increase even further over the coming months because hospitals must enforce stricter infection control measures, including social distancing.

This means only a limited number of patients can attend clinics or stay overnight on wards and theatres must be more thoroughly cleaned between procedures, meaning fewer operations can take place.

Patients coming in for routine surgery also have to be tested beforehand and self isolate, which can be a difficult feat. 

The number of people waiting more than 18 weeks to start hospital treatment also tripled in August compared to the same month last year.

Some 1.96million people had waited more than 18 weeks for treatment in August, around three times the number for August 2019 (662,043).

It’s the second highest total for any calendar month since records began in August 2007.

But the figure is down slightly from the number for July 2020, which was 2.15million, suggesting some progress is being made.

Jonathan Ashworth MP, Labour’s Shadow Health Secretary, commenting on the number of people waiting over a year to start their treatment, said: ‘This is a staggering increase in people waiting beyond 12 months for treatment.

‘It means people suffering longer in pain and distress and is simply unacceptable. Everyone understands the pressures facing the NHS but ministers have a responsibility to bring forward plans to ensure people receive the treatment they need on time.’

‘The implications of this are extremely worrying.’

It comes after the charity reacted to the Health Secretary’s suggestion this week that hundreds of thousands of cancer patients may face delays to planned surgery and chemotherapy, if the coronavirus outbreak continues to spiral.

Ms Bainbridge said: ‘We, and likely thousands of people living with cancer, are deeply concerned by the Health Secretary’s suggestion earlier today that the recovery of cancer services could be under threat if the virus is not controlled.

‘It is critical that the Government and NHS learns from the consequences of the first wave of the coronavirus — which are still being felt eight months on — and does not disrupt vital services that take a long time to recover, while people with cancer are left waiting.

‘It must not be underestimated just now serious the implications of postponing or cancelling cancer treatment and tests would be for patients’ physical and mental health — and for the already significant backlog the NHS faces.’

Almost 2.5million people missed out on cancer tests and treatments during the first wave of the pandemic, according to Cancer Research UK.

They said more than 2.1million are still waiting for crucial screenings for breast, cervical and bowel cancer. Another 290,000 have missed out on urgent referrals to confirm or rule out tumours. More than a million women missed checks for breast cancer at the height of the pandemic, Breast Cancer Now has said.

If these extra procedures had been allowed to go ahead, some would have saved lives or extended them, granting extra invaluable time to families.

Research has shown the impacts on cancer survival will be felt for years to come.

Britons are now more likely to die from some types of cancer than they were 15 years ago because of the coronavirus pandemic, London School for Hygiene and Tropical Medicine have said after modelling what effect the disruption of cancer services will have by 2025. 

The Government is planning to make wards in private hospitals hired by the NHS ‘Covid-19 free’ so that it can continue treating cancer and other diseases, while battling a surge in hospitalisations due to the virus in a ‘second wave’. 

Mr Hancock told the Commons on Tuesday: ‘Because (private hospitals) very rarely have the pressures of emergency attendance that means that we can ensure that they are part of the ‘green’ part of the health service.

‘(This means) that they are as free as is feasibly possible from coronavirus and therefore able to carry out all sorts of cancer treatments.’

He added: ‘These referrals are leading to the action that’s necessary and it’s very important that the message goes out that the NHS is open and that anybody with a concern over cancer should come forward and that we can save lives.’

MATT HANCOCK SAYS CANCER PATIENTS COULD HAVE TREATMENT DELAYED UNLESS COVID STAYS ‘UNDER CONTROL’

Cancer patients will only be guaranteed treatment if Covid-19 stays ‘under control’, Matt Hancock claimed today as he faced a roasting from MPs over an Excel spreadsheet blunder that has potentially led to tens of thousands of Britons being unaware they are infected with the virus.

The Health Secretary claimed that it was ‘critical for everybody to understand the best way to keep cancer services running is to suppress the disease’, suggesting that hundreds of thousands of patients may face delays to planned surgery and chemotherapy, if the outbreak continues to spiral.

Vital operations were cancelled and patients missed out on potentially life-saving therapy in the spring because tackling Covid-19 became the sole focus of the health service, instead of cancer and other cruel diseases. 

Almost 2.5million people missed out on cancer screening, referrals or treatment at the height of lockdown, even though the NHS was never overwhelmed — despite fears it would be crippled by the pandemic.

Experts now fear the number of people dying as a result of delays triggered by the treatment of coronavirus patients could even end up being responsible for as many deaths as the pandemic itself.

Surgeons have worriedly called for hospital beds to be ‘ring-fenced’ for planned operations during the pandemic, to avoid the upheaval of spring where patients faced a ‘tsunami of cancellations’ as the health service focused on battling coronavirus. 

But in the House of Commons today, Mr Hancock warned Covid-19 could once again disrupt cancer treatment and told MPs that controlling the virus would allow the NHS to ‘recover the treatment that we need to for cancer and other killer diseases’.

He said: ‘It’s critical for everybody to understand that the best way to keep cancer services running is to suppress the disease, and the more the disease is under control the more we can both recover and continue with cancer treatments.’

The Government is planning to keep private hospital wards hired by the NHS ‘Covid-19 free’ so that it can continue treating cancer and other diseases, while battling a surge in hospitalisations due to the virus. 

Royal Stoke University Hospital, which transferred its cancer treatment to Nuffield Health in Newcastle-under-Lyme at the start of the pandemic, was held up as an example of what others should look to achieve.

Mr Hancock said: ‘Because (private hospitals) very rarely have the pressures of emergency attendance that means that we can ensure that they are part of the “green” part of the health service.

‘(This means) that they are as free as is feasibly possible from coronavirus and therefore able to carry out all sorts of cancer treatments.’

He added: ‘These referrals are leading to the action that’s necessary and it’s very important that the message goes out that the NHS is open and that anybody with a concern over cancer should come forward and that we can save lives.’

The NHS data released today also showed the number of people waiting more than a year to start hospital treatment is at its highest level since 2008 — 111,026 patients. 

In August 2019, the figure was 90 times lower, at just 1,236.

Those affected are patients waiting for planned, non-urgent surgery such as hip and knee replacements, cataract surgery or kidney stone removal. 

Waiting times are expected to increase even further over the coming months because hospitals must enforce stricter infection control measures, including social distancing.

This means only a limited number of patients can attend clinics or stay overnight on wards and theatres must be more thoroughly cleaned between procedures, meaning fewer operations can take place.

Patients coming in for routine surgery also have to be tested beforehand and self isolate, which can be a difficult feat. 

The number of people waiting more than 18 weeks to start hospital treatment also tripled in August compared to the same month last year.

Some 1.96million people had waited more than 18 weeks for treatment in August, around three times the number for August 2019 (662,043).

It’s the second highest total for any calendar month since records began in August 2007.

But the figure is down slightly from the number for July 2020, which was 2.15million, suggesting some progress is being made.

Jonathan Ashworth MP, Labour’s Shadow Health Secretary, commenting on the number of people waiting over a year to start their treatment, said: ‘This is a staggering increase in people waiting beyond 12 months for treatment.

‘It means people suffering longer in pain and distress and is simply unacceptable. Everyone understands the pressures facing the NHS but ministers have a responsibility to bring forward plans to ensure people receive the treatment they need on time.’

The latest data also showed that the total number of people admitted for routine treatment in hospitals in England was down 43 per cent in August compared with a year ago.

Some 155,789 patients were admitted for treatment during the month, down from 275,267 in August 2019.

But the year-on-year decrease recorded in July was 55 per cent, and in June the drop was 67 per cent.

Overall, the waiting list, including people waiting under 18 weeks, stood 4.22million in August, lower than the 4.43million in February before Covid-19 struck. 

Meanwhile, people are still refraining from going to A&E. Some 479,800 went to the emergency department on September 2020 — down nine per cent from 529,903 in September 2019.

Macmillan said this was also a concern for cancer, because under normal circumstances, around one in five cancer diagnoses in England take place following an emergency presentation.

Commenting on today’s figures, president of the Royal College of Surgeons of England, Professor Neil Mortensen said: ‘Today’s data show what a mountain the NHS has to climb to get on top of the immense backlog of planned operations, with more than 100,000 people now having waited longer than a year for treatment.

‘It is welcome to see a slight drop in the number of patients who have waited longer than 18 weeks, reflecting what Trusts are doing to get people seen and treated.

‘But the continued recovery of surgical services cannot be taken for granted. 

‘Winter pressures from a flu outbreak, along with a resurging incidence of coronavirus, will put the fragile recovery of planned surgery at risk. Action is needed right now to ensure staff are Covid-tested regularly, and beds are ring-fenced for patients who really need their operation.

‘It is also of critical importance that patients continue to come forward to their GPs for referral if they are unwell; early detection of disease always makes for more effective treatment, so people must not be deterred because they know waiting lists are long.’ 

Siva Anandaciva, Chief Analyst at The King’s Fund, also said the data revealed ‘what a mountain the NHS has to climb’ in order to bounce back, calling for routine testing of staff. 

He said: ‘NHS staff are working hard to restore services and find innovative new ways to care for patients, but as these figures show, there is a mountain to climb before waits for routine NHS care return to pre-pandemic levels. 

‘Combine these formidable challenges with the expected annual surge in demand for services and concern about exhausted and overstretched staff, and it is clear why many NHS leaders are braced for a torrid winter.

‘With the country facing a second wave of the virus, lessons need to be learnt from the initial peak in cases. 

‘As the Prime Minister has said, it is vital that cancer treatment and other non-Covid services can continue to provide treatment for patients. 

‘Much will therefore depend on whether the government can deliver increased capacity and improvements to the testing system to enable NHS and social care staff to be regularly tested for Covid.’ 

The latest data also showed that the number of people waiting more than six weeks for diagnostic tests is 10 times higher than the same point last year, although this has improved since earlier in the year.

A total of 472,088 patients were waiting for one of 15 standard tests, including an MRI scan, non-obstetric ultrasound or gastroscopy.

The equivalent number waiting for more than six weeks in August 2019 was 42,926.

The number waiting more than 13 weeks in August 2020 was 239,920, compared with 5,284 in August 2019.

An NHS spokesman said: ‘Hospitals are carrying out more than a million routine appointments and operations per week, with around three times the levels of elective patients admitted to hospital than in April, as they continue to make progress on getting services back to pre-Covid levels including scanning services which are delivering millions of urgent checks and tests.

‘It is obviously vital for patients that this progress continues, and isn’t jeopardised by a second wave of Covid infections spiralling out of control.’   

Furious daughter slams GPs after her mother was repeatedly refused an appointment for her cough because of Covid – which later turned out to be terminal cancer 

A daughter claims GPs used coronavirus as an excuse to repeatedly stop her mother booking an appointment – only for her cough to turn out to be terminal cancer.

Marina Sendall’s mum Ellie Krzywy has been told she has just six months to live after her chronic cough was eventually diagnosed as lung cancer in August.

However Ms Sendall, 33, claims Gloucester Health Centre in Gloucester, Gloucestershire, ‘didn’t want to see’ patients during the pandemic.

After rejecting Ms Krzywy’s request for a proper appointment, her GP prescribed antibiotics in two separate telephone consultations in June.

They believed the 62-year-old’s symptoms were a sign of a chest infection.

When she started suffering with severe breathlessness and her lips turned blue, she requested a face-to-face visit.

Marina Sendall (left) claims GPs used coronavirus to repeatedly stop her mother Ellie Krzywy (right) booking an appointment - only for her cough to turn out to be terminal cancer

Marina Sendall (left) claims GPs used coronavirus to repeatedly stop her mother Ellie Krzywy (right) booking an appointment – only for her cough to turn out to be terminal cancer

GPs believed 62-year-old Ms Krzywy's (pictured) symptoms were a sign of a chest infection and prescribed her antibiotics by telephone consultation

GPs believed 62-year-old Ms Krzywy’s (pictured) symptoms were a sign of a chest infection and prescribed her antibiotics by telephone consultation 

However the grandmother-of-eight was reportedly told she’d need to take a covid test before a paramedic would see her.

After testing negative for coronavirus, she was quizzed about her symptoms and the practitioner discovered the oxygen levels in her blood had plummeted.

They also discovered her right lung was silent and referred her for an x-ray, which had a fortnight waiting list and an additional seven-day wait for results.

Mum-of-three Ms Sendall, a retail administrator from Gloucester, Gloucestershire, rushed her mother to Gloucester Royal A&E on August 1st.

There, doctors told Ms Krzywy she had small cell lung cancer (SCLC) and had just six months to live.

The mother-of-four says she is ‘very disappointed’ that she was refused a face to face appointment while suffering from cancer.

She admits she is still ‘in shock to have so little time left’. 

Her daughter claims the doctors who initially refused to see her mother have robbed the family of precious time together by using covid as an ‘excuse’.

Ms Sendall said: ‘I do think Covid was used as an excuse not to see her, it seems that way.

‘Appointments were extremely difficult to get even before lockdown, you were often being dismissed as it is.

‘I don’t know if this [covid] has had a huge impact or whether it’s a ‘get out of jail free’ card [for GPs] thinking ‘now we can blame it on covid’. 

She added: ‘If my mum was seen when she first called we probably would have had a different outcome, but at this point it had spread.

‘Maybe she wouldn’t have had a brilliant prognosis but we definitely would have had a lot more time with her.

‘My mum was completely dismissed when she finally got a face-to-face appointment.’

Cleaner Ms Krzywy began chemotherapy that is due to finish at the end of this month following a biopsy and CT scan.

A spokesperson from NHS Gloucestershire Clinical Commissioning Group said: ‘We are very sorry to hear about this patient’s experiences and that the lady concerned and her daughter are unhappy with the service provided.

‘We have been working very closely with our GP surgeries throughout the COVID-19 pandemic to ensure that appropriate arrangements and safeguards are in place to see patients face to face if their medical need requires it.’



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