Staff shortages force UK doctors to pick which cancer patients to treat promptly

Cancer patients’ chances of survival are falling because of treatment delays in England as staff shortages force doctors to choose which patients they can treat promptly, a group of expert clinicians has warned.

The Royal College of Radiologists, along with professional bodies representing cancer physicians, nurses and pharmacists, have written to Steve Barclay, UK health secretary, to express “serious concerns about a critical lack of capacity within oncology departments”. 

They said many departments were “having to make difficult decisions over whether to withhold access to approved treatments or prioritise which patients can receive treatment within a safe time at the expense of others”. 

For each month a patient was delayed from starting treatment, the risk of death increased by about 10 per cent. “These types of waits are now sadly routine,” the letter added.

The state of the NHS will be a crucial battleground at the general election next year. Prime minister Rishi Sunak has made reducing waiting times for treatment one of the “five priorities” by which he expects to be judged by the voters.

The most recent NHS England performance data revealed the number of people waiting more than two months to start cancer treatment after an urgent referral had fallen year-on-year for the first time since the start of the pandemic.

But at the end of March almost 20,000 were still waiting longer than the target of 62 days. Referrals for suspected cancer have been running at record levels for the past two years, according to NHS England.

Meanwhile a long-delayed workforce plan for the NHS, the first in 20 years, is finally expected to be published within the next few weeks.

In their letter to Barclay, the signatories — including the Association of Cancer Physicians, British Oncology Pharmacy Association and UK Oncology Nursing Society — said that demand for cancer treatment was increasing by about 6 to 8 per cent every year, partly owing to the rising incidence of cancer but also because more treatments were being made available on the NHS.

In the 2021-22 financial year, about 92 per cent of cancer drugs submitted to the National Institute for Health and Care Excellence, which assesses value for money, were approved, compared with 60 per cent in 2011-12, the College said.

However, a lack of equivalent investment or support for the oncology workforce meant departments were failing to keep pace. Oncology teams were “having to create capacity in ways which compromise patient safety and quality of care and increase pressure on already overworked staff”, the clinicians added.

The professional bodies called on the government and the health service to take steps ranging from better workforce planning to “desperately needed action to boost the oncology workforce”. 

Without action patients would not receive “an optimal and effective level of care”, the NHS would continue to fall behind on its cancer targets “and the government will fail to meet its national cancer ambitions”, they said.

The Department of Health and Social Care said the number of NHS cancer doctors had risen by more than half between January 2010 and January this year.

This included an increase of more than 3,000 — of whom 63 per cent were consultants, the most senior doctors — “who are working with teams to provide care and cut NHS waiting lists, one of the government’s top five priorities”, the department said.

It added: “We want to build on this progress and will publish a workforce plan shortly to ensure we have the right numbers of staff, with the right skills, to transform and deliver high quality services fit for the future.”