When you’re worried that something may be seriously wrong with your health, you want to know what the problem is, and for it to be fixed as soon as possible.
So imagine if your doctor agrees that something’s wrong, and refers you for a test.
You wait for the test. You have the test. You wait for the results.
When the results come back, you’re told you have cancer – and you need treatment.
And then you wait for your first round of treatment.
In the words of Margaret, diagnosed with cancer in 2014, this process was “agonising”.
“I just wanted something doing – I kept thinking, it’s six weeks on and it’s still growing.”
Now imagine all that taking more than two months.
But tens of thousands of people don’t have to imagine. Despite the NHS in England promising that at least 85 per cent of people should start their treatment for cancer within two months of an urgent referral from their GP, this target has been missed constantly since the beginning of 2014.
And the latest figures, published today, aren’t pretty.
This means that since the beginning of 2014, more than 50,000 people in England have had to wait in limbo for more than two months to start treatment.
The number of people waiting more than two months is still increasing. We can now see that 2015 was the worst year since the NHS started recording waiting times in 2009.
Waiting times are a barometer for how well cancer services are doing and the pressure they’re under. It’s clear that the health service needs more resources to ensure patients don’t have to wait this long.
This isn’t just about figures, missed targets and percentage points. Behind these stats are real people, waiting far too long to find out whether they have cancer – and if they do, to start treatment that could save their lives.
Why is this happening?
Health professionals (GPs, dentists, pharmacists) know how important it is to diagnose cancer early. It makes a big difference to a patient’s chances of successful treatment. And as a result of new NICE referral guidelines – brought in last year to help diagnose cancers earlier, and efforts to get more people to see their doctor if they spot suspicious symptoms, or go for screening if they want it, more people are now being referred for diagnostic tests.
Over 1.5 million urgent GP referrals for suspected cancer were made last year – an increase of 50 per cent in the last four years. This is a good sign as we want more people to have their symptoms checked if they could be cancer.
Unfortunately, as the waiting time statistics make clear, the rest of the NHS can’t keep up. Instead of finding out results and starting treatment (or getting the ‘all clear’), patients are waiting longer than they should. And, as we’ve revealed previously, some of them are waiting a very long time indeed.
Around 24,300 patients waited more than 62 days for treatment during the last financial year (2015/16). And of these patients, more than four in 10 (43 per cent) were left waiting between two weeks and one month beyond the target before starting treatment. And around a quarter (26 per cent) had to wait an extra month on top of the goal of within 62 days.
This means less than a third of patients were treated ‘just after’ the target, compared with the majority of patients who had to wait much longer.
And this is, once again, simply unacceptable. The NHS isn’t ‘just’ missing this target, and patients are being failed as they are left waiting longer and longer for treatment.
Things can only get better?
The waiting times problem has been going on for more than two years – and it won’t get better on its own. In fact, it looks like the problem is only going to get worse as the population ages, and more people need tests.
As an example, by 2020, it’s predicted that the NHS will need to do more than 750,000 extra endoscopies (tests used to diagnose gastrointestinal cancers) every year. That’s more than the population of Leeds.
This means the NHS needs more up-to-date machines, and enough staff to operate them. Unfortunately, this demand hasn’t been met, and the cracks are already starting to show, with high staff vacancy rates, high amounts of overtime working, and too much money spent on temporary staff.
As an example, we only have around 48 radiologists (doctors who diagnose diseases using imaging techniques such as X-rays and scans) per million people in the UK, compared with 92 in Germany, 112 in Spain and 130 in France.
This isn’t sustainable – the government needs to take action now so that patients aren’t left waiting.
So we know what the problem is. And we know that, without action, it could get worse.
But there is a solution.
Last July, the Independent Cancer Taskforce published the cancer strategy, which set out many recommendations for how the NHS and the Government in England could help improve cancer services.
And in September 2015 there was some good news: to put this into practice, the Government announced it would spend up to £300 million more per year on diagnostics by 2020. They also agreed to introduce a 28-day turnaround between being referred for a test and being given either a diagnosis or the all clear, and give all patients a copy of their test results.
Since then we’ve been waiting for more detail on how this money will be spent. And now it’s arrived, in the form of a plan from the NHS published today.
We’re pleased to see that there are steps being taken, and the plan states that the NHS needs to:
Focus on ensuring that diagnostic services are ready and able to respond to this rising demand so that people are diagnosed quickly
And they’ve put some of the £300 million earmarked for diagnostics into a fund, which will help local areas increase the number of tests they can do.
Health Education England – the organisation in charge of training doctors and other health professionals – has also said that work is underway to address the shortage in experts needed to carry out these tests.
So it’s extremely good news that NHS England has published its plan to put this into practice. This is crucial if the health service is to give patients best chance of a cure, and if it’s serious about seeing survival in the UK match the best in the world.
Of course, we’ve only been talking about England in this article. That’s because, as we discussed earlier this week, health policy is dealt with separately in the different UK nations. The ways that waiting time targets are measured is different in each country in the UK – so comparisons should not be made between countries, only each country against their own measures (more about this here).
But we know waiting times are an issue in other nations too. And the anxiety caused by waiting for a cancer diagnosis doesn’t respect borders. Patients like Margaret use words like “agonising” to describe their wait, no matter where they live.
So we want to see action in Northern Ireland, Scotland and Wales to improve their waiting times as well. And we’ll be working with governments across all the UK’s nations to make sure they keep cancer high on the agenda, and put plans into action.
It will take time to get the waiting time statistics back down again, but for the sake of the Margarets of the future, the action needs to start right now.
Rose Gray is a policy advisor at Cancer Research UK