NHS England waiting times for cancer referral and treatment at record high

Waiting times for cancer referrals and treatment are at record highs in England as the country emerges from the pandemic, a damning analysis has revealed amid a row over the Government’s NHS catch-up plan. 

An estimated half a million people with suspected cancer will not be seen by a specialist within the two-week maximum target set by the health service this year.

And for the first time ever, the number of patients diagnosed with the disease who do not start treatment within the crucial one-to-two-month window is expected to exceed 75,000. 

Reacting to the figures, which were laid bare in an analysis by the House of Commons library, experts warned the delays could reverse survival rates. Cancer charities said patients directly affected by the waits were languishing in ‘unimaginable distress and anxiety’.

It comes as Boris Johnson’s blueprint for tackling the NHS backlog for cancer and routine surgeries was pushed back as ministers failed to sign off the draft document. It was due to be published today.

Health service insiders suggested the Chancellor Rishi Sunak is demanding tougher targets in return for funding — although Sajid Javid, the Health Secretary, blamed the recent Omicron wave for the delay.

The wrangling has fuelled concerns about the heightened tension between the embattled Prime Minister and Mr Sunak, after several of the Chancellor’s allies quit No10 over the Partygate scandal. 

NHS England aims to treat 85 per cent of cancer patients who receive an urgent referral from their GP within two months, but in November 2021, the latest available, only 67.5 per cent of patients received treatment in this time frame. While the problem predates the Covid pandemic, the disruption to services caused by the virus has exacerbated the problem

Boris Johnson's blueprint for tackling the NHS backlog for cancer and routine surgeries was scheduled to be unveiled today

But it has been pushed back as ministers failed to sign off the draft document. Health service insiders suggested the Chancellor Rishi Sunak is demanding tough targets in return for funding

FEUD: Boris Johnson’s blueprint for tackling the NHS backlog for cancer and routine surgeries was scheduled to be unveiled today, but it has been pushed back as ministers failed to sign off the draft document. Health service insiders suggested the Chancellor Rishi Sunak is demanding tough targets in return for funding. Boris and Rishi are pictured separately this morning

The Commons library analysis was commissioned by shadow health secretary Wes Streeting, who himself was treated for kidney cancer last year.

It found that, between April and November last year, 290,428 with suspected cancer did not see an oncologist within 14 days of an urgent referral from their GP — a target introduced in 2009.

Despite covering just seven months, it was the most of any full year and significantly more than the 235,549 in 2020. It is the equivalent of around 41,000 late referrals each month. 

The analysis warns that if the trend continues, up to 498,000 people with symptoms synonymous with cancer will not have had their first specialist appointment by the end of the 2021-2022 period in April.

If the projections come true, it will represent a more than 10-fold rise on the 45,000 a decade ago.   

Placing a GP and a nurse outside A&E to redirect patients could save NHS millions and alleviate pressure on hospitals, study shows 

Placing a GP and a nurse outside A&E to redirect patients could save the NHS millions and alleviate pressure on hospitals, a trial has found.

Since the start of December a group of GPs have been testing a scheme which places two practitioners at the front door of a hospital’s A&E department.

The duo help assess patients when they arrive and then redirect those who do not need urgent care elsewhere.

As many as 75 patients have been redirected in a single day at Northwick Park Hospital in Harrow, North West London, for ailments that could easily be treated by a GP or even a pharmacist.

While some turned up for recurrent problems, such as a bad back, one patient even went to A&E because they had run out of Calpol.

Instead of spending hours in the emergency waiting room, creating a backlog in an already-stretched system, they were given the option of booking a local GP appointment that very same day or the next morning.

Those behind the trial predict the scheme — which has redirected 700 patients in total so far — could save the NHS up to 30 per cent in costs and help ease the current pressure on hospitals caused by Covid.

The pilot, which is in place until the end of March, has been commissioned by local NHS leaders and organised by Northwick Park Hospital and Harrow Health — a not-for-profit organisation run by a group of GPs based in Harrow.

Dr Kanesh Rajani, chairman of Harrow Health and a GP himself, said: ‘People go to A&E because they know it’s there.

‘They know that they can access it easily, and they can be seen by a healthcare professional for the problem, but it may not be the most appropriate place for them.

‘The sorts of things people come in for – whether it be a shoulder problem or muscular injuries they’ve had for days or weeks, or a cough they’ve had for a long time, or vomiting and diarrhoea – they want help and advice but they may not know a pharmacist can help them or their local GP.

‘The doctor and nurse will be able to help them and make an assessment and appropriately signpost the patient to the right care.’ 

Commons researchers also found a record 12,498 people diagnosed with cancer between April and November last year did not get their ‘first definitive treatment’ within 31 days of their diagnosis.

They warned it could mean that, by April 2022, more than 21,000 confirmed cancer patients will have waited  longer than a month in the past year for care. That would be five times more than the number in 2011.

But there are an even larger number of patients not getting their first treatment within 62 days of an urgent GP referral — another crucial NHS cancer target,

Among people diagnosed in the seven months of 2021, 32,647 were not given surgery, chemotherapy or radiotherapy within that timescale. 

Mr Streeting told the Guardian: ‘Cancer care is in crisis. As this new analysis shows, terrifyingly large numbers of people are waiting longer than they should to receive vital cancer care and treatment with the insecurity of not knowing.’

Macmillan Cancer Support said the figures highlighted the ‘huge challenge’ the NHS faces in clearing the cancer backlog and warned of the ‘worry and anxiety’ of people who are directly affected by the delays. 

As well as cancer, the pandemic has seen waiting lists for other illnesses skyrocket, with a record 6million waiting for routine operations.

The Prime Minister had hoped to unveil the multi-billion pound NHS catch-up plan today as he scrambles to get his premiership back on track. 

But the publication of the NHS elective recovery plan has been bumped as ministers failed to sign off the draft document. 

The £12billion a year national insurance hike coming in from April is being allocated to the NHS and social care reforms, with £5.9billion earmarked for investing in elective surgery, diagnostics, and technology over the next three years

The hold-up will fuel anxiety about Mr Johnson’s authority after the Partygate crisis sparked a welter of calls from Tories for him to quit. 

Mr Sunak, seen as a potential successor, last week pointedly disowned a jibe Mr Johnson made at Keir Starmer for failing to prosecute Jimmy Savile.

The PM moved to ‘reset’ his top team over the weekend by bringing in former journalist Guto Harri as his communications director, and making Cabinet minister Steve Barclay his chief of staff.

He is expected to make more appointments in the coming days, as well as carrying out a mini-reshuffle of the government’s much-criticised whipping operation.

Mr Javid insisted the plans would be published ‘shortly’ and claimed he did not recognise reports of a feud with the Treasury, arguing that Omicron had already forced the government to hold off in December.

He told Sky News: ‘We will publish the plan shortly. What I would say about the Treasury is that I couldn’t wish for a better partner when it comes to the challenges I have. I don’t recognise that (the suggestion) at all.

‘Having been chancellor, having a close relationship with the Treasury, having a strong partnership for any department is crucial and right now for health and care I am just really pleased we have got that really good working relationship.’

A Treasury source denied that Mr Sunak had blocked the publication of the plan.

‘We didn’t block, the NHS agreed with us it’s not ready yet,’ the source said.

But Matthew Taylor, chief executive of the NHS Confederation, said: ‘Increasingly getting the sense that Johnson now faces the same (but more intense and short-term) challenges Tony Blair had in his third term, namely that HMT (HM Treasury) is loath to agree to any No 10 plans involving money, as the Chancellor sees these as opportunistic and wasted on a dying administration.’

Mr Taylor worked as head of policy in No 10 under Mr Blair.

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