Getting cancer care back on track could take a year longer than previously thought after a huge spike in the number of people coming forward for care, NHS England officials have said.
It was hoped that the backlog of patients waiting longer than 62 days from an urgent GP referral for suspected cancer would be returned to pre-pandemic levels by March 2023.
But NHS officials told MPs that a new target of March 2024 is being discussed with ministers.
And they raised concerns that planned strikes by junior doctors could have a “further impact” on cancer patients.
The health service has seen a record number of referrals for cancer since March 2021.
The reason that we're at '23 and not exactly at pre- pandemic levels is that we've seen record levels of urgent cancer referrals since March '21— Dame Cally Palmer
The increase has been linked to a number of factors including the number of people who put off seeking care during the pandemic now coming forward, growth in cancer rates and more people coming forward as a result of public awareness campaigns or high profile cancer deaths.
Indeed, MPs were told there was a “big surge” in suspected bowel cancer cases after the death of Dame Deborah James.
Between 200,000 and 250,000 people are referred for suspected cancer every month, but only around 6% of these will have suspected cancer, MPs were told.
Dame Cally Palmer, national cancer director for NHS England, said that the weekly count of the backlog of patients waiting longer than 62 days from an urgent GP referral for suspected cancer stood at 23,500 – down from almost 34,000 last summer.
“The big focus has been on recovering that backlog beyond 62 days by March 23 to pre-pandemic levels,” Dame Cally told MPs on the House of Commons’ Health and Social Care Committee.
“We’ve made very significant progress – so the backlog was at an all time high of around 34,000 last summer and last week it was 23,500, so we’ve dropped by around 10,000, but there’s still further to go.
“The reason that we’re at ’23 and not exactly at pre-pandemic levels is that we’ve seen record levels of urgent cancer referrals since March ’21.
“The majority of those people waiting on that 62-day pathway do not have cancer, but they’re waiting for a decision… and that creates a lot of anxiety for people.
“So we’re really focusing very much on the diagnostic part of that pathway so we can get through that as quickly as possible.
“As Amanda (Pritchard, chief executive of NHS England) told the Public Accounts Committee in November, we’re not going to meet the pre-pandemic target by the end of March, simply because there’s record levels of demand.”
Asked when the target will be met, she said: “We’re discussing currently with the Secretary of State the target for March ’24.”
Dame Cally told MPs that she hoped that another recovery target – that 75% of patients who have been urgently referred by their GP for suspected cancer receive a diagnosis or have cancer ruled out within 28 days – will be met by March 2024, or sooner.
Currently around 71% receive this level of care, she added.
I don’t think anybody is comfortable with the fact that we have a large number of people who are waiting too long to get their diagnosis and start their treatment— Professor Peter Johnson, NHS England
Meanwhile Professor Peter Johnson, national clinical director for cancer at NHS England told MPs: “I don’t think anybody is comfortable with the fact that we have a large number of people who are waiting too long to get their diagnosis and start their treatment.
“What we need to do is contend with a very large number of referrals – between 200,000 to 260,000 people every month are referred for investigation of possible cancer, whom only about 6% will have cancer.
“About a quarter of all GP referrals into secondary care are for suspected cancer.
“We have driven down the numbers waiting longer, and the numbers are falling really quite rapidly at the moment as a result of all the work that’s gone in.
“Of course, if you prioritise the people who’ve been waiting longest, that doesn’t actually help the number going past 62 days because if they’ve been waiting 68 days and you remove them from the waiting list that doesn’t improve things, and we felt it was critical that we were looking at the people who’ve been waiting longest and prioritising people’s investigational treatments on the basis of their clinical need, rather than hitting a specific target.
“But clearly if we get things right our ability to hit those targets will continue to improve.”
Asked about the impact the forthcoming junior doctors’ strike will have on cancer care, Dame Cally said: “I think in the initial industrial action, people worked incredibly hard in the NHS to reschedule patients quickly, and we had a national derogation for chemotherapy and the most urgent cancer surgery.
“I think I’m concerned about the junior doctors industrial action, and think that will create even further impact for patients.
“Sometimes it’s quite hard to reschedule cancer care because it’s multiple teams.
“I hugely value the work that NHS staff do to deliver the very best for patients, so I hope it’s resolved as quickly as possible.
“In the meantime, what we do know is people are working incredibly hard to reschedule as fast as they can.”
