NHS Delays: Cancer Targets Missed

According to a Daily Telegraph report, researchers investigating 135,000 NHS patients’ cancer cases in England discovered that before initial diagnosis, some two-thirds had escaped GPs’ notice. Less than a third (32 per cent) of bowel cases and less than three in ten lung tumour diagnoses (28 per cent), the two most common types of cancer, had received hospital referrals from GPs.

Lack of Curiosity

In turn, long hospital and specialist waiting lists were exacerbating the negative effects on patient health. Worryingly, two in three health service trusts were not achieving NHS targets for cancer detection and timely treatment.

As a result, patients found themselves at increased and potentially unnecessary risk. MPs described the extended waits as agonising and unacceptable. Notably, scrutiny by the Public Accounts Committee (PAC) had prompted accusations that health authorities lacked adequate curiosity regarding the patient harm caused by delays in starting treatment.

Patient Compensation Payments Double

In the fiscal year 2017-18, NHS compensation payments for delays and misdiagnosis totalled £655 million, double the £327 million paid four years previously in 2013-14. Furthermore, in November 2018, less than four in ten (38 per cent) of health trusts achieved the widely reported NHS target for cancer treatment to begin within two months.

Patients reported suffering extra anxiety, inconvenience and pain. Apart from the harm that results from the deterioration of patients’ underlying medical conditions due to long waiting periods, MPs expressed concern about the discontinuation of sanctions and penalties for missed hospital targets.

As if to highlight the calamity, the chairperson of the PAC, Meg Hillier, spoke of an unacceptable downward spiral and the need to regain control. She mentioned the concern felt by MPs at the seeming lack of understanding of how the current situation was adversely affecting patients who experienced long waits for treatment.

Performance Measurement Fears

In a move which some could perceive inflammatory, NHS bosses are currently reviewing the statistical methods used to measure waiting lists (July 2019). Speculation exists whether officials might discontinue the 18-week waiting list target, as well as the much-reported four-hour yardstick for patient treatment in accident and emergency departments. The review of waiting times was as crucial as ever, Ms Hillier said, but it could not be an excuse for lower standards. Any changes had to protect and improve outcomes for patients, she insisted.

Similarly, a leading health charity called for prompter treatment to ensure that patients could have some peace of mind.

In March 2019, the National Audit Office (NAO) found that NHS staff shortages, insufficient available beds and emergency care pressures resulted in delays to elective and cancer surgery appointments. Seemingly, the inability of the NHS to keep pace with the growing number of referrals was due only in part to demographic trends. Instead, capacity issues resulted mainly from a lack of finance.

Optimistic Note?

On the positive side, 44 per cent of trusts carried out planned cancer operations within the 18-week target. However, in June 2019, more than 4.2 million patients were awaiting operations to treat the disease.

Encouragingly, the proportion of cancer patients diagnosed through urgent referrals increased to 38 per cent in 2016, in comparison with only 31 per cent in 2010. Thankfully, an increase in the number of urgent referrals has helped to improve early diagnosis rates.

Help at Hand

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