Nearly 10,000 more cancer patients in England will not be treated on time because the government will fail to meet its targets, amid a failure of leadership, focus and resource, experts have warned.
The NHS set an interim target to treat 80% of cancer patients within 62 days of urgent referral or consultant upgrade by March 2027. But with little more than 100 days to go, the proportion of patients starting treatment on time in September was 70.7%, down from 71.9% in August, NHS figures show.
Exclusive analysis of official figures for the Guardian reveals the NHS would have to treat 2,850 additional patients on time each month to get back on track, assuming patient volumes remain consistent.
According to calculations by Radiotherapy UK, 24,400 cancer patients a month would need to start treatment on time to hit the 80% target in March. But the NHS is only treating about 21,500 cancer patients a month within the 62-day target, leaving a monthly shortfall of 2,850 and a cumulative shortfall of 9,490 patients, the charity found.
Prof Pat Price, the chair of Radiotherapy UK and a leading oncologist, said: “The government is going to miss its cancer treatment target because the NHS does not have enough staff or equipment to treat the number of patients coming through its doors. This lack of leadership means thousands more people could die because they don’t get their treatment on time.”
The analysis also found significant disparities between treatment of common cancer types. While more than two-thirds of patients with prostate and breast cancers were treated within two months ((70.1% and 68.8% respectively), only 60.9% of those with lung cancer and 60% of those with gynaecological cancers were treated on time. For head and neck cancers, barely half (56.5%) were. Regional inequalities were also stark, the research found. The Midlands had the lowest proportion treated on time, at 66.6%, compared with 77.3% in London.
Mark Lawler, a professor of digital health and chair in translational cancer genomics at Queen's University Belfast, believes failures of accountability and focus are to blame. He said: “The whole system is being held together by goodwill glue alone. Lack of leadership is derailing efforts to improve cancer survival. Unless there is accountability for these failures by the NHS, a radical change in mindset and a focus on the basics, we will miss hitting treatment targets for another decade.”
The figures come as analysis of latest cancer diagnosis targets by Cancer Research UK shows that, over the last year, barely half (55.4%) of patients with cancer were diagnosed within 28 days of an urgent referral, against the faster diagnostic standard target of 80%, compared with 79.1% of patients who received the all-clear on time.
Naser Turabi, Cancer Research UK's director of health policy and evidence, said hospital capacity was not able to keep pace with surging demand for cancer diagnosis – with urgent referrals in England up about 20% over the past four years alone. “While recent investment in diagnostic equipment is welcome, we're not seeing enough progress to cut waiting times for the 6% of people who go on to receive a cancer diagnosis,” he said.
Dr Hilary Williams, the Royal College of Physicians clinical vice-president and a consultant in medical oncology, said crucial earlier diagnosis was only beneficial if patients could then be treated quickly.
“To close the gap, the NHS needs sufficient capacity across the whole cancer pathway,” Williams said. “That means more diagnostic capacity, including imaging, endoscopy and pathology, alongside the specialist workforce needed to deliver and interpret those tests. It also means enough treatment capacity in surgery, radiotherapy and systemic treatments so that diagnosing people more quickly doesn’t simply move the bottleneck further down the pathway.”
Dr Stephen Harden, the president of the Royal College of Radiologists, said “chronic shortages” of clinical radiologists and clinical oncologists, who diagnose, monitor and treat cancer, were “driving dangerous delays” in diagnosing and treating the disease.
“Perversely, NHS hiring freezes for these doctors have doubled in the last year, making it even harder to keep patients safe,” Harden said. “Technology and new ways of working can relieve pressure to an extent, but fundamentally, rising demand for cancer care has outpaced workforce capacity. The government must now step in to end recruitment freezes and ensure services have the doctors they need to diagnose and treat patients on time.”
A Department of Health and Social Care spokesperson said: “Cancer waiting times are moving in the right direction, with all three cancer standards better than a year ago, and around 290,000 more people over the last year getting diagnosed on time or having cancer ruled out, compared to the year before the election.
“But we know there is much more to do. Our national cancer plan will help more people to get diagnosed earlier and begin treatment sooner, giving them the best possible chances of recovery and survival.”
