The UK’s leading cancer charities have called on the Government to rethink its decision to scrap a dedicated plan for tackling cancer after new data revealed “the worst year yet” for treatment of the disease.
The heads of Cancer Research UK, Breast Cancer Now, and Macmillan Cancer Support told i that a long-term strategy to combat “disastrous” cancer care in the UK is urgently needed with the total number of people waiting more than a month to start treatment now over three times higher than five years ago.
NHS England cancer waiting times data published on Thursday also reveals delays for cancer treatment were the worst they have been in 14 years. More than 30,000 people newly diagnosed with cancer in England in 2023 waited more than a month to start treatment, the highest figure since current records began in 2009.
The number of people who waited more than two months to start treatment following an urgent GP referral for suspected cancer rose to over 70,000 – a new highest on record.
While there were some improvements last year for the main referral to diagnosis 28-day target, there were still more than 800,000 people who waited more than four weeks to have a cancer diagnosis confirmed or ruled out.
Gemma Peters, Chief Executive at Macmillan Cancer Support, said: “Today’s data confirms the shocking truth that 2023 was the worst year yet for cancer treatment delays. These alarming figures mark a new low and highlight the desperate situation for people living with cancer.”
She added: “Cancer services are under extreme pressure and too many people are facing devastating delays to lifesaving tests and treatment as a result.
“While some challenges impact the whole NHS, such as workforce recruitment and the need to tackle inequalities, there are life-threatening problems in cancer care that require special attention and it’s vital that these issues are prioritised. For this to happen we need to see a long-term cancer strategy that will ensure cancer care is fit for the future, so people can get the timely, quality care they need, when they need it.”
Ministers scrapped a 10-year strategy dedicated to the disease last year and instead merged it into a wider “major conditions strategy” that also covers a range of other major diseases. But the charity bosses said the decision will cost lives.
Breast Cancer Now chief executive Baroness Delyth Morgan said: “Cancer care in England is in a disastrous state. Breast screening uptake remains below target for the fourth consecutive year, lengthy wait times are denying women prompt and potentially life-saving treatment, and right now a vital life-extending drug – trastuzumab deruxtecan – is being kept out of reach of certain women with incurable secondary breast cancer.
“Deeply concerned that the proposed Major Conditions Strategy falls far short of what’s needed to stop the unravelling of cancer diagnosis and treatment in England, we’re calling on the Government to urgently think again and develop an ambitious, dedicated cancer plan that will give us the best chance of tackling the alarming cancer crisis.
“Of course, the success of any cancer plan in truly delivering the best care for everyone affected by cancer depends on necessary funding and a fully staffed workforce. This must become a reality as only then will we guarantee people with breast cancer the best chances of survival, both now and in the future.”
The latest NHS England figures reveal the proportion of patients in England waiting longer than 62 days in December from an urgent suspected cancer referral or consultant upgrade to their first definitive treatment for cancer was 65.9 per cent, up from 65.2 per cent in November. The target is 85 per cent.
Just under three-quarters (74.2 per cent) of patients urgently referred for suspected cancer in December 2023 were diagnosed or had cancer ruled out within 28 days, up from 71.9 per cent the previous month, according to NHS England. The target is 75 per cent. GPs in England made 219,841 urgent cancer referrals in December, down from 269,631 in November but up year-on-year from 213,636 in December 2022.
The NHS Constitution pledges that patients should wait less than six weeks for a diagnostic test but the target is regularly missed. Around 416,900 patients were waiting six weeks or more from referral for one of the 15 key diagnostic tests at the end of December 2023, latest NHS England figures published on Thursday show. This was 26.8 per cent of the total number of patients waiting at the end of the month.
Jules Fielder, 39, from East Sussex, is living with stage four lung cancer, which has spread to her spine and pelvis. As her cancer is incurable, she relies on her treatment and scans being on time to keep her and her family informed about her prognosis.
She said: “The NHS is in crisis and for patients like me it is heartbreaking. In the past year I have had scans cancelled, had treatment appointments cancelled, had to chase for my own scan results, been booked for the wrong blood test and had prescriptions forgotten about. All because staff are under too much pressure and trying so hard to cater for everyone.
“All of this comes on top of my stage four cancer diagnosis which has turned my life upside down. It scares me how much I have to advocate for my care. I feel like I have to fight for myself. If I didn’t, I’d get left behind. I am constantly fighting to live. It is time for change. The UK Government needs to listen now and understand the devastating impact delays are having on people living with cancer who feel helpless. Lives could be saved.”
Cancer Research UK’s chief executive Michelle Mitchell said: “Cancer survival in the UK is at the highest point it’s ever been. But in recent years this hard-won progress has slowed considerably, and many cancer patients today face anxious, long waits for tests and treatments.
“With a general election on the horizon, there’s a real opportunity to accelerate progress on cancer survival. Cancer Research UK’s manifesto, ‘Longer, better lives’, sets out actions that could help to prevent 20,000 cancer deaths every year by 2040. The time to act is now – with political will and leadership, underpinned by a long-term, ambitious strategy on cancer from the UK Government, we can all have more moments with the people we love.”
A Department of Health and Social Care spokesperson said: “One in four people now live with at least two health conditions, and that proportion is expected to rise over time. We know we must adapt our model of care to rise to this challenge.
“That’s why we have taken the decision to develop a major conditions strategy – a blueprint for improving outcomes over the next 5 years that not only covers cancer but heart disease, musculoskeletal disorders, mental ill-health, dementia and respiratory diseases.
“The NHS has seen and treated record numbers of cancer patients over the past two years, with survival rates improving across almost all types of cancer. We will shortly legislate to create the first smoke-free generation – the biggest single public health intervention in decades”.
The spokesperson said the latest NHS England figures also show a record number of urgent cancer referrals were made last year, and record numbers of patients received a cancer diagnosis or all-clear within four weeks.
“We have invested £2.3bn speeding up diagnosis and launched 153 Community Diagnostic Centres across England, which will help us achieve our aim of catching 75 per cent of all cancers at stage 1 or 2 by 2028,” they said.
The charities’ call comes as hundreds of thousands of NHS patients turn to private care due to growing waiting lists. Last year around 70,000 patients had chemotherapy in the private sector, according to the Independent Healthcare Providers Network (IHPN), making it one of the most common procedures that patients receive inpatient treatment for in the private sector.
Separate figures from the Private Healthcare Information Network, an independent, government-backed information service about private consultants and hospitals, reveal that almost 300,000 people funded chemotherapy treatments through insurance between 2018 and 2023. A further 13,900 paid for their own chemotherapy, the data shows.
The spotlight fell on the disease again this week when Buckingham Palace announced that King Charles has been diagnosed with a form of cancer. The type of cancer has not been revealed – it is not prostate cancer but was discovered during his recent treatment for an enlarged prostate The King began “regular treatments” on Monday and will postpone public duties during it, the Palace said.
A spokesman said Charles, 75, “remains wholly positive about his treatment and looks forward to returning to full public duty as soon as possible”. No further details are being shared on the stage of cancer or a prognosis.
Around one in three diagnostic scans reveals an unexpected health problem, an expert said following the announcement. Dr Tom Roques, vice president and specialist in clinical oncology at the Royal College of Radiologists, said discovering separate health issues during treatment was not uncommon.
An NHS spokesperson said: “The NHS is now treating more than double the number of people for cancer than in 2010, and, in the last year alone, almost 3 million people received potentially lifesaving cancer checks and over 336,000 people started treatment – with over 90 per cent of these patients starting treatment within a month.
“Amid record pressures and the impact of a year of industrial action, NHS staff continue to work hard to prioritise the longest waiters and most urgent cases – and their efforts are helping ensure that more people are being diagnosed at an early stage than ever before and survival rates are higher than ever.”
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