Cancer waiting time targets could be scrapped under NHS proposals


Proposals to scrap a target for patients to see a specialist within two weeks if they are suspected of having cancer are being considered by NHS England.

Instead, there has been a consultation on the new “faster diagnosis standard” which proposes that patients who have been urgently referred should have cancer ruled out or receive a diagnosis within 28 days.

An NHS England spokesperson today confirmed the proposals were being looked at.

“These proposals were put forward by leading cancer experts and have the support of cancer charities and clinicians,” they said.

“By making sure more patients are diagnosed and treated as early as possible following a referral and replacing the outdated two-week wait target with the faster diagnosis standard already being used across the country, hundreds of patients waiting to have cancer ruled out or diagnosed could receive this news faster.

“The changes will also remove the need for unnecessary outpatient appointments in order to comply with waiting times rules, allowing more patients to be referred ‘straight to test’ and the wider deployment of diagnostic technologies including artificial intelligence.”

Health Secretary Steve Barclay told Sky News this morning that no changes would be made to cancer targets unless they had been recommended by cancer clinical experts and that everything would be done in consultation with leading charities.

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He confirmed the government had held a consultation and “we’ll have something to say in the coming days”.

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Cancer patients face worsening delays

He said what mattered about cancer targets was “survivability” and that those rates had been improving.

“There’s a 9% increase in the one-year all cancer survival rate over the last 15 years. There’s an improvement in the five-year survival rate.

“So what is it that makes the most difference in terms of people’s survival? And what is it that the leading clinical figures want us to do? And then how are we consulting with the leading cancer charities about any changes? That’s the work we’ve been doing.”

Asked whether he would be prepared to sign off a potential reduction in the target, the health secretary said: “As I say, we’ll have an announcement in the coming days. That’s not something being announced today, but we’re in discussion.”

In the consultation on proposals that began last year, the NHS said that the current two-week wait target did not set an expectation of when patients should receive test results or have a confirmed diagnosis.

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NHS treatment list at record high

Cancer Research UK has also said the proposed new targets should lead to improvements in diagnosis.

But oncologist Pat Price, the head of the Radiotherapy UK charity, said the potential new targets were “ominous and deeply worrying”.

“The performance against the current targets is shockingly bad and has been for many, many months now, deteriorating over years,” she said.

“While we agree chasing too many targets can be disruptive and divert resources away from the main patient 62-day treatment target, poor performance is not as a result of how we are measuring it.

“The clear and simple truth is that we are not investing enough in cancer treatment capacity and getting the whole cancer pathway working.”

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‘Mentally it kills you’

Under the faster diagnosis standard, patients who have been urgently referred, have symptoms of breast cancer, or have been picked up through screening, should have cancer ruled out or receive a diagnosis within 28 days.

Those with cancer should then receive their first treatment within a month of the decision to treat after the diagnosis, which is known as the 31-day decision to treatment standard.

Patients who receive a cancer diagnosis will start treatment within nine weeks from the date of referral, known as the 62-day referral to treatment standard.

There are currently nine cancer performance targets which span three areas, including the two-week wait between a GP referral and first consultant appointment; a one-month wait for care once a decision has been made to offer treatment for cancer and a two-month wait from the urgent GP referral to a first treatment of cancer.

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The faster diagnosis standard will have an initial performance threshold of 75% – meaning three quarters of patients should have a diagnosis within a month.

The proposals come as NHS England figures published on Thursday showed cancer wait times remain below targets set by the government and the health service.

In June, 261,006 urgent cancer referrals were made by GPs in England, up 6% on 245,595 in May and 13% year-on-year from 231,868 in June last year.

Some 80.5% of patients saw a specialist within two weeks – down from 80.8% in May but still significantly below the target of 93%, which was last met in May 2020.

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