On 1st October 2023, revised cancer waiting time targets in England will come into effect, reducing nine ‘outdated’ standards down to three.
These major changes come after most cancer targets have been routinely missed in recent years, with current figures amongst the worst on record. Medics have called for change after the previous set of standards had become what they deemed unwieldy to manage and confusing for patients.
This is the first time in ten years that cancer waiting time standards have been reviewed. Consultation began in 2022 and the Department of Health has approved the new Faster Diagnosis Standard which aims to catch and treat cancers early.
What cancer targets are being dropped?
There are six cancer waiting time targets that are being streamlined into two new categories. NHS England are combining three of the 62-day treatment targets to make more patients eligible, as well as another three 31-day decision to treat targets.
The main one being removed is the one that patients will be most aware of: the two-week wait (2WW) for a first consultation appointment.
This has not changed in 20 years, but health professionals say it has become at odds with what’s best for patients. Instead, patients who present at their GP with concerns or ‘red flag’ symptoms of cancer will be sent for diagnostic tests.
In essence, it cuts out the middleman and speeds up the process to give patients the answer sooner. The two-week pathway doesn’t take into account how long someone will then have wait for any tests they need, for the test results to come back, and for them to be told whether or not they have cancer.
But charities like The Eve Appeal, which focuses on gynaecological cancers, have said they are disappointed to see this two-week referral target being scrapped as it has previously acted as a ‘clear message of urgency for GPs to refer to a specialist.’
What are the new cancer targets?
Under the Faster Diagnosis Standard, the three cancer targets will now be:
- Diagnosis within 28 days of referral (75% target)
- Start treatment within two months (62 days) of urgent referral (85% target)
- Start treatment one month (31 days) after decision to treat (96% target)
The 28-day diagnosis target will be reviewed again in 2025/26 and increased to 80%. However, only 60% of patients are currently diagnosed with cancer within 28 days. But the government believes that, by bringing in these changes, this figure will increase to 70% by March 2024.
These new targets will apply to people who have been urgently referred by their GP, have had an abnormal screening result, or where non-cancer investigations by a consultant have flagged up suspected cancer.
These come into effect from 1st October 2023.
Will these changes improve patient outcomes?
It’s easy to forget that there are real people behind these statistics. There are currently 21,000 patients waiting more than two months for a diagnosis or to begin treatment for cancer. That’s 21,000 people who are missing out on life-saving services, facing an anxious wait for answers, or cannot plan for the future.
Delays to cancer diagnosis or treatment have a huge impact on families. Patients need clearer expectations for when they should receive a diagnosis or have cancer ruled out.
More people than ever are coming forward to get checked for cancer, which shows that awareness campaigns are working. But it also means that additional pressures are put on cancer services. Between 200,000 and 260,000 people are referred for cancer investigations each month, but only 6% of those will have cancer.
While new diagnostic techniques and technology, such as mobile scanners deployed into the community, are great in theory, they are only as good as the ability to meet them. Staffing levels remain a major issue in the NHS. There is currently a 24% shortfall in specialist cancer doctors in England, and a further 41% shortfall in radiologists. This means that it’s taking longer to put new processes into practice.
Even after a person is diagnosed with cancer, the worry doesn’t end there. The target for treatment to begin within two months of diagnosis is 85% but June’s figure was well below this, at 59.2%. The last time the 85% target was met was in 2015. The NHS is seeing frequent delays for things like radiotherapy and chemotherapy.
Waiting times are likely to vary with the type of cancer a person is diagnosed with. Lung cancer, for example, often requires more involved investigations with imaging, pathology samples and biopsies that take longer to be reported.
For each month that a patient waits for cancer treatment, the risk of death increases by 10%. It is unescapably stressful to be told your cancer cannot be treated any quicker.
As specialist clinical negligence solicitors, we see first-hand the human impact that delays to cancer diagnosis and treatment have. People are being forced to resort to private healthcare to get answers far faster than through the NHS so they don’t have to feel like they’re helplessly living in limbo with a ticking time bomb they cannot do anything about
Current performance across cancer services is abysmal, but it is also fixable. However, targets on their own are not the answer. Targets are just that, something that others would like to achieve.