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More than 380,000 cancer patients have failed to receive timely treatment since 2015, according to Cancer Research UK, which said delays are due to staff shortages and insufficient diagnostic equipment. 

A key NHS target for cancer care is for 85% of people to start treatment for cancer within 62 days of a GP's urgent referral. An analysis by the charity of NHS England's cancer waiting times data found that the number of patients starting treatment in England within 62 days after being urgently referred had not been met since December 2015.

"The 62-day target has been missed for years," Matt Sample, policy manager at Cancer Research UK, told Medscape News UK. "The pandemic played a role in making things worse, but this was already a problem before 2020," he said.

Performance has improved in recent months, with the 62-day backlog having been reduced to pre-pandemic levels for the first time. However, in March this year, more than two out of three (68.7%) patients were still waiting longer than 62 days to begin treatment.

Specialist Staff Shortages

"A growing and ageing population means that more people are being diagnosed with cancer in England than ever before, and our health service has struggled to keep up with rising demand," Sample said. "We are also getting better at treating cancer, but this can mean more complicated treatments for patients sometimes, which can take longer and require more planning before they begin."

A lack of diagnostic equipment, such as CT and MRI scanners, and too few staff, was hampering progress. The Royal College of Radiologists described a "staggering" 30% shortfall in clinical radiologists and a 15% shortfall in clinical oncologists – figures which were projected to get worse in the next few years. 

"This has created a crisis where demand is vastly outstripping capacity," Dr Katharine Halliday, president of the Royal College of Radiologists, told Medscape News UK. "We've reached a point where patients are missing out on potentially life-saving therapies because there are no doctors available to deliver them."

Cancer Care Delays Becoming Routine

In March this year only one of three targets for cancer care was met – the faster diagnosis standard. This target is for 75% of people to be diagnosed, or have cancer ruled out, within 28 days of an urgent referral. In March 2024, this figure was 77.3%.

In addition to the 62-day referral to treatment target of 85% being missed, the 31-day decision to treat target of 96% was also missed, with only 91% of people starting treatment within this period.

Cancer Research UK pointed out that the number of cancer cases were set to rise across the UK, with 2.2 million people expected to be diagnosed with cancer in the next parliamentary term and by 2040, around half a million people being diagnosed with cancer every year. 

In a recent report, the Royal College of Radiologists reported that the target for 94% of cancer patients to receive radiotherapy treatment within 31 days had not been met since July 2021. 

In its latest annual Clinical Oncology Workforce Census 2023, the College found that demand for cancer treatment had surged by 6%-8%. However, patients were delayed from starting radiotherapy in 92% of centres, and from starting systemic anti-cancer therapy in 95%of centres, due to workforce shortages. The College warned that cancer care delays were becoming "routine", with nearly half of cancer centres experiencing weekly delays to treatment. It also found that 85% of cancer centre leaders were worried about workforce shortages impacting patient safety.

"We simply do not have enough doctors to manage the increasing number of patients safely, and this problem will only worsen as demand continues to rise and more doctors leave the NHS," stressed Halliday in a press release.

System Lacks Capacity

Two-thirds (66%) of clinical oncologists who left work in 2023 were under the age of 60, with the average age that consultants left the workforce in 2023 being 54 years – down from 57 in 2022. Over a third (37%) of consultants who left in 2023 were under 45 years of age.

A "ticking timebomb" is putting patients at risk, warned the College, as more doctors were retiring early, and the growing reliance on outsourcing/locums was unsustainable and expensive. 

"There simply isn't the capacity in the system," Professor Karol Sikora, a consultant oncologist, told Medscape News UK. "We are at crisis point in cancer care. You can still get the best care in the world from the NHS but you have to beat the system to get to the front of the queue. Some do, but many don't. That's why our cancer outcome data is now amongst the worst in Europe," he said. 

"All political parties should commit to a long-term, fully funded strategy to back cancer research across the UK and improve and reform cancer services in England, in order to provide our health service with much needed equipment and staff," urged Michelle Mitchell, chief executive of Cancer Research UK, in a press release. "Without this, cancer patients will not receive the level of care that they deserve."

Sikora called for the same determination in improving cancer treatment as was seen with the rollout of the COVID-19 vaccine programme. "That showed the NHS can do it," he said. "Let's do it again and give local clinical managers the power to drive efficiency."