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the Reframe teamJan 13, 2023 5:17:03 PM6 min read

Cancer Backlog

In recent news, there has been an increasing number of cancer stories making headlines. The NHS backlog for healthcare waiting times has reached an all-time high and cancer treatment delays could cause a cancer emergency in the UK.

The cancer backlog

The Covid-19 pandemic put immense pressure on both NHS and private healthcare, which saw a sharp reduction in the number of people receiving elective and cancer care. This has contributed to the increased cancer backlog with patients at every point on the cancer pathway, struggling with long wait times - from pre-diagnosis all the way through to post-treatment.

The latest figures (Sept 2022) show that only 60.49% of people are meeting the NHS target to receive their first cancer treatment within two months of an urgent GP referral. The operational standard of 85% has not been met since August 2019; the percentage has continued to fluctuate and drastically fallen since the beginning of the pandemic. Delays in receiving treatment could result in an increase in cancer emergencies, more treatment required for patients and sadly, an increase in mortality rates.

Plans for recovery

In February 2022, the 3-year delivery plan to tackle the backlog (for elective and cancer care) was published by NHS England. This publication states that there has been continued prioritisation for cancer treatment throughout the COVID-19 pandemic and has consistently seen record levels of urgent suspected cancer referrals, since March 2021. The executive summary is outlined as follows (in relation to cancer):

  • To maintain the focus of prioritising cancer care, the ambition is that, by March 2024, 75% of patients who have been urgently referred by their GP for suspected cancer are diagnosed or have cancer ruled out within 28 days. This will help contribute to the existing NHS Long Term Plan ambitions on early diagnosis.
  • Local systems have also been asked to return the number of people waiting more than 62 days from an urgent referral back to pre-pandemic levels by March 2023.

The NHS are under a lot of pressure to deliver this 3-year plan; however, there is reassurance that the backlog will be a focus as £14 billion of capital and resource funding has been allocated to support this recovery – between 2022-23 and 2024-25.

NHS plans for recover


Reports on the current backlog

Reports are showing the number of patients waiting longer than 62 days, from an urgent GP referral for suspected cancer (with and without a decision to treat) every week since w/e 2nd February 2020 until w/e 20th October 2022. This report shows that the backlog has reached an all-time high and figures have more than doubled from February 2020 to October 2022.

Current progress

On 16th November 2022, NHS England announced that the NHS is now giving GP teams access to tests and scans to help speed up cancer diagnosis. This is one of the major positive changes that have recently been announced to help with the backlog recovery. Direct access for GP practices can help reduce the long waiting times “to as little as four weeks”, which is positive news for those awaiting a diagnosis.

Speeding up the confirmation of a cancer diagnosis allows patients to receive treatment for their cancer quicker and receiving this at an earlier stage, can essentially help with more successful outcomes.

The role of the private sector has also recently been announced as one of the measures the government has taken to ease the pressure on NHS hospitals and help clear the record waiting times.

Private capacity is purchased as a plan to maximise the use of all available hospital capacity and although this is not specific for cancer, NHS patients may find themselves being offered surgery at private hospitals. It is however, still unclear how much the NHS will lean on the private sector.


Pending recommendations and reports

The National Audit Office (NAO) released a 63-page report titled ‘Managing NHS backlogs and waiting times in England’ in November 2022 which covers the cancer backlog. Within this report, there are the following recommendations specific to cancer:

  • In Quarter 1 of 2023-24 NHSE should review the elective and cancer recovery actions it took in 2022-23, to assess progress and any unintended effects. At the same time, DHSC and NHSE should determine whether elective recovery targets and trajectories need to be adjusted, and how to allocate recovery funding, for future years based on actual performance in 2022-23.
  • During 2023-24, NHSE should publish a report to improve transparency on the progress it is making with the recovery of elective and cancer care. This should include an assessment of the results of its major recovery initiatives, including its approaches to reducing cohorts of long-waiters, CDCs (Community Diagnostic Centres), surgical hubs, outpatient transformation, and increasing specialist advice and guidance. NHSE should then consider whether the report should become annual for the duration of the recovery.
  • In 2024-25, with the benefit of two years of managing elective recovery, DHSC and NHSE should develop a long-term plan for returning elective and cancer services to a state in which legal and operational waiting time standards are met. DHSC should publish the plan so the public can understand at a high level how the recovery will continue after March 2025.

We are currently awaiting further official reports, which are expected to be released in the first quarter of the new year. NHS England intend that, by March 2023, the number of patients waiting more than 62 days from an urgent referral for cancer care should return to pre-pandemic levels. It is important to note that the objectives of the recovery plan are still below the operational standard.

Reframe are here to complement the healthcare system (NHS or private), giving support to employers, employees and their loved ones, along a cancer journey. Our support is led by Cancer Nurse Specialists, who can guide individuals through what to expect, discuss clinical concerns and provide advice on easing side effects. Our team can also help with the practicalities, including chasing referrals and results, returning to work, as well as sourcing additional support services such as counselling. We help employers understand the best ways that they can support when there is a cancer diagnosis in the workplace too.

Get in touch now to find out more about how we can support your organisation.


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Reports on NHS backlog: