Suspected Cancer Waiting List Won't Drop For At Least 2 Years in England

Around six million people in England are on the NHS waiting list for treatment, including hip and knee replacements, cataract surgery, and tests. According to the plan, if all 10 million people estimated to have stayed away during the pandemic came forward for treatment, and activity was not increased above pre-pandemic levels, the waiting list could hit 14 million.

Health Secretary Sajid Javid said: "Assuming half of the missing demand from the pandemic returns over the next 3 years, the NHS expects waiting lists to be reduced by March 2024. Addressing long waits is critical to the recovery of elective care and we will be actively offering longer waiting patients greater choice about their care to help bring these numbers down."

Four Areas of Delivery

The plan will focus on "four areas of delivery", including increasing health service capacity together with the independent sector; prioritizing diagnosis and treatment; reforming care such as making outpatient appointments more focused on "clinical risk and need", and increasing activity through dedicated and protected surgical hubs. The plan also sets out how patients will be helped to make use of the NHS App to better manage appointments, bookings, and the sharing of information.

As previously announced, some 9 million additional treatments and diagnostic procedures will be brought in by 2025, while the admin burden on staff will be cut. NHS England said this will mean that over a 3-year period, patients will be offered around 17 million more diagnostic tests – an increase in capacity of a quarter compared with the 3 years prior to the pandemic.

The plan further promises to create dozens more community and NHS-based sites for surgical procedures and "convenient, quick diagnostic checks, towards our ambition of a network of surgical hubs and diagnostic centers covering the entire country".

This is in addition to the network of 122 surgical hubs already operating.

Teams of specialists will be deployed to help patients prepare for their operations, and groups of clinicians and teams will be able to get instant access to test results, offering patients faster clinical advice.

Cancer Treatment

For cancers, waiting time targets have been progressively rolled out since the mid-2000s, designed to speed up the process of diagnosing (or ruling out) cancer after a GP referral and beginning treatment.

The chart below shows that the principal target that at least 85% of people should begin treatment within 62 days of being referred with suspected cancer has not been met since 2013/14. In 2018/19, the performance hit a record low with only 79.1% seen within the target time. This is on course to fall even further in 2019/20. The number of people being treated within target times has increased since 2010/11, but so has the number waiting longer. This rate seems to have gotten much worse after the pandemic. The proportion of cancer patients starting treatment within 62 days would return to its pre-pandemic level by March 2023, Mr. Javid said, although this would still leave it some way short of the 85% target.

Reaction to the Plan

Richard Murray, chief executive of The King’s Fund, said: "This is a welcome plan, but the NHS will need more staff to make it a reality."

Matthew Taylor, chief executive of the NHS Confederation, welcomed the plan and added: "The NHS is working hard to prioritize patients with the greatest clinical need, including by carrying out 1.3m consultant-led treatments in a single month and we have seen some brilliant examples of innovation where data and technology have been used to both support patients and ramp up activity."

Speaking in the Commons, Mr. Javid said that despite the NHS’s "exceptional efforts", there "is now a considerable COVID backlog of elective care".

He said 1600 people were waiting longer than a year for care before the pandemic but that figure is now over 300,000.