Cancer waiting times: ‘target met’?

This piece first appeared on Macmillan Cancer Support’s ‘Evidence and Influence’ blog in March 2015

Cancer waiting times featured once again in last week’s Prime Minister’s Questions. The discussion focused on performance in one local area — but how does this relate to the national picture?

‘Target met’

Ed Miliband used all of his questions in last week’s PMQs to focus on the NHS, including one on the NHS missing the 62-day cancer waiting times target. David Cameron responded:

Let me bring the right hon. Gentleman closer to home — genuinely, to his home in Doncaster. This is the answer. Here are the cancer waiting times for his constituents: 95.2% of patients with suspected cancer were seen by a specialist within two weeks, and the target is 93% — target met; 97.9% of patients diagnosed with cancer began treatment within 30 days, and the target is 96% — target met; and 87% of patients began cancer treatment within 62 days of an urgent GP referral, and the target is 85% — target met.

It’s important here to look in detail at the most recent figures: while 87.5% of people living in Doncaster Clinical Commissioning Group who were given an urgent GP referral for cancer treatment in the second quarter of 2014/15 began treatment within 62 days, above the 85% target, in the third quarter Doncaster has begun to dip below the target:

The story of missed cancer waiting times is also bigger than Doncaster alone, and while the overall trend is the same — a downward one — much of the rest of the country has fared worse.

Looking at the figures by Clinical Commissioning Group (CCG), more than half missed the target in the most recent quarter. England is now a patchwork of missed cancer targets (click below to view our interactive map):

And at a national level, England as a whole has missed the 62-day target for every quarter so far in 2014/15, and four quarters in a row. In the most recent quarter 68 trusts1in England failed to meet the target, leaving more than 5,000 people waiting more than 62 days to start urgent treatment. That’s thousands of worried patients; thousands of families in unnecessary distress; and thousands of people potentially being treated too late to experience the best possible outcomes.

What explains missed cancer targets?

NHS England has previously said the failure to meet this target is in part explained by an increase in the number of patients beginning treatment for cancer following urgent GP referrals.

While referrals have continued to increase, the NHS maintained performance against the 62-day target for nearly five years despite rising referrals, and there is nothing about the past year of referral trends that is especially unusual. The number of urgent GP referrals has risen quite predictably by between 10–12% a year for the past four years, and 2014/15 has followed a fairly similar trend; annual growth is predicted to be around 14%.2A more in-depth look will be needed to determine exactly where the bottleneck lies.

Cancer isn’t fixed

Whatever the cause, the government must take serious steps to improve performance against cancer waiting time targets. We know that being diagnosed early is essential if patients are to experience the best possible outcomes, and the UK currently lags behind much of the rest of Europe’s cancer survival rates. Put simply, cancer isn’t fixed. That’s why Macmillan is calling on the next government to commit to delivering cancer outcomes that match the best in Europe by the end of the next parliament.