Macmillan responds to December 2021 Cancer Waiting Times data for England

Responding to December 2021’s Cancer Waiting Times data for England, Minesh Patel, Head of Policy at Macmillan Cancer Support, said:

“Today’s data confirms the huge challenge still facing the NHS, with performance against cancer waiting times going from bad to worse over the last year. We know this will be having a devastating impact on many people with cancer who are experiencing agonising delays and risk a worse prognosis.

“The Government’s Elective Recovery Plan failed to address the desperate need to enhance the cancer workforce, and it’s now vital that the upcoming 10-year Cancer Plan sets out an approach to urgently support the NHS, so it has the staff and resources needed to tackle the cancer care backlog and ensure everybody gets the care they need now and in the future.”

Key facts

• The number of people in England who saw a specialist for suspected cancer in December 2021 following an urgent GP referral was again higher than the pre-pandemic average — however, it was lower than in the previous month, even after taking working days into account, at a time when there is a desperate need to clear the backlog in ‘missing’ cancer diagnoses[i]
• In addition, the number of people who waited more than two weeks to see a specialist was the second-highest on record, at more than 46,000 in December, and performance against this target was also the second worst on record[ii]
• The number of people who waited more than a month to start treatment after a decision to treat was the third highest on record in December[iii]. The total number of people who have started cancer treatment in England since the start of the pandemic is still more than 31,000 lower than expected[iv] — a figure basically unchanged from the previous month, raising concerns that progress against clearing the treatment backlog may have stalled again in December
• Today’s data also shows that during 2021 overall, more than 400,000 people waited more than two weeks to see a specialist with suspected cancer following an urgent GP referral, and close to 20,000 of those diagnosed with cancer waited more than a month to start treatment[v]. In the second half of 2021, the number who waited more than two weeks to see a specialist following an urgent GP referral was more than double in the same period in 2019, and the number who waited more than a month to start treatment was 66% higher[vi]
• The latest Macmillan analysis estimates the NHS in England would still need to work at 110% capacity for further 16 months to catch up on missing cancer diagnoses[vii] and for 12 months to clear the cancer treatment backlog[viii]
• New figures from Macmillan show that, in November, more than one in three (35%) of those receiving cancer treatment in the UK were worried that delays to their treatment as a result of Covid-19 could impact on their chances of survival[ix]

Wider fact box:

• The 62-day target was breached again in December 2021 — only 67% of patients in England started treatment within two months of being urgently referred by their GP with suspected cancer, against the target of 85%[xiii]. This represents yet another new lowest performance on record (previously 67.5% in November 2021).
• The 62-day target first started to be frequently breached almost eight years ago and it has now been missed continuously for six years (72 months in a row), since January 2016[xiv]
• Since the target first started to be frequently breached in January 2014, more than a quarter of a million people with cancer (250,167) people have waited more than two months for treatment to start[xv]
• More than four in five NHS hospital trusts in England (89%) missed the 62-day target in December 2021. A total of 85 trusts — more than three in five — missed it by ten percentage points or more, and 48 trusts — over one in three — missed it by twenty percentage points or more[xvi]
• The 31-day wait target for subsequent cancer treatment through surgery has been missed every single month since August 2018[xvii]

-ENDS-

References

[i] NHS England. Cancer waiting times. Cancer Waiting Times — National Time Series Oct 2009 — December 2021 with Revisions.

[ii] As per ref i. In December 2021, just 78.6% of people saw a specialist within two weeks of an urgent referral from their GP for suspected cancer, the second-lowest figure on record, and over 46,000 people waited for more than two weeks to see a specialist for suspected cancer following an urgent referral from their GP, the second-highest number on record

[iii] As per ref i. In December 2021, 1,719 people waited for more than a month to start treatment following a decision to treat, the third highest number on record

[iv] As per ref i. The total figure for March 2020 to December 2021 is 541,121. Using the monthly average for 2019 of 26,010 we would therefore expect the figure for the 22-month period from March 2020 to December 2021 to be at least 572,220

[v] As per ref i

[vi] As per ref i. From July 2021 to December 2021 inclusive, 245,320 people waited more than two weeks to see a specialist for suspected cancer following an urgent referral from their GP, compared with 112,497 in the same period in 2019 — a 118% increase. The equivalent figures for those who waited more than one month to start treatment were 10,392 and 6,290, a 66% increase

[vii] Public Health England’s National Cancer Registration and Analysis Service. Covid-19 rapid cancer registration and treatment data. Accessed February 2022. Macmillan analysis shows a 8.15% drop in new cancer diagnoses between March 2020 and September 2021 compared to expected figures based on diagnoses in 2019. This drop is equivalent to the increase we would see if new diagnoses occurred at 110% of 2019 rates for 16 months

[viii] As per ref i. Macmillan analysis shows a 5.43% drop in first cancer treatments between March 2020 and December 2021 compared to 22 months of the 2019 average. This drop of 31,095 treatments is equivalent to the increase we would see if first treatments were delivered at 110% of pre-pandemic 2019 rates for 12 months

[ix] Macmillan Cancer Support/YouGov survey of 2,085 adults in the UK with a previous cancer diagnosis, including 216 currently going through cancer treatment. Fieldwork was undertaken between 12th November and 2nd December 2021. The survey was carried out online. The figures have been weighted and are representative of people living with cancer in the UK. Question wording as follows: How worried, if at all, are you about the following? Delays to my cancer treatment because of coronavirus (COVID-19) affecting my chances of survival

[xiii] Refers to the Two Month Wait from GP Urgent Referral to a First Treatment for Cancer. Ref as per i

[xiv] As per ref i

[xv] As per ref i

[xvi] This figure refers to all provider trusts, excluding independent trusts, at which 5 or more patients started cancer treatment in December 2021, which amounts to 131 NHS trusts in total. NHS England. https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2022/02/DECEMBER-2021-CANCER-WAITING-TIMES-PROVIDER-WORKBOOK-PROVISIONAL.xlsx

[xvii] Refers to One Month Wait from Decision to Treat to a Subsequent Treatment for Cancer (Surgery). Ref as per i