Macmillan responds to July 2021’s Cancer Waiting Times data for England

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

“As more people come into the NHS for cancer diagnosis and treatment, it’s vital the Government urgently invests in cancer services, including the guaranteed use of additional private sector capacity. The funding announced this week is a start, but a long-term investment plan is needed to clear the backlog caused by Covid-19 and ensure everybody who is diagnosed with cancer receives the care they need.”

Key Facts:

• The number of people in England being seen by a specialist for suspected cancer following an urgent referral by their GP was 224,086 in July 2021. This is considerably higher than the pre-Covid-19 average[i].
• However, the total number of people who have seen a specialist for suspected cancer since the pandemic began is still more than 230,000 lower than expected (a drop of 7%)[ii]
• In addition, the number of people who waited for more than two weeks to see a specialist following the urgent referral by their GP was the second-highest level on record, at more than 32,000[iii]
• The number of people in England starting treatment for cancer in July 2021 was 27,072. This is also higher than the pre-pandemic average, but is slightly lower than the previous month[iv]
• The total number of people starting cancer treatment in England since the start of the pandemic is still more than 33,000 lower than expected[v]

· The data for July 2021 also includes the fourth publication of new cancer waiting times data for England, showing how many people had a cancer diagnosis confirmed or ruled out within 28 days of an urgent referral. The future target of 75% was not met[vi] and the data shows almost 57,000 people had to wait for more than four weeks to find out whether or not they had cancer from their initial urgent referral[vii]

· In July 2021, there was also a new record-high number of people who had waited for more than two months before they started cancer treatment following an urgent referral from their GP — more than 4,000 people[viii]

• The total number of people starting cancer treatment following a referral from a screening service in England since the start of the pandemic is still 26% lower than expected[ix]

· The latest Macmillan analysis estimates the NHS in England would need to work at 110% capacity for 17 months to catch up on missing cancer diagnoses[x], and for 13 months to clear the cancer treatment backlog[xi]

· Macmillan research shows more than a third (40%) of those receiving cancer treatment in the UK in the run-up to this January’s lockdown were worried that delays to their treatment could impact on their chances of survival[xii]

Wider fact box:

• The 62-day target was breached again in July 2021 — only 72% 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]
• The 62-day target first started to be frequently breached over six years ago and it has now been missed continuously for over five years (67 months in a row), since January 2016[xiv]
• Since the target first started to be frequently breached in January 2014, more than 227,000 people have waited more than two months for treatment to start[xv]
• Almost nine in ten NHS hospital trusts in England (87%) missed the 62-day target in July 2021. A total of 72 trusts — more than half — missed it by ten percentage points or more, and 28 trusts 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]

References:

[i] NHS England. Cancer Waiting Times — National Time Series Oct 2009 — July 2021 with Revisions. The monthly average for 2019 was 198,392.

[ii] As per ref i. The total figure for March 2020 to July 2021 is 3,135,112. Using the 2019 monthly average of 198,392, we would therefore expect the figure for the 17-month period from March 2020 to July 2021 to be at least 3,372,664

[iii] As per ref i.

[iv] As per ref i. The monthly average for this figure for 2019 was 26,010, while 27,293 started treatment for cancer in June 2021.

[v] As per ref i. The total figure for March 2020 to July 2021 is 408,572. Using the monthly average for 2019 of 26,010 we would therefore expect the figure for the 17-month period from March 2020 to July 2021 to be at least 442,170

[vi] The figure for July 2021 was 74%; the target of 75% is due to be in place from quarter three of the 2021/22 financial year onwards

[vii] As per ref i

[viii] As per ref i. This refers to 4,015 people who started treatment outside the two months standard in July 2021, not those who are still waiting to do so.

[ix] As per ref i. The total figure for March 2020 to July 2021 is 22,672. Using the monthly average for this figure for 2019 of 1,798 we would therefore expect the figure for the 17-month period from March 2020 to July 2021 to be at least 30,566.

[x] Public Health England’s National Cancer Registration and Analysis Service. Covid-19 rapid cancer registration and treatment data. Accessed September 2021. Macmillan analysis shows a 10.8% drop in new cancer diagnoses between March 2020 and May 2021 compared to 15 months of the 2019 average. This drop is equivalent to the increase we would see if new diagnoses occurred at 110% of 2019 rates for 17 months.

[xi] As per ref i. Macmillan analysis shows an 7.6% drop in first cancer treatments between March 2020 and July 2021 compared to 17 months of the 2019 average. This drop of 33,595 treatments is equivalent to the increase we would see if first treatments were delivered at 110% of pre-pandemic 2019 rates for 13 months.

[xii] Macmillan Cancer Support/YouGov survey of 2904 adults with a previous cancer diagnosis, including 293 currently going through cancer treatment. Fieldwork was undertaken between 2nd — 22nd December 2020. The survey was carried out online. The figures have been weighted and are representative of all UK adults 18+ who are living with cancer. Question wording as follows: How worried, if at all, are you about each of 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 July 2021, which amounts to 132 NHS trusts in total. NHS England. Provider-based Cancer Waiting Times for July 2021 (Provisional).

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