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

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

“It’s deeply concerning to see that record numbers of people waited too long to see a specialist and start cancer treatment in September. On top of this, progress to clear the backlog stalled. Last month’s Spending Review failed to provide the long-term investment needed to grow the overstretched NHS workforce as well as guarantee cancer services a share of the elective recovery funding. Without this, cancer care remains in limbo. As we approach yet another difficult winter, it’s vital the Government urgently provides the NHS with the support and investment required to ensure everyone with cancer receives the care and support they need and deserve.”

-ENDS-

Fact Box:

• The number of people in England being seen by a specialist for suspected cancer following an urgent referral by their GP was 231,421 in September 2021. This is again 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 190,000 lower than expected (a drop of 5%)[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 set a new highest level on record, at more than 36,700 — the first time this figure has risen above 35,000 in a single month — and performance against this cancer waiting time target fell back, to its second-worst level on record[iii]
• The number of people in England starting treatment for cancer in September 2021 was 27,342, which is higher than the pre-pandemic average[iv]
• However, the total number of people starting cancer treatment in England since the start of the pandemic is still more than 32,000 lower than expected[v]
• In addition, the number of people who waited for more than one month to start cancer treatment following a decision to treat reached the highest level on record, at more than 2,000 — the first time this figure has risen above 2,000 in a single month — and performance against this cancer waiting time target fell to the worst level on record[vi]
• The data for September 2021 also includes the sixth 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[vii] and the figure dropped again, setting a new lowest level since it started to be published. The data shows more than 64,000 people had to wait for more than four weeks to find out whether or not they had cancer from their initial urgent referral[viii]
• In September 2021, there was also another 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 4,750 people — and performance against this cancer waiting time target also fell to the worst level on record[ix]
• 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 22% lower than expected[x]
• The latest Macmillan analysis estimates the NHS in England would need to work at 110% capacity for 15 months to catch up on missing cancer diagnoses[xi], and for 13 months to clear the cancer treatment backlog[xii]
• Figures from Macmillan show more than a quarter (29%) of those receiving cancer treatment in the UK in August were worried that delays to their treatment could impact on their chances of survival[xiii]

Wider fact box:

• The 62-day target was breached again in September 2021 — only 68% of patients in England started treatment within two months of being urgently referred by their GP with suspected cancer, against the target of 85%[xiv]. This represents the lowest performance on record (previously 70% in February 2021).
• 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 (69 months in a row), since January 2016[xv]
• Since the target first started to be frequently breached in January 2014, more than 236,000 people have waited more than two months for treatment to start[xvi]
• Nine in ten NHS hospital trusts in England (90%) missed the 62-day target in September 2021. A total of 89 trusts — two in three — missed it by ten percentage points or more, and 45 trusts missed it by twenty percentage points or more[xvii]
• The 31-day wait target for subsequent cancer treatment through surgery has been missed every single month since August 2018[xviii]

References

i NHS England. Cancer Waiting Times — National Time Series Oct 2009 — September 2021 with Revisions. The figure for September 2021 was 231,421, and the monthly average for 2019 was 198,392.

ii As per ref i. The total figure for March 2020 to September 2021 is 3,577,464. Using the 2019 monthly average of 198,392, we would therefore expect the figure for the 19-month period from March 2020 to September 2021 to be at least 3,769,454.

iii As per ref i.

iv As per ref i. The monthly average for this figure for 2019 was 26,010.

v As per ref i. The total figure for March 2020 to September 2021 is461,714. Using the monthly average for 2019 of 26,010 we would therefore expect the figure for the 19-month period from March 2020 to September 2021 to be at least 494,187.

vi As per ref i. In September 2021, 92.6% of people started treatment within one month of a ‘decision to treat’, against the target of 96%

vii The figure for September 2021 was 71.7%; the target of 75% is due to be in place from quarter three of the 2021/22 financial year onwards.

viii As per ref i

ix As per ref i. This refers to 4,757 people who started treatment outside the two months standard in September 2021, not those who are still waiting to do so.

x As per ref i. The total figure for March 2020 to September 2021 is 26,622. Using the monthly average for this figure for 2019 of 1,798 we would therefore expect the figure for the 19-month period from March 2020 to September 2021 to be at least 34,159.

xi Public Health England’s National Cancer Registration and Analysis Service. Covid-19 rapid cancer registration and treatment data. Accessed November 2021. Macmillan analysis shows an 8.3% drop in new cancer diagnoses between March 2020 and July 2021 compared to the previous year. This drop is equivalent to the increase we would see if new diagnoses occurred at 110% of 2019 rates for 15 months.

xii As per ref i. Macmillan analysis shows a 6.6% drop in first cancer treatments between March 2020 and September 2021 compared to 19 months of the 2019 average. This drop of 32,473 treatments is equivalent to the increase we would see if first treatments were delivered at 110% of pre-pandemic 2019 rates for 13 months.

xiii Macmillan Cancer Support/YouGov survey of 2,032 adults in the UK with a previous cancer diagnosis, including 236 currently going through cancer treatment. Fieldwork was undertaken between 30th July and 15th August 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

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

xv As per ref i

xvi As per ref i

xvii This figure refers to all provider trusts, excluding independent trusts, at which 5 or more patients started cancer treatment in September 2021, which amounts to 131 NHS trusts in total. NHS England. https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2021/11/SEPTEMBER-2021-CANCER-WAITING-TIMES-PROVIDER-WORKBOOK-PROVISIONAL.xlsx

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