NHS in England to replace two-week cancer appointment target | Cancer

Patients with suspected cancer may have to wait longer to get a diagnosis, under government proposals due this week.

The target that all patients should see a specialist within two weeks of an urgent referral for cancer tests by a GP is expected to be scrapped under NHS England plans to streamline cancer targets.

Ministers have been consulting on the proposals, which would scrap six of the nine existing cancer targets and replace them with just three.

Under a new “faster diagnosis standard”, three-quarters of patients should have a diagnosis or be told they do not have cancer within 28 days. Once diagnosed, patients should receive their first treatment within 62 days from referral or 31 days after the decision to treat.

That standard would replace the nine existing cancer targets, including the two-week wait between a GP referral and first consultant appointment; a one-month wait for care once a decision has been made to offer treatment for cancer such as chemotherapy, radiotherapy and surgery; and a two-month wait from the urgent GP referral to a first treatment of cancer.

Latest figures show that only 59% of patients in England started their first cancer treatment within two months of an urgent GP referral, well short of the 85% target. And only 62% of patients were seen within two months of a positive result from a national cancer screening test, compared with the 90% target.

When a consultation on the proposals began last year, the NHS highlighted that the current two-week target set no expectation of when patients should receive test results or have a confirmed diagnosis.

But speaking on BBC Radio 4’s Today programme, Pat Price, a visiting oncology professor at Imperial College London and co-founder of the Catch Up with Cancer campaign, accused ministers and NHS leaders of “fiddling around” in the middle of an NHS crisis and of watering down the targets.

“Changing the targets won’t help patients, unless we can treat patients better and quicker. And that means now increasing treatment capacity.”

On breast cancer, the target is that 93% of women should be seen in a one-stop clinic in two weeks, but the figure is now 74%. Price said: “The target we think is only going to be 75% in 28 days, that’s actually worse. Is it really the best that government and senior NHS leaders can do is fiddle around with targets in the middle of this crisis?”

The BBC reported that the outcome of the consultation was expected to be announced within days, although implementing the changes would be subject to final approval by the health secretary, Steve Barclay.

Speaking on the Today programme, he said the proposals were designed to improve outcomes and were what the sector wanted. He said: “Any changes will be those where it’s been requested by clinical specialists within the cancer field and would be done in consultation with the leading cancer charities.

“The consultation has been about working with consultants, clinical leaders, as to what drives the best outcomes, what is the way of getting the best survival rates.”

There has been a 28% increase in urgent GP referrals for suspected cancer, he added, and £2.3bn investment in 160 community diagnostic centres, with 114 of those open.

Dr Tom Roques, a vice-president of the Royal College of Radiologists, said simplifying the targets would make it easier for cancer teams to deliver care, but warned targets were no panacea.

“It’s important to remember that the targets are just a tool to try and improve care – the targets achieve nothing on their own. And the real need is investment in workforce, in newer ways of working, so we can improve the situation on the ground, which I think if you ask any cancer team is just not good enough at the moment for the patients.

“I think one of the problems that we have with targets as a whole is that they often focus on the process rather than the outcomes that are important to patients. So if you look at the old two-week target to see a doctor, you may not need to see a doctor to be diagnosed or not diagnosed with cancer, you may need teledermatology to assess your skin lesion and tell you whether it’s cancer or not. You may need to have an endoscopy test to quickly look and see whether you got bowel cancer and an artificial focus on you must see a doctor by 14 days may not be the best way to get patients quickly through the system.”

Wes Streeting, the shadow health secretary, said: “The Conservatives have created a crisis in cancer care, leaving patients waiting dangerously long. Having missed the targets, they are now cynically moving the goalposts.

“Rishi Sunak should focus on cutting waiting times, not cutting standards for patients. If he hasn’t got a plan to bring down cancer waits, then what is the point of him? Labour will get cancer patients diagnosed and treated on time again, by training the doctors and nurses the NHS needs, and reforming the service to make it fit for the future.”