Cancer waiting times are now the worst they have ever been with only 54% of patients starting their first treatment within 62 days in November 2022, according to a recent report. On Tuesday, the Welsh Government announced that there was an urgent need to improve cancer services in Wales.
It comes after NHS Wales published a three-year improvement plan, which has outlined how health board and trusts in Wales can plan and deliver their cancer care that will improve cancer patient outcomes and reduce health inequalities. According to the report coinciding with the plan, there was a 25% increase in the number of new cancer diagnoses in 2019 compared to 2002.
Whilst survival has significantly improved for many cancer types, outcomes for other 'less survivable cancers' have improved slowly. Suspected cancer referrals, demand for diagnostic tests and some treatments such as immunotherapy were rapidly increasing prior to the coronavirus pandemic, the report said. But with the capacity of the healthcare systems struggling to cope with this demand, it had "undoubtedly been exacerbated".
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In a press conference on Tuesday, the health minister for Wales, Eluned Morgan MS, said that the pandemic had its impact on cancer services by distorting access and creating "huge pressures" in the wider system, which had an implication on cancer investigations, access to theatres and critical care.
According to the report, cancer waiting times are now the worst they have ever been with only 54% of patients starting their first treatment within 62 days in November 2022. It went on to say that no health board in Wales had met the target of 75% since July 2020.
The median number of days from point of suspicion to starting first definitive treatment was 62 days in November of last year, which was a 19% increase since January 2021 with 52 days. The median number of days from diagnosis to treatment was 33 days in November 2022, which was a 38% increase since January 2021 at 24 days.
At the press conference, the health minister Eluned Morgan MS said that the government needed to ensure that services were in place to "maximise positive health outcomes". She said: "Today, the cancer improvement plan has been published by NHS Wales.
"With one in two of us developing some form of cancer in our lifetime, cancer will touch all of our lives at some point. For those people that develop cancer, we need to ensure we have quality services in place to support them and treat them quickly and appropriately to maximise positive health outcomes.
"We are making progress, but we know that performance must improve. We change the way we measure performance of cancer services so that it can be more of a useful tool in improving performances. Our primary target is that 75% patients requiring cancer treatment should start definitive treatment within 62 days of the point to which cancer is first suspected, but we are currently way short of that target.
"Demand is growing, our capacity is struggling to keep pace and we are now much better at accurately counting everyone that is on a cancer pathway." She added: "Things are very difficult at the moment, with our services working flat out to meet the needs of patients. But I am pleased to report that the NHS Management Data shows a fall in a number of people waiting for more than 62 days for their treatment in the run up to December."
Last week, the Welsh Government invested £86m to improve cancer services and outcomes in Wales. With a recent survey for cancer patients in Wales showing that 92% of respondents rated their treatment at least seven out of 10, the Cancer Services Improvement Plan aims to focus on diagnosing cancer earlier and treating patients with "the most effective treatment", it says.
The report determined that cancer prevention offered the most "cost-effective long-term strategy", as well as the need to address known risks such as tobacco smoking, obesity and alcohol consumption. Although the report said that earlier diagnosis through screening was offered to the eligible population, it noted that the offer was not taken up equally across the population groups in Wales, which resulted in "inequities of outcomes".
The report also noted the need for faster diagnosis, elective care recovery as well as effective treatments amongst other solutions. In response to the improvement plan, Breast Cancer Now charity said that is was "hugely welcomed", but they were "deeply concerned" by the government's "lack of ambition" to increase the speed of diagnosis for breast cancer patients.
Baroness Delyth Morgan, the Chief Executive at Breast Cancer Now, said: "Today’s publication of Wales Cancer Network’s Cancer 2023-26 Improvement Plan is hugely welcome, particularly its recognition that the needs of people living with secondary breast cancer must be met, and services designed accordingly.
"In particular, we applaud the commitment to supporting healthcare professionals effectively and confidently diagnose potential cases of secondary breast cancer, as early as possible, and to capturing accurate data at all stages of secondary breast cancer treatment, ahead of the national audit.
"We’re deeply concerned however by the Welsh government’s lack of ambition on increasing the speed of diagnosis for breast cancer patients; an 80% target for patients starting treatment within 62-days of initial referral by 2026 risks normalising poor performance and long waiting times.
"The Plan also fails to set out how it will improve access or uptake to breast screening and omits reference to recent changes to open invite letters for women aged 50-53, despite data suggesting that this model can adversely affect uptake and widen health inequalities.
"Implementation of this Plan must include an evaluation of breast screening invite models to reverse long-term decline in uptake. The Welsh Government and Wales Cancer Network must also commit to specific, progressive targets for breast cancer to ensure timely diagnosis, along with a fully funded long-term workforce plan needed to realise successful delivery of many components of this Plan."
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