The number of patients receiving cancer treatment within the target time of 62 days of first being suspected of cancer is at its all time low in Wales. Just 50.1% of patient pathways (881 out of 1,760) started their first treatment within the targeted 62 days of being suspected of cancer in January.
The Macmillan cancer charity has labelled the system as being in "crisis". They say more and more people are coming forward with cancer symptoms and the workforce is not equipped to deal with the demand. They are calling for a focus on training and recruitment to take place to relieve the pressures on "exhausted NHS staff"
New data from the Welsh Government shows that patients waiting for cancer treatment in Wales are facing increased waiting times as the NHS struggles with demand. In January, that figure hit an all time low since records began in 2020 and was 2.8 percentage points lower than December, and 3.6 lower than the January 2022. This is falling significantly short of the target that 75% of patient pathways should start treatment within 62 days, and way off a target of 80% aimed to be reached by 2026.
Read more: 'I waited over 140 days to start cancer treatment and I counted every one of them'
The term patient pathways is not the same number as individual patients because some patients have multiple open pathways relating to cancer care. This means a person might be waiting longer than 62 days for two different cancer treatments and therefore be counted twice in the data.
Richard Pugh, Head of Partnerships for Macmillan Cancer Support in Wales said: “Cancer treatment in Wales now rests firmly on the flip of a coin – people with cancer face no better than 50/50 odds on whether they are treated on time, or whether they face the heartache of delays that may impact on the outcomes that can be achieved for them and their quality of life."
He warned that 2022 was the worst year on record for cancer treatment in Wales - and 2023 is following the same trend already.
In Wales, the way this data is collected is slightly different to the rest of the UK. The number of days a patient is waiting for treatment is measured from the first instance that a healthcare professional suspects cancer - for example, the first appointment with a GP and or nurse. In other parts of the UK, this is measured from the first referral appointment to a specialists. For more stories about important issues in Wales, sign up to our WalesMatters newsletter here.
Kerry Lynne, the senior strategic communication manager for Macmillan, said that one of the reasons why Wales is so far behind its target for cancer treatment is that more and more people are coming forward with cancer symptoms but the system does not have the workforce to deal with them.
She said: "There is just not enough specialists coming through training. We need 80% more clinical nurses for cancer services by 2030. That is quite a huge gap." There is also growing concern about the future of the services with a fear the workforce is not prepare to replace clinicians due to retire.
Mr Pugh added: “Despite the tireless efforts of NHS staff, there can be little doubt that Wales’ cancer care system is in crisis. It is a system that is consistently failing to keep up with a rising demand for cancer care, or to manage the wider pressures being placed upon it."
Speaking on behalf of Macmillan, Mr Pugh said the charity believe the only way these figures will improve is by future proofing the services, and are calling on the Welsh Government to offer the leadership required to turn the crisis around and "reverse the current trajectory in which more and more people may find their quality of life, or even their chances of survival are lessened because of delays in their care."
The charity say there needs to be a "relentless" focus on the training and recruitment required to take the pressure off exhausted NHS staff. Mr Pugh added there needs to be a focus on building the "capacity of Wales’ specialist cancer care workforce so that it can begin to meet what is an ever-growing demand for cancer care in Wale."
Earlier this year A Cancer Improvement Plan for NHS Wales was published by the Welsh Government. Announcing the plan in January, health minister Eluned Morgan said: "The plan sets out how the NHS, collectively, will respond to the quality statement for cancer and our wider commitments to improving diagnostic and end-of-life care for people affected by cancer."
Addressing the target for patients starting cancer treatment, Ms Morgan said: "This expectation has been really challenging to deliver and there are three main reasons for this. The first is the introduction of the new suspected cancer pathway, which overhauled how we counted people on the cancer pathway—unique in the UK—capturing more people earlier on in their pathway without pausing the waiting time clock. The second is the historic growth in demand for cancer investigation and treatment, caused by our population factors and lowering of the risk threshold for referral, to ensure that we don't miss any potential cancers. And, thirdly, delivery has been restricted by our service capacity to refer, investigate, treat and care for people affected by cancer. In short, demand is growing, our capacity struggles to keep pace, and we’re now much better at accurately counting everybody on a cancer pathway."
She added that the pandemic has had an impact too. The Cancer Improvement Plan looks at all aspects of care, from actions that are needed to try and prevent cancer from occurring in the first place, to diagnosis, treatment and living with or dying well with cancer.
As part of the plan, an NHS Wales organisation called Health Education and Improvement Wales(HEIW) will work with the rest of the NHS in Wales to develop plans to make the workforce more resilient and better at what they do - the HEIW is also responsible for trainin and growing the workforce for the future.
You can contact Macmillan for advice, information or a chat for free on 0808808000 or visit macmillan.org.uk.
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