A Liverpool man was "worried" and "nervous" about a lump in his throat after his mum died of cancer.
Karl Stead, 51, felt the sensation in his throat for four weeks before going to his GP, keen to get help fast after seeing his mum die of cancer. The GP sent him to Broadgreen Hospital where he had a transnasal gastroscopy - a new procedure involving a camera fed through the nose and down the throat - on Thursday.
Speaking to the ECHO before his appointment, Karl from Wavertree said: "I think I've got something stuck, a lump in my throat. When I eat, I can swallow, but when I'm swallowing something else, I can feel it as well, so I've just come here to get checked over."
READ MORE: Taxi driver still haunted by 'clown-like' grin of Liverpool Women's Hospital bomber
The procedure Karl underwent this week is part of an initiative to cut cancer waiting lists in Merseyside at a time when health services are buckling under the backlog of cases. Seven in 10 NHS trusts in England are missing targets for urgent referrals in suspect cancer patients, according to analysis of NHS data by the PA news agency.
The backlog was exacerbated by the Covid-19 pandemic, during which an estimated 50,000 cancer diagnoses were "missed", according to Macmillan Cancer Support. Cheshire and Merseyside Cancer Alliance said the backlog was caused by capacity constraints during each wave of the pandemic, as well as record numbers of new referrals, which were 30% higher than pre-pandemic levels this June. It said first treatments were at 111.7% of pre-pandemic levels.
Hospitals should see at least 93% of patients within 14 days of receiving their GP referral, according to the NHS, but the number of NHS trusts missing this target is the highest it's been in at least three years, The Guardian reports. Almost half of cancer patients at Liverpool University Hospitals, of which Broadgreen is part, wait more than two months for further investigations or the start of treatment after being referred to hospital by their GP.
They should see 85.0% of patients within 62 days of receiving an urgent referral for suspected cancer, but Wirral University Teaching Hospital (81.5%) and The Clatterbridge Cancer Centre (84.6%) are currently the only trusts in Merseyside which come close to meeting this.
Dr Neil Haslam, a consultant gastroenterologist at Liverpool University Hospitals, said it's been "difficult" working under the pressure of rising waiting lists. He told the ECHO: "You can see the way it's going up. Across the [Cheshire and Merseyside endoscopy] network, we have about 4,000 patients waiting more than 13 weeks, which is clearly, I would say, unacceptable, but it is what it is at the moment. I think everybody's striving to do what they can."
In an attempt to speed up this process, Broadgreen Hospital started offering a new test for cancer and other diseases in the upper gastrointestinal tract in April. Liverpool University Hospitals NHS Trust, which includes Broadgreen, Aintree and Royal Liverpool hospitals, said this has reduced the waiting list for gastroscopy by 2,479 places, cutting waiting times by more than a third.
By feeding a smaller camera and tube through the nose, instead of the mouth, the diagnostic test causes less discomfort than the usual method, making the process quicker and easier for both patients and clinicians. This is in part because it provokes less of a gag reflex than it would going through the mouth, improving visibility for nurses leading the service.
Because patients don't need to be sedated during the procedure, it can be done quicker, allowing for more patients to be seen each week. This requires fewer staff, freeing up valuable resources in a health service struggling with staff shortages. The also runs on Saturdays and Sundays, further increasing capacity
Clare Jones, the clinical endoscopist running Karl's procedure, said: "Some of the referrals we were getting were some months beforehand, so that's going to have an impact if we can diagnose them sooner. Some patients will come in and say, 'I've had these symptoms for six months or so', and it might not always be cancer. They could have an ulcer, but they've been suffering for that amount of time without treatment. It's not nice to be waiting that long, so if we can do something to help here then that's good."
Karl's procedure was over within roughly 10 minutes, during which time three clinicians were in the room managing the equipment and comforting Karl with soothing words and a hand on the shoulder. His results were all clear, leading Karl to say: "It's a relief that it's not cancer because that's what I actually thought it was with the lump. I'm made up. Mum had it, you see, when she passed away in 2013. It's nearly 10 years she's been gone now. I miss her every day."
Other efforts to reduce waiting lists in Cheshire and Merseyside include an accelerated, supervised training scheme to allow endoscopy trainees nearing provisional sign-off to reach that sooner. So far, 15 endoscopists have completed that training, according to the NHS.
A test known as "sponge on a string", or Cytosponge, is being rolled out to identify people most at risk of oesophageal, or gullet, cancer after a successful pilot at St Helens and Knowsley hospitals and Countess of Chester Hospital.
A stool test being used as a faster alternative to endoscopy has seen 67% of the 49,000 patients who've undergone it need no further secondary care as a result, saving endoscopy capacity. And community diagnostic centres have opened across the region to give quicker diagnoses closes to home.
Dr Haslam said: "The challenging part is making sure we have more capacity than we have demand. The real limiting step on our capacity is our staff, and it's probably nurses and healthcare assistants which is our biggest resource, so it's recruiting more nurses and more healthcare assistants to make sure we can use the capacity as well as we can, because it's to annoying to see rooms standing idle when you you could be doing patients if we had enough staff."
The NHS has struggled to recruit enough nurses, leaving nearly 47,000 unfilled vacancies - the most ever - due in part to nurses leaving for jobs abroad or in different professions. Nurses are due to strike later this year after voting in favour of industrial action this month as part of a dispute over pay and conditions, particularly the stress of working on regularly understaffed shifts.
Dates are yet to be confirmed, but NHS trusts affected by the strike are expected to implement reduced services akin to a bank holiday or weekend, which could see services like endoscopy postponed.
Dr Michael Gregory, medical director for NHS England in the North West, said: "The NHS across the North West continues to work tirelessly to address the waiting lists that have grown and been exacerbated throughout the Covid-19 pandemic and to ensure that our most vulnerable patients, and those waiting the longest, are treated and cared for as quickly and as efficiently as possible.
"In recent months the NHS has seen extraordinary high demand for its services, including people referred by their GPs for suspected cancer, and I’d like to thank our NHS staff who are working extremely hard to provide timely treatment to those who need it most, and to catch cancers earlier than ever before.
"We understand how difficult it can be for patients to wait longer than expected to receive treatment after a GP referral and strongly encourage anyone concerned about new or worrying symptoms not to delay contacting their GP and getting checked to ensure they can be seen as soon as possible."
READ NEXT
-
Expert shares five prostate cancer warning signs you should get checked out
-
Mum 'devastated' by diagnosis after pain 'like nagging toothache'
-
Worried Liverpool prepares for life under the 'direct rule' of government
-
Serving Lancashire Police officer charged with attempted murder after hotel incident
