In this column, Richard Pugh, Head of Partnerships for Macmillan Cancer Support in Wales explains that concerns over NHS Wales is taking a toll on the wellbeing of people with cancer, how waiting times for treatment show that Wales' cancer care is failing to cope with the demand, and the desperate need for more staff in the system.
In late 2022, research by Macmillan showed that growing concerns over NHS Wales were taking their toll on the wellbeing of people with cancer. Almost two in three people with cancer in Wales (65%) said the NHS was one of their biggest concerns.
More than half of people with cancer (55%) were worried about how the pressures being faced by the NHS will affect their chances of survival. It is not difficult to see why. Cancer treatment times data shows that 2022 was the worst year so far for Wales’ new cancer treatment targets. More people than ever before were left with their lives hanging in the balance and facing agonising delays in life-saving cancer treatments.
Unfortunately, 2023 brought only fresh heartbreak for cancer patients and their loved ones, with Wales registering its worst ever level of performance against its national treatment targets. In January 2023, only 50.1% of people with cancer started their treatment on time. The national target is 75%. It has never been met.
Read more: NHS Wales waiting times: A&E waiting and ambulance response times worsen
That data showed how cancer treatment in Wales had come to rest firmly on the flip of a coin, with people with cancer facing no better than 50/50 odds on whether they were treated on time, or whether they were left to face the heartache of delays that could impact on the outcomes that can be achieved for them and their quality of life.
For some cancer types, such concerns over treatment delays run even deeper, with as few as one in four people receiving their treatment on time. For example, only a quarter of people with gynaecological cancers were treated within the 62-day target in January (25.6%) and December 2022 (25%).
Throughout the last six months of 2022, the number of people waiting too long to be seen by a specialist and to start treatment also accelerated faster than the overall numbers of people being seen and treated. When compared to pre-pandemic performance, the number of people experiencing delays increased 1.2 times faster than the total number of people starting treatment.
There could be no clearer sign that, despite the heroic efforts of front-line staff, Wales’ cancer care system is consistently failing to cope with an increased demand on services.
Only in February 2023 did Wales see any sign of improvement, with a slight rise in performance finally arresting what had become a consolidated downward trend. But even then, with only 52.5% being treated on time, the fact remains that almost 1 in 2 people with cancer still faced delays in their care.
What is more encouraging, is that the latest Wales Cancer Patient Experience Survey – where more than 6,000 people treated for cancer in Wales in 2020 aired their views – showed that most cancer patients were happy with their care.
Again, there can be no greater testimony to the efforts of Wales’ cancer care staff who have gone above and beyond to manage services through many years of crisis. In that survey more than nine in 10 (92%) of people with cancer surveyed rated their cancer care during the first year of the pandemic as 7 or above out of 10 – with 45% rating their care as very good or 10 out of 10.
Many people with cancer praised being treated with dignity and respect when in hospital (90%), privacy during examinations and treatment (94%) and having trust and confidence in the healthcare professionals treating them (84%). That trust in health professionals is significant. Macmillan’s latest research shows that Wales will need to recruit, train and achieve an 80 per cent increase in the number of cancer nurses by the end of the decade if it is to meet demand for cancer treatments.
Pressures on the cancer work force existed well before they were exacerbated by staff having to crisis manage front-line care through years of a global pandemic. A Macmillan cancer nursing workforce census from as far back as 2017 showed that almost three quarters (74%) of breast clinical nurse specialists were set to retire within the next decade – just one indicator of the long-running crisis in the overall capacity of Wales’ cancer care workforce.
Of all the urgent actions required to put cancer services back on track and deliver the ambitions of Wales’ new Cancer Improvement Plan, putting the appropriate workforce in place is the keystone. Nothing can be rebuilt without the cancer workforce, and that is why the Welsh Government must make it a priority to put the right funding and training in place to grow the capacity of the cancer care workforce in Wales. Only then will we be able to meet demand for care both now and in the future.
Macmillan continues to do everything we can to help, and we are here for anyone with cancer and their loved ones. For advice, information or a chat, you can call us free on 0808 808 0000 or visit macmillan.org.uk.
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