• Documents leaked to HSJ show more than 1,000 patients needing surgery within four weeks have no appointment 
  • “Most” NHS surgical centres now “compromised” and more than 300 patients have surgery postponed
  • Papers also show current plans to use independent sector are “insufficient”

More than 1,000 people needing urgent cancer surgery in London have no date for their treatment, HSJ can reveal.

A document leaked to HSJ showed that, at the end of last week, more than 1,000 of London’s cancer surgery patients without an appointment date were defined as P2 (priority two), meaning they needed to be seen within four weeks or risk their condition worsening.

The report seen by HSJ also showed more than 300 P2 patients had their surgery postponed in the past week, a statistic NHS England London has so far refused to disclose.

Hospitals in the capital are facing their highest-ever covid-19 occupancy rates, with surgical lists at many trusts being cancelled.

Meanwhile, a separate NHSE London document reported in the press this week revealed: “Most NHS Green sites [those cancer surgery sites intended to be covid-free to avoid risk to very frail patients] are now compromised with only a limited number of cases being undertaken in NHS sites this week”.

The papers also said the current plans to increase indepedent sector capacity usage were “insufficient to offset the NHS shortfall”, and noted there was a two week lead-in time to move patients into private hospitals “based on clinical rotas, theatre bookings, [and] patient isolation”.

The total work carried out in the NHS and private sector last week was less than half of the 500 treatments a week required to keep up with demand, with the document adding: “Potentially this figure could be significantly higher given that colorectal and [other] diagnostics work flows which stopped in May need to continue.”

HSJ reported last month that a failure to strike a deal with three private hospital groups — HCA, The Cromwell Hospital and The London Clinic — would leave NHS P2 patients sicken while less urgent private patients were treated in their stead. HSJ understands the NHS offer for using these facilities was not high enough.

Over the weekend, NHSE London medical director Vin Diwaker wrote to trust medical directors urging them to tell their medics to prioritise NHS work over their work for the private sector.

Meanwhile, large cancer surgery centres have contradicted NHSE London when it said “urgent” surgery was still being carried out.

The documents show that, as of the end of 27 December, there were 39,000 people on the cancer waiting list in total, covering everything from GP urgent referrals to those awaiting treatment. Of them, 3,800 were waiting longer than 62 days.

Research published in the BMJ last November revealed it was riskier than previously thought to delay some cancer surgeries. In colorectal cancer surgery, it estimated chance of death increased by 4 to 8 per cent for each four week delay in treatment.

A NHS London spokesperson said: “Hospitals are coming under significant pressure from high covid-19 infection rates and while staff are going the extra mile to care for patients, the NHS is also working closely and flexibly with independent sector providers to secure more capacity which has happened in London and elsewhere through a combination of national and local deals.

“Our staff are working round the clock opening hundreds of beds including the London Nightingale and some surgery is being postponed based on clinical need to ensure all Londoners continue to receive very urgent cancer surgery, making best use of existing NHS facilities and independent sector sites.”

The London Nightingale will not be hosting cancer surgery but operating as a vaccine centre and hosting step-down beds for patients who are not yet ready to be discharged.

The spokeswoman added: “On behalf of our NHS staff, I say to Londoners: We are depending on you. Stay at home, do everything possible to reduce the transmission of the virus, and help us save lives.”