- More than 500 operations cancelled over three months, HSJ reveals
- Despite national officials saying cancer procedures should go-ahead amid pressures
- Leeds, Leicester, Bristol, Birmingham and Lancashire hospitals reported the highest numbers of operations cancelled
- Cancer charity says delays could affect patients’ chances of survival
More than 500 cancer operations were cancelled by hospital trusts in England due to winter pressures, HSJ can reveal.
HSJ received information from 81 acute NHS trusts, of which 43 said they had cancelled at least one operation between December and February.
Across those 43 trusts, 530 operations were cancelled. This included some diagnostic procedures such as biopsy.
NHS officials had recommended cancelling most elective hospital care during January and February, while pressures were most severe, but stated that “cancer operations and time-critical procedures should go ahead as planned”.
The largest numbers of cancellations were at some of England’s largest hospital trusts.
Leeds Teaching Hospitals reported 109 cancer cancellations, which it said was out of around 1,400 cancer procedures it would have carried out over the three months. It said it was “very sorry” but “had no other option… during a period of extreme pressure”.
University Hospitals of Leicester reported 88 cancellations, and its main commissioner has said that 32 cancer operations were cancelled over a five-day period as “bed occupancy within all three UHL sites prevented patients stepping down from the [intensive care unit]”.
University Hospitals Bristol reported 66 cancer cancellations, University Hospitals Birmingham reported 45 and Lancashire Teaching Hospitals 29.
Numbers of cancer cancellations for previous years are not available but experts, and the trusts with the most cancellations, said the figures shared with HSJ for 2017-18 were unacceptable.
Pressures on bed availability and other capacity was widely acknowledged through winter, and NHS England said February was probably the NHS’s most difficult ever month.
Royal College of Surgeons senior vice president Ian Eardley told HSJ it was “very concerning and unacceptable”. He said: “Any delay in an operation can be extremely distressing for patients and their families.
“The type of cancer a patient has, and the length of delay in them receiving treatment, will be relevant to how it may impact their overall outcome. All cancelled cancer operations should be re-scheduled as quickly as possible.”
Macmillan Cancer Support executive director of policy and impact Fran Woodard said it was “absolutely unacceptable” people had to wait longer, and would cause patients and families more anxiety.
“Depending on the type of operation, a delay could mean that the cancer not only progresses in that time but that the chances of survival are also affected,” Ms Woodard said.
“Ultimately it is down to the government, not hard-pushed NHS trusts, to ensure there is sufficient funding and enough staff to provide prompt treatment.”
The trusts which cancelled the largest numbers of operations told HSJ they regretted it and it was due to pressure on capacity.
Leeds Teaching Hospitals chief medical officer Yvette Oade said it had been admitting high numbers of acutely ill patients through the emergency department and there were periods of “very high demand for our intensive care facilities”.
Dr Oade said: “We regret that we had no option other than to reschedule a small number of cancer operations during a period of extreme pressure on our services.
“Slightly more than 1 per cent of our cancer treatment operations and around the same percentage of diagnostic procedures were cancelled.”
“We are very sorry for the distress caused to patients and their families,” Dr Oade said. “Sometimes need to prioritise clinically to ensure we can treat people safely and continue to give high quality care.” She said cancelled cancer procedures were always rebooked as soon as possible, and that by 3 April all the 109 people would have had their operation.
University Hospitals Bristol deputy chief executive Mark Smith said: “Over the winter we saw an increase in the number of emergency admissions. This increased demand regrettably meant we had to cancel some surgical procedures for patients with cancer during this period.
“We would like to apologise to anyone who was affected by this.”
Asked for comment, NHS England did not address the number of cancellations directly, but a spokeswoman said: “Actually, despite all the pressures from flu and norovirus, NHS hospitals treated 2,615 more cancer patients this January (2018) than last January (2017) - that’s 5.7 per cent up.
“What’s more, the proportion of cancer patients fast tracked for treatment within 62 days was the highest this January than it’s been for the past three years.”
Performance figures for December 2017 indicate slightly fewer people were treated than in 2016 (1.7 per cent down), while data for February is not yet available.
The national emergency pressures panel, chaired by then NHS England medical director Sir Bruce Keogh, issued advice over winter to cancel planned procedures, but said cancer appointments should go ahead.
- Acute care
- Bruce Keogh
- Cancer waiting times
- LEEDS TEACHING HOSPITALS NHS TRUST
- Macmillan Cancer Support
- NHS Leicester City CCG
- Quality and performance
- Royal College of Surgeons
- UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST
- UNIVERSITY HOSPITALS BRISTOL NHS TRUST
- UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST
- Winter pressures