The must-read stories and debate in health policy and leadership.

Leaked data from NHS England shows the shocking pressure faced by cancer services nationally. 

Published data has focused on referrals officially classified as “urgent” – those meant to be seen within 62 days. This number peaked at 34,000 in May 2020 and then dipped. It has, however, started to grow again in March 2022.

What has not been made public before is the total waiting list for all suspected cancer referrals. This data, obtained by HSJ, shows there are now more than 10,000 people with suspected cancer waiting more than 104 days. This data covers all methods of referral, including screening, consultant upgrade and GP referral. From a patient’s point of view most referrals will feel pretty urgent.

The data also reveals the huge regional variation in performance. A total of 4.6 per cent of the Midlands’ cancer waiting list have been waiting more than three months, while in the South East it is 2 per cent. That means Midlanders are more than twice as likely to face delayed diagnosis and treatment than people in the South East. The impact on excess deaths and life years lost will not be known for a few years but is not hard to predict.

To some degree, the service has been a victim of its success in driving up referrals after the slump seen during the pandemic – and, so far, the increased activity has not seen a significant increase in diagnosed cancer.

The NHS has also been doing well on increasing cancer diagnostic and treatment activity, but its chances of getting the number of long waiters back to pre-pandemic levels by next March (it had originally hoped to do it by this March) now look slim.

To put it mildly there is some scepticism in policy circles that Sajid Javid’s 10-year strategy for cancer is going to offer any substantial help.

Covid’s latest side effect

The government and most of the country wants to forget about covid, but the virus still threatens to derail the NHS.

Amid rising covid admissions, HSJ has learned that the organisation which supplies blood to hospitals is in “crisis mode”.

Well-placed senior sources said NHS Blood and Transplant is close to issuing a formal “amber alert” over stock shortages, which would mean it could not guarantee blood supplies to hospitals. 

NHS trusts would have to start cancelling elective operations if they cannot ensure that necessary bloods are available. NHSBT has already written to trusts asking them not to over-order supplies, and to ensure management plans are in place should the situation escalate.

Supplies of the common O blood types are at fewer than three days’ worth. If they were to drop to two days, this would trigger an amber alert.

NHSBT has reported shortages previously in the pandemic, most recently in January, but the sources said stock shortages have not previously sunk to the current levels.

Whenever covid rates have risen in prior waves, hospital activity, and therefore demand for bloods, has decreased sharply. Now, however, hospitals are experiencing high demand for emergency care while also seeking to maximise elective activity.

Also on today

In Mental Health Matters, Emily Townsend examines last week’s long-awaited draft bill to reform the Mental Health Act and identifies some notable omissions, and in comment, Kate Lee explains why  providing better post-diagnostic support benefits people with Alzheimer’s and the NHS.