Breast cancer target performance drops 10pp in a year

The national target is for 93 per cent of patients referred with breast cancer symptoms to be seen in outpatients within two weeks.

Data published by NHS Improvement this afternoon showed national performance for 2018-19 had dropped to 81.2 per cent, from 92.3 per cent in 2017-18.

The lowest performance was at Wye Valley Trust which saw 8.5 per cent of these referrals within a fortnight. The trust said no patients had come to harm as a result of the delays.

The chair of British Medical Association’s consultants committee Rob Harwood said the results were a “major red flag”.

Dr Harwood said: “Despite the BMA warning over a month ago of the crisis in cancer care, it is extremely concerning that we are continuing to see a rising trend in the number of patients forced to wait over two weeks to see a cancer specialist after their GP referral, further adding to their distress.

“The government must get an urgent grip on the crisis that is continuing to unfold in the NHS.”

NHS Providers said the breast cancer screening wait statistics were “very worrying”. Director of policy and strategy Miriam Deakin said: “Delays in any area of care can have a significant impact on patients, but we know that cancer outcomes often depend on the speed at which patients can access the treatment they need.

“There is a growing demand for cancer services, as more people are receiving two-week referrals for treatment. It is positive that more people are identifying the risks early, but in terms of some outcomes the UK is now lagging behind other comparable European countries.

“Behind this is a growing shortage of diagnostic specialists required to support cancer services. That has led to an increasing reliance on external partners to help provide these services. We also need to see better investment in the equipment needed to both diagnose and treat cancer. This must come from adequate capital funding.”

Performance against another key cancer target also declined sharply.

Eighty-five per cent of urgent GP referrals for cancer are supposed to be seen within 62 days. This fell from 82.3 per cent in 2017-18 to 77.3 per cent in 2018-19.

Charity Breat Cancer Care said the figures were “extremely concerning”.

Head of policy and evidence Gunes Kalkan said: ”We need NHS England to investigate why the proportion of women being seen within the two-week wait target has fallen, and lay out clear plans to ensure this failure does not continue.

“As proposed new targets begin to be tested across the NHS, we cannot lose sight of the importance of minimising these waiting times for patients and their families. We look forward to the results of these pilots to fully understand the impact of any changes to the current targets and ensure that they will tangibly improve patient experience of diagnosis.”

An NHS England spokeswoman said: “More people than ever before are being referred for cancer checks and over the last year over 400,000 people were referred for suspected breast cancer – the highest number on record.

“And over the past five years independent experts say breast cancer mortality rates have improved faster than the rest of Europe and are now better than France and Germany.” The study in question looked at mortality over a five-year period from 2014-19, and the results of a downturn in performance in 2018-19 will not have had significant bearing on it.

Wye Valley Trust said it had seen a 12 per cent increase in referrals year-on-year, something its commissioners said were due to “better public health campaigns, higher profile for breast awareness, and patients, public and GPs being more aware and alert to the requirement for referral”.

Herefordshire Clinical Commissioning Group managing director Jo-anne Alner said: “The CCG is aware of the disappointing performance and cited that this was associated with limited capacity in 2018-19.

“However, the CCG is now assured by the actions which have been taken to address this and we are working with the trust to ensure continuing improvement.”

The trust said it had “recruited a new clinician” and “drawn up a business case for additional clinical nurse specialists”.

It added that it had “increased the number of clinics and the consistency of capacity delivery across the year” and “increased capacity for breast radiology”, but did not explain how.