NHSE and government reprimanded for ‘selective reporting’ of cancer performance

The chair of the Public Accounts Committee Meg Hillier wrote to NHS England CEO Amanda Pritchard requesting “greater realism about the scale of the challenge” on cancer services.

It follows the government and NHSE claiming in a government response to the committee that they had “implemented” one of its earlier recommendations, to “bring cancer treatment back to an acceptable standard”.

Earlier this year the health service missed a March 2023 target to bring the backlog of 62-day waiters after urgent cancer referrals back to pre-covid levels. Trajectories produced earlier this year and seen by HSJ suggested it is likely to still be higher in March next year.

In their February report on backlogs and waiting times, MPs said cancer delays were “unacceptable” and services should be recovered “as a matter of urgency”. The report also criticised NHSE for “over-optimism” when drawing up cancer and elective recovery plans.

A subsequent response to the committee report, issued by the government with information from NHS England, indicated this recommendation had been “implemented”. It said “NHS England [had] set out clear plans and actions to reduce waiting times, including for cancer care”, and pointed to falls in the 62-day cancer backlog and “early signs of a recovery in early-stage diagnosis”.

But in a letter to Ms Pritchard issued yesterday (Monday), committee chair Meg Hillier criticised NHSE for painting an inaccurate picture of the current state of cancer services.

The MP said the response “implies that cancer treatment is back at an acceptable standard, which would mean 85% of people with cancer being treated within 62 days of an urgent referral, as we made very clear in our recommendation.

“Yet Quarter 4 of 2022-23 saw the lowest recorded performance (58.8%) against the operational standard of 85%. And 6,300 people waited for more than 104 days for treatment following an urgent referral.

“I would ask in future correspondence and discussions with the committee on cancer for less selective reporting of indicators and greater realism about the scale of the challenge.

“I also ask that you reconsider whether this recommendation has indeed been implemented, or if you would not be better to consider it work in progress until such time as your operational standard is met or, at the very least, there has been substantial progress towards it.”

HSJ asked the committee why the letter was addressed to Ms Pritchard rather than government, and a spokesman said they were “most relevant to the content”, and that DHSC and NHSE worked together on responses.

An NHSE spokeswoman said: “NHS England has NOT painted an inaccurate picture of cancer recovery – while there are really clear plans in place to address backlogs and progress has been made thanks to hardworking staff, the NHS is totally clear that there is a huge challenge ahead to recover cancer services.

“The Faster Diagnosis Standard has been met for the first time since its inception earlier this year, and the 62-day backlog decreasing year-on-year for the first time since 2016. Thanks to NHS campaigns and early diagnosis initiatives we are also seeing record numbers of referrals and diagnosing a greater proportion of those at early stage than ever before.”

It follows a trust leader issuing an “unreserved apology” after accusing NHSE of “spin” on cancer waiting times.

Newcastle Hospitals Foundation Trust deputy chief executive Andy Welch indicated on Twitter in May that he thought comments made to the Commons health and social care committee by NHSE’s national cancer director were “pathetic and dishonest”.

Mr Welch, who also chairs the Northern Cancer Alliance, subsequently apologised, saying he was “horrified” that the remarks had been taken as criticism of NHSE cancer director Dame Cally Palmer.

Updated at 2.10pm on 4 July to make clear that the criticisms relate to NHSE and the government, rather than Ms Pritchard personally. Updated again at 2.54pm to include NHSE statement.