• Cancer surgery volumes down by around a third in several parts of the south east and London
  • Theatre activity badly disrupted in Essex, Bedfordshire, Surrey, Sussex and Hertfordshire
  • Comes as the NHS struggles with severe pressures from coronavirus

There were 800 fewer cancer surgeries in the first two weeks of January than usually take place during the period, according to provisional data seen by HSJ.

The bulk of this reduction came in London and the surrounding counties such as Essex, Bedfordshire, and Surrey.

London and the south east have been severely hit by coronavirus pressures, causing widely reported mass cancellations of non-urgent elective surgery. However, the impact on cancer cases has, so far, been less clear.

NHS England has insisted in the last week that urgent cancer cases should be given the same priority as coronavirus patients.

The “weekly activity returns” data, seen by HSJ, which is used to provide timely information to NHS management, suggests that from 1 November to 20 December, London performed a weekly average of around 410 cancer surgery procedures (ranging between 390 and 450).

Then in the two weeks from 3 January to 17 January, the capital averaged just 270 operations per week. This suggests London performed 280 fewer operations than would have been expected without the covid pressures, a fall of around 33 per cent. Within the capital, north central and north east London were hardest hit.

HSJ discounted the Christmas fortnight from its analysis, as activity always drops significantly at this time.

Comparing the fortnight running up to the Christmas break with the one following it, surgical activity in the following areas was also badly affected;

  • Activity for the cancer alliance covering Essex, Hertfordshire, Bedfordshire and Milton Keynes was down 34 per cent, equating to around 155 operations
  • The Sussex and Surrey network was around 28 per cent down on its expected levels, equating to more than 100 operations
  • Cambridgeshire and Norfolk was down by 23 per cent, representing about 120 operations

Nationally, volumes were down by around 800, a reduction of 13 per cent.

The weekly activity returns data typically under-reports the volumes of surgery carried out, compared to the official cancer statistics which are published with a two-month lag. Therefore, it was not possible to reliably compare the activity at the start of January with the same period in January 19.

However, data from previous years suggests activity volumes in the first two weeks of January typically return to their pre-Christmas period levels, so comparing these two periods in the same dataset gives a strong indicator of the expected trend.

Professor Neil Mortensen, president of the Royal College of Surgeons in England, said: “Surgeons in London told us just before Christmas that they were forced to cancel swathes of P2 [urgent] surgery, including cancer.

“Not enough private sector capacity had been secured, and NHS hospitals were overwhelmed by steep increases in covid patients. We made urgent representations to NHS England, as this group of patients need surgery within 28 days, so cancellations and delays are hugely problematic.

“Although deals have now been struck, and operations booked in again, we cannot continue with a stop-start approach to surgery. We’ve run the system too ‘hot’, pushing both physical resources and staff to their limits. Looking ahead, we need to build a more resilient and sustainable system.”

An NHS England spokeswoman said: “The most recent, complete data shows that cancer surgery in November was at 94 per cent of the level it was in 2019 and figures for after this point do not reflect the full picture of surgery that took place.

“The NHS is facing unprecedented pressure which has meant some procedures have had to be delayed but, thanks to the hard work of NHS staff and hospitals working together, surgery levels in most areas remain above or close to pre-pandemic levels.”

Michelle Mitchell, Cancer Research UK’s chief executive, said: “NHS staff have been doing everything they can to protect services and deliver urgent care, but we’re extremely concerned to hear about delays leaving patients waiting for potentially life-saving surgery at what is already a very anxious time for them.

“The government and NHS leaders have taken positive steps to make extra care available through the private sector but they must guarantee the NHS can cope in all parts of the country so that every cancer patient has access to the treatment they need, and clearly reassure people the NHS is still open for them.”