Revealed: Long-wait cancer patient list grows again

Data obtained by HSJ shows the total backlog of NHS patients waiting over three months for their first treatment since referral grew by ten per cent month-on-month, from 10,361 as of 26 June, to 11,212 by 28 August.

There are now nearly 341,000 patients are waiting to start their cancer treatment after being referred, the internal data also reveals.

The growth has been driven by a small number of trusts, with North Bristol Trust seeing the largest increase of patients (288) tipping into the 104 day (See table below).

Other trusts reporting large numbers tipping over the 104-day mark month-on-month also included University Hospitals Birmingham Foundation Trust, which also has the largest 104-day patient backlog of all trusts overall (725 patients).

Under current NHS rules, the 104-day point marks a “backstop” – beyond which any patient waiting longer than this for treatment should be reviewed for potential harm. The NHS has not achieved this target since 2014.

In 2018, NHSE said there should be “zero tolerance [of] non-clinically justifiable 104-day delays”.

But as of 28 August 2022 every English NHS acute non-specialist trust had a backlog of patients who have waited longer than 104 days for treatment. The trust with the smallest such backlog was Warrington and Halton Teaching Hospitals Foundation Trust (four patients).

A spokeswoman for Blackpool Teaching Hospitals FT confirmed its figures were correct and said the trust had seen a “significant increase in referrals, particularly to gasto and colorectal cancer pathways”. 

She added reducing the backlog was a “prime focus for the whole team for some months” and said the creation of a sixth endoscopy room would boost the recovery work. 

A spokeswoman for Mid and South Essex FT said it was “absolutely committed” to delivering its phased recovery plan. The trust is implementing “rapid diagnostic centres and straight-to-test options to reduce the backlog across its sites in Basildon, Broomfield and Southend for colorectal services. It has also developed a “focused plan” with the ICS and NHSE on reducing waits for skin cancer, which has the largest proportion of patients waiting for treatment.  

As exclusively revealed by HSJ in July, the 104-day breach figure hovered between 8,600 and 9,000 for the first half of 2022, before jumping sharply in June to around 10,000. This is around double the 5,000 104-day breaches there were as of June 2021.

The data is recorded by all trusts as a weekly patient tracking list and sent to NHSE. The regulator, which has made driving down cancer and elective targets key priorities for trusts, has not disputed HSJ’s figures.

An NHSE spokeswoman said urgent cancer referrals had been at “record levels” over the past year. She added: “The NHS is working hard to return the number of people waiting more than 62 days to start treatment to pre-pandemic levels by March 2023 and we have written to trusts with the longest backlogs asking them to set out plans to reduce waits, and are helping them redesign their care to meet increased demand.”

All five trusts in the table above were approached for comment. 

Information about three-month cancer waits is not made public on a regular basis.

NHSE publishes data for the total backlog of patients waiting over 62 days, but it does not make public the regional or trust-level results, or reveal how many patients are waiting three months or more.