Exclusive: Cancer workforce shortages having ‘direct’ impact on patient care

The charity warned in a new report analysing shortages in the cancer workforce, shared exclusively with HSJ, that cancer care could face substantial shortfalls by 2022 based on demand growth and existing vacancies.

The charity’s workforce report has formed part of considerations by Health Education England as it draws up a new workforce strategy ordered by health secretary Jeremy Hunt and due to be published in coming weeks.

The report said: “There are shortages across the workforce. Although some workforce groups have modest vacancy figures, our research indicates that these are likely to be underestimates of the true workforce gaps as many posts have been vacant for up to two years and vacancy rates only reflect current vacancies.

“These workforce shortages are having both direct and indirect implications for the workforce and the treatments they are able to deliver. The lack of time to do research came up as a theme across all the workforce groups. Staff shortages are also affecting services’ ability to successfully provide high quality patient experience, long-term workforce planning and professional training and development amongst many others.”

The charity said that if oncologists retire early, the projected 2022 workforce could be roughly half of what it believes will be needed to deliver best practice care with a shortage of between 1,389 and 2,175 consultant oncologists.

It warned there was a possible 12 per cent shortage of clinical oncologists by 2022, a gap of 1,004 and a 23 per cent shortage of medical oncologists. Therapeutic radiographers could have a 10 per cent shortfall.

The charity highlighted that all staff groups were experiencing shortfalls now and its figures were based on likely underestimates from 2015 staffing vacancy rates which only show unfilled positions and many posts had been unfilled for two years.

Emma Greenwood, Cancer Research UK’s director of policy, said: “The NHS must ensure there are enough staff to cope with the rising number of people with cancer. By 2035 an extra 150,000 people are expected to be diagnosed with cancer annually. Without investment in the treatment workforce, patients may be denied the best treatments available in the future.

“The report also shows that research to improve cancer treatments is suffering as a result of workforce shortages. If staff don’t have time to do research, then our world class health system will start to slip down the ranks.

“We want [HEE] to improve opportunities for treatment workforce training, including increasing training places for oncologists. We’ve also called on the government to employ more NHS staff to diagnose cancer earlier.”

The report added: “More staff is needed to be upskilled, training these expanded responsibilities and to backfill the roles. Currently the shortages of oncologists are having an impact on our ability to deliver best practice and improve the service.

“In the future, we are likely to have shortages in most of the workforce. In order to implement the skills mix approaches more widely, national workforce planning bodies should look at how the UK can increase the number of pharmacists, therapeutic radiographers and clinical technologists. Alongside this, there is a need for a continued increase in training places for oncologists to take on the most specialised treatment techniques.”

In a survey as part of its work 43 per cent of respondents said they did not have patient facing time to deliver best practice care.

One director of cancer services told the charity: “Workforce planning? What workforce planning? We do the best with what we have, but we’re not able to plan ahead for future need.”

A head of radiotherapy added: “Without time to research and develop treatments, it will feel like the early 90s again, when we were really behind the rest of Europe and our techniques were out of date. [In those days] our outcomes were right at the bottom of the table”.