NHS CANCER SERVICES ‘Worst winter crisis ever’

Marchers on a demonstration to defend the NHS – cancer services have been severely cut and privatised under the Tory government

NHS CANCER services plunged into the worst winter on record as patients were left waiting weeks for treatment, warns a new BMA report

Doctors’ leaders have warned that thousands of cancer patients were left waiting weeks for treatment this winter according to the NHS’s own data.

New BMA analysis also revealed that other key parts of hospital care in England missed critical targets by the largest margin on record.

Writing separately for the BMA, an anonymous emergency care doctor describes wards ‘bursting with patients awaiting beds’ and how ‘when a critically ill patient arrives now I’m not sure where I’ll put them’.

The new BMA analysis, NHS Pressures – Winter 2018/19: A Hidden Crisis, uses NHS England figures to examine the performance of the NHS during recent winters and over the long term. Key findings include:

Cancer treatment services

  • Almost a quarter of cancer patients had to wait more than two months for their first treatment after an urgent referral by a GP, with only 76.2 per cent being seen within the 62 days; well below the 85 per cent target. This is the worst performance on record. Overall, 6,240 people were waiting beyond the target, a 39 per cent rise on last year.
  • The number of people waiting to see a cancer specialist for more than 21 days rose to a historic high of 8,820, up from 5,099 last winter; an increase of 73 per cent.
  • Between January and February 2019, the NHS failed to meet its target of 93 per cent of patients being seen by a cancer specialist within two weeks of referral for the first time in a winter period, registering 92.5 per cent. The NHS has now missed the two-week target for nine of the last twelve months.
  • The number of patients needing help rose by 17 per cent.
  • Overall, more than a third (36 per cent) of NHS providers missed the two-week target in January 2019, up 15 percentage points on the same period last year.

Emergency care

  • A record 6.2 million patients visited major emergency care departments this winter.
  • Almost one in four patients were left waiting more than four hours to be seen at major emergency care units and 214,000 were left on trolleys waiting more than four hours to be seen after being admitted. This is the second worst performance quarter on record.
  • Overall, 85.1 per cent of patients were seen within the four-hour target, only 0.1 per cent better than the worst figures on record last winter.
  • February 2019 was the single worst month since records began with only 75.7 per cent of patients at major accident and emergency departments being seen within the required target time.

Hospital care

  • The total number of patients waiting for operations and further care rose to a record 4.3 million in February 2019 with the average wait for an operation now at close to seven weeks.
  • Between 3rd December 2018 and 3rd March 2019, 93 per cent of beds in the NHS were occupied, only marginally down from last year. The NHS itself has said that bed occupancy above 92 per cent results in a serious negative impact on patient care.

BMA council chair, Dr Chaand Nagpaul, said:

‘Behind these statistics, which show the NHS plunged deeper into crisis this winter, are stories of real lives in distress.

‘Forcing a patient to wait two months for their first cancer treatment is shameful for a leading nation and as a doctor, I can imagine only too well the distress this will cause to them and their families.

‘It also places stress on the clinicians who treat them as they are well aware that the cancer may have worsened during the delay between referral and treatment.

‘The government needs to realise that the crisis in the NHS is not going away as our health service struggles in an underfunded and understaffed environment against a backdrop of rising patient demand.

‘We need urgently to ensure that the NHS is provided with the 10,000 extra beds it needs and that funding is brought up to levels enjoyed by other leading Western European countries, a target that will not be reached under the government’s recently announced Long Term Plan for the NHS.’

BMA patient liaison group chair, Amanda Cool, said:

‘When a patient receives a cancer diagnosis it is devastating.

‘What that individual needs is rapid, urgent assessment to ensure they get the treatment they need. These latest figures show that thousands of patients are being left in limbo and that the NHS is now missing its own targets across the board.

‘The government needs to urgently examine why this is happening and put in place measures that gives patients the high level of care they deserve.’

  • Responding to the launch of the RCGP’s ‘tech manifesto’, Dr Farah Jameel, BMA GP committee executive team, IT lead, said:

‘Ensuring NHS IT systems and infrastructure are fit for purpose is fundamental for improving patient care and increasing productivity, and advances in technology have the potential to transform the lives of both healthcare staff and patients.

‘As the RCGP points out, we must walk before we can run, and getting the basics right must be the priority ahead of any promised ‘digital revolution’.

‘The College’s manifesto echoes what the BMA has been saying for some years about IT in general practice, and across the health service.

‘A recent survey of BMA members found that a quarter felt that IT systems at their place of work are not fit for purpose, with over half reporting that the current IT infrastructure significantly increases their day-to-day workload.

‘It is crucial, therefore, that the starting point is to address the serious deficiencies in the current system, which result in additional workload and stress, and can put patient safety at risk.

‘To this end, the BMA wrote to the Health and Social Care Secretary earlier this month outlining our own recommendations for IT in the NHS.

‘Basic hardware must be upgraded to meet a national standards, while patient experience and staff education and training must all be considered as key factors for achieving digital transformation.

‘As part of this year’s GP contract deal, GPC negotiated important digital commitments, ensuring improvements to the current GP IT estate and fully-resourced IT infrastructure that is both fit for purpose and for the future, aligning with national ambitions towards digital-first primary care.

‘Only when systems can seamlessly communicate, be these in GP practices, hospitals or other settings, can we have a truly interoperable NHS and fully embrace a collaborative way of working to improve the lives of both staff and their patients.’