MORE than a quarter of patients who received an urgent suspect cancer referral (USC) in Scotland did not start treatment within the 62-day target set by the Scottish Government last year.

Analysis of the months in 2023 where Public Health Scotland data has been published reveals that one in four cancer patients (28%) were not being seen within 62 days of a referral.

The National found that over the last 10 years, the percentage of patients who do not start treatment within 62 days of a referral has steadily increased.

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The current targets for waiting times in Scotland are no more than 62 days between the date the hospital receives an urgent suspected cancer referral and the start of treatment, and no more than 31 days between the meeting at which a treatment plan is agreed and the start of treatment.

However between January and September of 2023, out of 13,153 eligible patients, 3719 (28%) waited more than 62 days to start treatment.

The target, which is met if 95% of patients receive treatment within 62 days of a referral, has not been met in Scotland since 2013.

The National:

The number of patients who received their first definitive treatment within 62 days is as follows:

  • 2013 – 95%
  • 2014 – 93%
  • 2015 – 91%
  • 2016 – 89%
  • 2017 – 87%
  • 2018 – 83%
  • 2019 – 83%
  • 2020 – 86%
  • 2021 – 83%
  • 2022 – 76%
  • 2023 – 72%

Data for October to December 2023 is not yet available. Analysis found that 31% of patients were still waiting to start treatment in the first quarter of 2023, compared to 26% in the second quarter and 28% in the third quarter.

NHS staff facing huge pressures

Dr Philippa Whitford (below), a former NHS breast cancer surgeon and now SNP MP for Central Ayrshire, spoke to The National about what the latest figures mean. 

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She pointed out that in the 62 days between a USC referral and the start of treatment, “patients’ feet don’t touch the ground”. 

“It’s 62 days until your first main treatment. That will include a clinical examination, scans, biopsy, a biopsy result, the team discussing the treatment, discussing the treatment with the patient, making a decision and then – as it’s often surgery first – finding an operating list,” Whitford told The National. 

“A lot of that time is not waiting; it’s actually just moving from one step to the other along the pathway.” 

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She added that there had been a 24.2% increase in the number of urgent referrals from December 2019, and attributed the declining number of patients being seen within the 62-day target to a backlog caused by the pandemic. 

“Staff are under huge pressure, and if you’re not taking that 24% increase into account then you’re ignoring the basic struggle that they face”. 

Whilst 72% of patients had started their first main treatment within 62 days in Scotland in 2023, in England this figure sits at 61.6%, and at 55% in Wales. 

Why is Scotland performing better than the UK?

“It’s not specifically down to the SNP, but it’s SNP policies,” Whitford told The National. 

“We still have a public NHS here in Scotland. To some extent it’s still the same in Wales, but in England the Health and Social Care Act 2012 broke everything up into competing trusts. 

“They don’t collaborate with each other. Cancer pathways are quite complex, you need a lot of collaboration if you’re going to build a smooth pathway around patients. 

“We also have a higher per capita ratio of GPs, of nurses, of consultants [than in England]. We pay higher, we’ve maintained that higher ratio of staff and beds than is the case in England. 

“While we are struggling, Scotland is still ahead because the system that’s been maintained by the Scottish Government is still a united public health system.” 

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Trade unions express concern

However, trade unions have been more critical, as Unite said the latest figures reflected a “national health emergency” in Scotland, and that staff were at “breaking point”. 

James O’Connell, Unite industrial officer, told The National: “The alarming data on cancer waiting times, which shows more than a quarter of patients are waiting longer than the 62-day target, continues to demonstrate the crisis the NHS in Scotland is currently experiencing. 

“It is a deeply worrying and anxious time for patients which is being exacerbated by a failure on the Scottish Government to invest in the NHS. 

“The situation regarding waiting times has got significantly worse over the last decade and Unite would describe it as a national health emergency.  

“The Scottish Government must provide a strategic plan backed by investment. If it continues to underfund the NHS and cut services then we fear the health of patients is being put at risk. 

“NHS staff are at breaking point across the whole service and it’s just not possible for them to give anymore.” 

Responding to the latest data, a Scottish Government spokesperson said:  “Cancer remains a national priority for the Scottish Government and we are treating almost 50% more patients on the 62-day cancer pathway than 10 years ago.   

“While the median wait from an urgent suspicion of cancer referral to treatment is 50 days, data shows that diagnostic pressures remain. 

“We published a 10-year cancer strategy in June 2023, focused on improving cancer survival and providing equitable access to treatment, including investing a further £10 million over the last year to support cancer waiting times and continue to redesign diagnostics services.” 

Cancer Research UK has also been approached for comment.