ONCOLOGY
Professor Brain said: “Our survey suggests that nationally coordinated campaigns with clear messaging to inform the public that they will be contacted about screening – and to encourage them to consider taking part – are urgently needed. “We also need to continue to run
interventions to reduce non-COVID screening barriers among non-responders and to make sure the public is aware that screening services are open safely and explain what will happen at the appointment to minimise COVID-19 risk. “Lastly, we also need to ensure that there are enough healthcare staff to urgently deal with the screening backlog and ensure people who need further diagnostic tests receive them in a timely manner.”
State of cancer services According to the latest figures – cited by cancer charity, Macmillan – the number of people in England being seen by a specialist for suspected cancer following an urgent referral by their GP was 207,188 in May 2021 (Source: NHS England). This is higher than the pre-COVID-19 average, but slightly lower than in the previous month. The total number of people who have seen a specialist for suspected cancer since the pandemic began is still almost 300,000 lower (a drop of 10%) than expected.
The number of people in England starting treatment for cancer in May 2021 was 24,810. This is still lower than the pre- pandemic average and slightly lower than in the previous month, at a time when there is an urgent need to clear the backlog in treatment. In addition, the total number of people starting cancer treatment in England since the start of the pandemic is still more than 35,000 lower than expected. The data for May 2021 also includes the
We need to continue to run interventions to reduce non-COVID screening barriers among non-responders and to make sure the public is aware that screening services are open safely and explain what will happen at the appointment
to minimise COVID-19 risk. Professor Kate Brain, Cardiff University’s School of Medicine
second publication of new cancer waiting times data for England, showing how many people had a cancer diagnosis confirmed or ruled out within 28 days of an urgent referral. The future target of 75% was not met and the data shows more than 52,000 people had to wait for more than four weeks to find out whether or not they had cancer from their initial urgent referral In May 2021, there was also a record number of people who had waited for more than two months before they started cancer treatment following a referral from a NHS screening service. The total number of people starting cancer treatment following a referral from a screening service in England since the start of the pandemic is still 32% lower than expected.
The latest Macmillan analysis estimates the NHS in England would need to work at 110% capacity for 18 months to catch up on missing cancer diagnoses, and for 14 months to clear the cancer treatment backlog. Macmillan research shows more than a third (40%) of those receiving cancer treatment in the UK in the run-up to the December lockdown were worried that delays to their treatment could impact on their chances of survival.
Recovery: review of diagnostic services Professor Sir Mike Richards, chair of the Independent Review of Diagnostic Services for NHS England, previously published an important report on cancer diagnostics and the impact of COVID-19 on cancer services.4 In this review, he stated that the pandemic has exacerbated “pre-existing problems in diagnostics”.
The risk of infection to and from patients attending for diagnostic tests has slowed throughput in all aspects of diagnostics, but particularly in CT scanning and endoscopy. This is due to the need to deep clean equipment and facilities if a patient’s COVID-19 status is positive or unknown. He added that major expansion and reform of diagnostic services is needed over the next five years to facilitate recovery after the pandemic and to meet rising demand. New facilities and equipment will be needed, together with a significant increase in the diagnostic workforce, skill-mix initiatives and the establishment of new roles working across traditional boundaries. This expansion must start as soon as possible. In the meantime, use of independent sector facilities, where possible, should be maximised during the recovery phase. Alongside expansion, new service delivery models are urgently needed to ensure safe pathways to diagnosis for patients in a post-pandemic world and to drive efficiency in service delivery. The key recommendations of the review included: l New pathways to diagnosis should be established, with virtual consultations and community diagnostics promoted to keep visits to acute hospital sites to a minimum.
l New pathways should separate emergency/acute and elective diagnostics wherever possible to improve efficiency and reduce delays for patients.
l Emergency/acute diagnostic services should enable patients to be imaged in A&E without delay and for inpatients to be imaged or to undergo endoscopy on the day of request.
l Community diagnostic hubs should be rapidly established to provide COVID-19 minimal, highly productive elective
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