Health

Scotland’s cancer waiting times worst on record amid growing demand


One in 20 cancer patients in Scotland is waiting longer than 116 days to be diagnosed and start treatment, amid growing numbers of referrals.

The target stipulates that at least 95% of people diagnosed with cancer should wait no longer than 62 days between an urgent referral – for example by their GP, or due to a suspicious screening result – and the date they commence treatment.

One cancer patient waited more than 300 days from referral to treatment, amid growing demand for diagnostic testsSource: Public Health Scotland

However, the target has not been met nationally by NHS Scotland since 2012, and in the most recent quarter was achieved in only one health board area – NHS Borders.

Overall, one in 20 patients waited over 116 days, with one waiting 322 days.

Patients with prostate cancer or colorectal cancer detected as a result of bowel screening faced the longest delays, with only 51% and 35% respectively beginning treatment within 62 days of an urgent referral for diagnostic tests.

READ MORE: Can we really say the NHS is ‘in recovery’ from Covid? 

Kate Seymour, head of Advocacy for Macmillan Cancer Support in Scotland said waits for cancer treatment have “have drifted from bad, to worse, to dreadful” over the past three years.

She added: “Most health boards reported staffing and workforce issues as being the root cause of the delays.

“Scotland’s cancer strategy is set to be launched later next year, but cancer patients and over-stretched staff can’t wait that long. The crisis is already here and it needs to be resolved now, particularly as we approach winter when we’ll inevitably see even more pressure on the NHS.”

Health boards blamed a raft of issues for the delays, especially staff absences linked to Covid, sick leave and vacancies in radiology, theatre and pathology, as well as bed shortages. 

Demand on the system has also grown from pre-pandemic levels, with 4,072 eligible referrals in the three months covering April to June this year – up by 9.4% compared to the quarter ending December 2019.

One cancer patient waited more than 300 days from referral to treatment, amid growing demand for diagnostic testsAfter dipping during 2020, the number of people being referred and diagnosed with cancer is now exceeding pre-pandemic levels (Source: PHS)

Referrals fell during 2020 as screening programmes were paused and the numbers of people visiting GPs and A&E departments with symptoms declined, but have since rebounded – putting pressure on diagnostic pathways.

On average, NHS Scotland continues to meet the 31-day standard – that at least 95% of eligible patients should wait no longer than 31 days between a decision to treat and the start of treatment – indicating that the bottlenecks continue to be concentrated in the diagnostic stage.

However, four health boards – Grampian, Greater Glasgow and Clyde, Highland and Lothian – fell short, with Highland meeting the 31-day target for just 87% of patients.

NHSGGC said it is experiencing “Covid-related staffing issues across all specialties” and “significant pressure” due to an increase in cancer referrals from GPs compared to pre-pandemic levels. 

READ MORE: Prostate cancer hope as statins slow tumour growth in groundbreaking Glasgow study 

From tomorrow asymptomatic frontline healthcare staff will no longer be required to routinely test themselves for Covid once a week. 

The move is expected to alleviate NHS absences, but there are also concerns that it could lead to increased virus spread to patients in hospitals.

NHS Highland said a “lack of staffing availability” has impacted on breast cancer pathways, as well as on tumour types dependent on endoscopy for diagnosis.

NHS Lothian said Covid had “affected staffing across the board”, particularly in relation to theatre capacity but also diagnostics. 

Scottish Conservative Shadow Cabinet Secretary for Health Dr Sandesh Gulhane MSP, said Scotland was facing a “ticking timebomb” on cancer diagnoses delays.

He added: “We know that early diagnosis is crucial to patients’ survival chances, so it’s frightening and unacceptable that almost a quarter are not beginning treatment within 62 days of their first referral.

“The Health Secretary can’t hide behind the pandemic as an excuse for this failure because the target has not been met by the SNP in almost a decade.”

READ MORE: More than half of excess deaths in Scotland caused by non-Covid illnesses for first time since start of pandemic 

Scottish Labour Health spokeswoman Jackie Baillie said: “This is nothing short of catastrophic, but the SNP government are nowhere to be seen.

“Humza Yousaf’s dangerous incompetence has broken yet another grim record, despite the tireless efforts of dedicated NHS staff.”

A Scottish Government spokesman said: “The 31-day standard has been consistently met throughout the Covid-19 pandemic with a median wait of five days.

“Despite treating more patients on a 62-day pathway compared to pre-Covid this quarter, and with a median wait of 47 days, performance remains challenged overall and we must do more.

“Cancer remains a priority for NHS Scotland, but Covid has not gone away – pressures remain in diagnostic and treatment pathways. In August we released an additional £10 million of funding to boards to support recovery and redesign of cancer services focusing on the most challenged pathways and to reduce backlogs.”





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