Scotland's cancer waiting times performance at record low

It comes after previous warnings that hospitals were reaching "breaking point" after Scotland's new bowel cancer home-testing kit contributed to a spike in referrals for diagnostic tests such as colonoscopies, amid a shortage of staff to cope with the increased demand.

Read more: Staff shortages blamed as half of patients wait too long for colonoscopies 

The figures emerged in a report revealing that Scotland's overall cancer waiting times performance fell to its worst on record, with only 81.4% of patients starting treatment within the 62 days of an urgent referral with a suspicion of cancer.

The target is 95%, but that has not been met for Scotland as a whole since the end of 2012 and only two health boards - Lanarkshire and Borders - achieved it in July to September this year.

The 31-day target, which measures how long patients wait between a decision to treat and their first cancer treatment, was achieved for the second quarter in a row, however.

On average, patients at this pointed waited just six days, indicating that delays are mainly hitting the diagnosis stage.

More people than ever are developing cancer as the population ages - incidence is up 8.4% in the past decade - but vacancies for radiologists, oncologists, and other key staff involved in diagnosis has led to bottlenecks.

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The roll-out in Scotland of the new faecal immunochemical test (FIT) in November last year has also increased participation in the bowel screening programme.

The new NHS test, posted to everyone aged 50-74, is more accurate and simpler to use because only one stool sample is needed, instead of the previous three.

The aim of the programme is to detect more cases of bowel cancer early, but it also has the effect of increasing workload for hospitals and generating more 'false positives' - potentially delaying the diagnosis of genuine cases.

In November, it emerged that more than 5000 patients a month in Scotland were waiting longer than six weeks for a colonoscopy, the test used to identify bowel cancer.

Claire Donaghy, head of Scotland for Bowel Cancer UK, said: "Insufficient endoscopy capacity has resulted in patients waiting longer for tests that can diagnose bowel cancer.

"As demand grows, it is crucial that health boards have the capacity to ensure patients are able to access diagnostic tests within the standard waiting period.

"Bowel Cancer UK is calling for the Scottish Government to publish their plan of action to tackle the growing endoscopy crisis in Scotland. Until this is done, this situation will only worsen and services will continue to struggle to provide high quality care."

Read more: Pledge to hit cancer waiting times target by 2021

Of the 172 patients who were referred for bowel cancer checks - and subsequently diagnosed with the disease - as a result of screening, only 39.5% waited 62 days or less between that initial referral and starting treatment.

ISD Scotland does not provide figures on how many people referred as a result of screening were given the all-clear.

In October, the Scottish Government announced an £850 million investment under its Waiting Times Improvement Plan, which aims to "substantially and sustainably improve NHS waiting times" for cancer diagnosis and treatment, outpatient appointments and day case procedures.

However, Health Secretary Jeane Freeman said the failure to meet the 62-day target across Scotland is "simply not good enough".

Ms Freeman said: "We are committed to significantly improving the experience of patients waiting to be seen or treated.

"I have been clear with Health Boards that achieving this will require a focused, intense programme of work that accelerates action that is already underway."

Gregor McNie, of Cancer Research UK, said: "Cancer services in Scotland are struggling to cope as every year more people are referred for diagnostic tests. Staff shortages remain a serious concern.

"Swift action from the Scottish Government is now needed to ensure there are enough staff in Scotland to deliver the vital tests people need."

Dr Grant Baxter, chair of the Standing Scottish Committee of the Royal College of Radiologists, said: “The cancer care system – all the way from the GPs who flag and refer suspected cases, through to the diagnostic teams who detect cancer and then on to the cancer centres who treat patients – is having to treat more-and-more patients with rationed workforce, equipment and support, when it urgently needs more capacity.

“Diagnostic radiologists are crucial to detecting cancer after an initial referral, but their full-time numbers have gone down in Scotland over the past five years due to chronic underinvestment. We simply don’t have enough radiologists to keep up with spotting cancer.

"Meanwhile, the clinical oncology teams who expertly plan and deliver cancer treatment are also under strain. Unless these clinical teams are better staffed and resourced, it’s hard to imagine cancer waiting time figures improving anytime soon.”