Cancer waiting times Scotland: Why are targets being missed?

Just 72% of cancer patients who started treatment in the three months to the end of September this year had done so within 62 days of an urgent referral for diagnostic tests.

The target is 95% and applies equally to patients referred as a result of symptoms or routine screening, but it has not been met nationally since 2012.

It was missed by every health board in the latest quarter, but was lowest - at 57% - in Grampian.

The 62-day target for cancer has not been met for more than a decade (Image: PHS)

The 31-day target - which stipulates that, once diagnosed, 95% of cancer patients should start treatment with 31 days of a referral for treatment - dipped to 94.9% overall, but was missed by four health boards: Fife, Greater Glasgow and Clyde, Lothian, and Grampian.

NHS Ayrshire and Arran reported that there had been "several issues" with its MRI scanner at Crosshouse hospital resulting in "multiple pauses in service", while NHS Fife said that a "theatre capacity issue" due to its new surgical robot had "resulted in increased waits" for cancer patients.

In NHS Greater Glasgow and Clyde, a flooding incident at its Beatson cancer centre put its PET scanner temporarily out of action - resulting in backlogs - while there was disruption to pathology in Grampian when a roof leak forced the mass relocation of staff.

Several health boards - including Forth Valley and Dumfries and Galloway - reported that their existing CT scanning capacity is unable to meet demand and have submitted business cases for a second and third machine respectively.

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Public Health Scotland added that "many boards have highlighted that staffing issues combined with a high number of referrals continue to limit capacity and impact on performance in the latest quarter".

NHS GGC said it was experiencing workforce challenges "across all specialties", while NHS Lothian reported "ongoing staffing issues related to theatres" and "difficulty recruiting" a lead nurse for its bowel screening service following a retirement.

Meanwhile, NHS Highland said that a "reliance upon single-handed clinicians in key specialties" was impacting on its cancer performance, adding that this was "more challenging in the light of a continued increase in referrals".

Between July and September this year, a total of 4,624 people referred for tests turned out to have cancer - equivalent to a record 101 cases per 100,000 people aged 16 and over.

This is up from 82 per 100,000 in the final quarter of 2019.

An ageing population means the incidence is projected to keep on increasing, piling pressure on NHS resources.

Eligible referrals relate to the number of people sent for diagnostic testing who turn out to have cancer. This will continue increasing due largely to an ageing population, but many more will also be referred for tests who are not ultimately diagnosed with cancer, putting pressure on diagnostic pathways (Image: PHS)

Kate Seymour, head of advocacy in Scotland for Macmillan Cancer Support said the waiting times were "simply unacceptable".

She added: "Today’s figures show that every health board in Scotland is feeling the impact from a struggling workforce, due to exhaustion and staff reaching retirement age.

"The knock-on effect of this is people living with cancer suffering needlessly, awaiting treatment and diagnosis.

"With a ten-year strategy now in place, it is critical that our cancer system is able to cope with today’s increasing pressures and the future demands of an ageing population.

"We need to ensure that every person diagnosed with cancer receives their treatment quicker, has access to the right information and is given the high-quality care they deserve."

Waiting times also varied markedly by cancer type. Just 36% of men with prostate cancer went from referral-to-treatment within 62 days in a sign of pressures on urology pathways, where several health boards reported staffing shortages. 

Prostate cancer had the lowest compliance against the 62-day standard, at 36.4 per cent (Image: PHS)

Scottish Conservative shadow health secretary Dr Sandesh Gulhane MSP said: “These figures are truly terrifying.

"It is appalling that well over a quarter of cancer patients didn’t start treatment for over two months after they were diagnosed.

“Everyone knows somebody who has been diagnosed with cancer and starting treatment as quickly as possible is crucial to patients’ chances of survival, yet no NHS board in Scotland is meeting this target.

“The discredited and distracted SNP health secretary Michael Matheson cannot hide behind the Covid pandemic for these missed targets. Successive SNP health secretaries have not met it for over a decade.”

A Scottish Government spokeswoman, said: “While the median wait from an urgent suspicion of cancer referral to treatment is 50 days, and around 700 more cancer patients were treated this quarter compared to pre-Covid, today’s data shows that diagnostic pressures remain.

“The Scottish Government has invested a further £10 million this year to support cancer waiting times and continue to redesign diagnostics services - developing optimal cancer diagnostic pathways, testing the role of [Artificial Intelligence] and delivering Rapid Cancer Diagnostic Services.”