Cancer diagnosis services in the NHS are understaffed and underfunded, and will need a new injection of spending if they are to cope with mounting demand, the country’s leading cancer charity has said.
Experts at Cancer Research UK said they were “deeply concerned” with the state of cancer testing, maging and surveillance services within the NHS.
Two separate reports prepared for the charity have identified looming gaps between the likely increase in demand for such services from a growing and ageing population, and the capacity of the NHS to provide timely tests for thousands of patients.
In a rare intervention, the charity is now calling on the Chancellor, George Osborne, to increase funding for diagnostic services.
The chances of surviving cancer can be hugely increased if the disease is detected early, and speeding up diagnosis is the key goal of a new five year plan, set out by NHS England’s cancer taskforce in July, to improve national survival rates.
There were about 280,000 new cancer diagnoses in England in 2013, and that figure is expected to continue rising. Already demand appears to be outstripping capacity. A key government target – for 85 per cent of cancer patients to receive specialist treatment within 62 days of being referred for tests by their GP – has not been met for a year and a half.
In one of the reports, published on 6 September, the research agency 2020 Delivery says cancer diagnostic imaging activity has been growing at nearly 6 per cent a year for a decade. Demand for CT scans and MRI scans is expected to grow even faster in the future, by 9 per cent a year, the report says.
However, England and the wider UK have a concerning shortage of the professional staff – radiographers, radiologists and sonographers – required to run cancer imaging services. The Royal College of Radiologists reports that whereas Germany, Spain and France have, respectively, 92, 112 and 130 radiologists per million people, the UK has only 48.
The UK also has only nine CT and seven MRI scanners per million people – about half the capacity of Spain and less than Germany and France. Much of the UK’s imaging equipment is also out of date and will cost an estimated £215m to replace, according to Cancer Research UK.
A second report, into endoscopy services – an investigatory procedure in which a tube with a small camera attached is inserted into the body to help diagnose bowel, gastrointestinal, and oesophageal cancers – predicts that more than 750,000 more such procedures will need to be performed each year in the UK by 2020.
Sara Hiom, Cancer Research UK’s director for early diagnosis, said new GP referral guidelines from the National Institute of Health and Care Excellence (NICE) – aimed at lowering the threshold at which patients can be referred for tests for suspected cancer – would drive higher demand in the future.
“The state of NHS diagnostic services is deeply concerning,” she said. “There aren’t enough trained staff, they’re often reliant on outdated equipment and in many cases they’re already operating services seven days a week.
“GPs do not have the access they need and that means patients are waiting too long for tests,” Ms Hiom said. “This has to change if doctors are to diagnose more people with cancer earlier.”
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Sean Duffy, the national clinical director for cancer at NHS England, said: “The independent Cancer Taskforce report has highlighted the need for improvements in cancer diagnostics in order to save lives, and NHS England is working with others across the health service on how to deliver these recommendations.
“Catching more cancers early will ultimately mean more patients surviving and leading full lives. It is critical that patients spot symptoms early and GPs make sure they are sent for diagnostic tests quickly.”
A Department of Health spokesperson said: “We want the NHS to be the best in the world at helping people with cancer and we invested an extra £750m to improve treatment and early diagnosis in the last five years. Survival rates are at a record high and diagnostic activity across the NHS is up by around a third since 2010, but we know there is more to do.”
