Delays worsening for cancer treatment

Radiologists say it's down to a lack of staff

Author: Jon BurkePublished 8th Jun 2023

Radiology leaders are warning cancer patients face worsening NHS delays and the prospect of more gruelling treatment, due to too few staff.

A poll of all 60 directors of the UK's cancer centres by the Royal College of Radiologists (RCR) found 95% felt staff shortages were leading to longer waiting times for appointments and delays in treatment.

Some 88% were concerned about shortages impacting the quality of patient care, with the RCR warning that for every four-week delay to cancer treatment, the risk of death increased by around 10%.

Half of services surveyed reported "frequent delays" in patients starting radiotherapy, occurring every month or most months, while in one-in-five (22%) centres, this was happening most weeks or every week.

'Difficult decisions about who to prioritise'

The RCR warned that staff shortages meant people were waiting longer than necessary to start chemotherapy or radiotherapy, while some doctors were now having to make "difficult decisions" about who to prioritise and were having to send patients to different hospitals.

According to one head of service, prostate radiotherapy patients in their area were facing a three-month minimum wait to receive treatment, while breast cancer patients had a seven to eight-week wait.

Staff shortages also meant costly medical devices, including linear accelerator (LINAC) machines for radiation, were forced to be switched off due to a lack of staff able to operate them, the RCR said.

Its new report stated that the UK had a 15% shortfall of clinical oncologists but, by 2027, this figure would rise to 25%.

Over the next five years, one-in-five clinical oncologists were expected to retire, and more than half (54%) of current clinical oncology vacancies had been open for over a year, it added.

Meanwhile, the proportion of more expensive locum staff now being used had grown from 4% to 8% in the last two years.

The RCR has published two reports today, one looking specifically at cancer care and the other at the clinical radiology workforce.

In the second report, 80% of directors surveyed said they believed a shortage in the number of interventional radiology consultants was causing patients to receive more invasive treatment.

In 97% of centres, patient treatment had been delayed because of staff shortages over the past year, while in about half of centres, shortages were causing delays almost every month, the RCR audit found.

Some 90% of those surveyed thought workforce shortages would impact patient safety and only one-in-four said they had enough staff to deliver safe and effective patient care.

Some 52% of trusts could provide adequate 24/7 interventional radiology services, the report said.

The RCR warned that across the UK, there were 4,745 whole-time-equivalent radiologists working in the NHS and the consultant workforce had a 29% shortfall.

It said there was a "ticking timebomb", adding: "Without action, there will be a 40% shortfall of radiologists by 2027."

Most consultants who left in 2022 were aged under 60, with many people suffering burnout, according to the RCR.

Furthermore, new Community Diagnostic Centres (CDCs) set up by the NHS had increased the workload on already stretched staff.

RCR president, Dr Katharine Halliday, said: "There are simply not enough doctors to safely treat the volume of patients needed, and this will only worsen as demand rises and more doctors leave the NHS.

"Action from the Government is now critical. We must train more doctors, while doing more to retain the ones we have. There is no luxury of time: doctors are stretched, stressed, and scared for their patients."

'Under-funding and poor planning responsible for lack of staff and equipment'

Chief executive of Cancer Research UK, Michelle Mitchell, said: "Due to under funding and poor planning from governments across the UK, there isn't enough staff or equipment to diagnose and treat cancer in a timely way.

"We urge political leaders in all UK nations to act now to address chronic staffing issues and unacceptable waiting times across the NHS.

"Without long-term and strategic planning matched with sufficient investment, it will continue to be difficult for people to benefit quickly from life-saving cancer checks and treatment."

Head of policy at Macmillan Cancer Support, Minesh Patel, said: "Macmillan and the Royal College of Radiologists have been sounding the alarm about the devastating impact of staffing shortages on delays to diagnosis and treatment for years now, but the crisis continues to be brushed aside by governments.

"At the heart of this crisis is a failure to recruit and retain enough specialist cancer professionals."

Chief executive of Breast Cancer Now, Baroness Delyth Morgan, said: "Today's report is the starkest warning yet that the Government's failure to tackle the crisis facing the cancer workforce, risks pushing cancer diagnosis and treatment to the brink of disaster."

A Department of Health and Social Care spokeswoman said: "There are more doctors, nurses and staff working in the NHS than ever before, with 50% more specialist cancer doctors treating patients now compared to 2010.

"The NHS is also seeing, treating and saving record numbers of people with cancer but we know there is more to do.

"That is why we are seeking views on our Major Conditions Strategy and the NHS will soon be publishing a long-term workforce plan setting out how it will recruit and retain even more staff."

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