Government has ‘overseen years of decline in cancer and waiting times targets’

The NHS has not met the 18-week target for people to receive planned treatment such as hip and knee replacements in England since February 2016.

16 March 2022

The Department for Health and Social Care (DHSC) has “overseen years of decline” in the performance of NHS cancer and waiting times targets, MPs have said.

The cross-party Public Accounts Committee criticised the department and NHS England as it warned that the waiting list for treatment – currently 6.1m people – is likely to grow for the next few years while performance against targets will be “poor”.

The NHS has not met the 18-week target for people to receive planned treatment (such as hip and knee replacements) in England since February 2016, while the number of people waiting more than a year or two has grown.

The number having to wait more than 52 weeks to start treatment stood at 311,528 in January, up from 310,813 in the previous month and 2% higher than in January 2021.

A total of 23,778 people were also waiting more than two years to start hospital treatment at the end of January – around nine times the 2,608 people who were waiting longer than two years in April 2021.

The NHS has also not met, in totality, the eight key standards for cancer care since 2014. For example, the proportion of patients in England seeing a specialist within two weeks if their GP suspects they have cancer fell to its lowest level on record in January.

In their new report, MPs said that, even before the pandemic, DHSC and NHS England “did not increase capacity sufficiently to meet growing demand” and did not adequately tackle the growing workforce crisis in the NHS, with thousands more staff needed.

They also reiterated their belief that DHSC had “allowed NHS England to be selective about which standards it focused on, reducing accountability”.

Looking to the future, PAC raised concerns about how many people have yet to come forward for help after they stayed away during the pandemic.

As of September, there were between 7.6 million and 9.1 million missing referrals of patients for planned care and between 240,000 and 740,000 missing urgent referrals for suspected cancer.

MPs said people face serious health consequences as a result of delays in treatment, with some dying earlier and many living with pain or discomfort for longer.

They added: “The very large numbers of people who have not presented for healthcare, or were not able to obtain it, during the pandemic, as well as those who have already been on waiting lists for long periods of time present a huge risk to primary and emergency care services.

“This is because unmet health demand can result in more GP appointments and more medical emergencies as people try to manage or suffer the consequences of their conditions.”

Labour MP Dame Meg Hillier, chairwoman of the PAC, said: “DHSC has overseen a long-term decline in elective and critical cancer care that is dragging our national health service and the heroic staff down.

“We on PAC are now extremely concerned that there is no real plan to turn a large cash injection, for elective care and capital costs of dangerously crumbling facilities, into better outcomes for people waiting for life-saving or quality-of-life improving treatment.

“Nor is it obvious that the department finally understands that its biggest problem, and the only solution to all its problems, is the way it manages its greatest resource: our heroic NHS staff.

“Exhausted and demoralised, they’ve emerged from two hellish years only to face longer and longer lists of sicker people. And this is compounded by staffing shortages in a number of professional areas.

“The cycle of glib headlines and fiddling with management structures must be broken, with an overhauled ‘people plan’ that gets to the core of the desperate under-staffing and under-resourcing that have undermined our health system.”

Among its raft of recommendations, PAC said DHSC must hold NHS England to account, including “specific expectations for improving waiting time performance in 2022-23.”

A DHSC spokesman said: “The pandemic has put unprecedented pressures on healthcare and we are tackling this head on.

“We have set out our action plan to deal with the Covid backlog and deliver long-term recovery and reform, backed by a record multibillion-pound investment over the next three years, and our 10-year plan on cancer.

“We are clear that business as usual is not enough. That’s why we are delivering brand new surgical hubs and another 100 community diagnostic centres providing an extra nine million scans, checks and procedures by 2025 to make sure patients get the surgery they need and earlier access to tests, including for cancer.”

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