Cancer workforce shortages ‘jeopardising’ early diagnosis for patients

In a new report published today, the Health and Social Care Committee has laid out its concerns around the damaging impact that staff shortages and the coronavirus pandemic are having on cancer care in England.

“There appears to be no detailed plan to address such shortages which threaten diagnosis, treatment and research equally”

Postponement

The cross-party group of MPs claimed there has been a lack of “serious effort” from the government to resolve staffing gaps within these services and once again stressed the need for a detailed workforce plan to address the situation.

These concerns are based on the findings of the committee’s inquiry, launched in September 2021, to examine why cancer outcomes in England continue to fall behind many countries with comparable health systems.

According to the report, cancer survival rates in England have improved “significantly over the past half century” but are still behind that of other countries.

It warned how 58.9% of people in England diagnosed with colon cancer will live for five years or more, compared with 66.8% in Canada and 70.8% in Australia.

Meanwhile, 20.8% of people diagnosed with stomach cancer in England will live for five years or more, compared to 29.8% in Canada and 32.8% in Australia.

“When it comes to other cancer types, such as breast cancer, the gap has shrunk but for many others including lung cancer, pancreatic cancer and liver cancer it remains stubbornly high,” the report added.

“Earlier cancer diagnosis is the key to improving overall survival rates, however progress is being jeopardized by staff shortages”

jeremy hunt

Key to improving cancer survival rates was earlier diagnosis, the report claimed.

However, after considering evidence from the government and the NHS, the committee concluded that the health service was not on track to meet its ambition of seeing 75% of people with cancer diagnosed at an early stage by 2028.

Concerningly, it warned that without progress, more than 340,000 people between 2019 and 2028 will miss out on an early cancer diagnosis.

Critical to improving earlier diagnosis was addressing staffing gaps, the report claimed.

“Neither earlier diagnosis nor additional prompt cancer treatment would be possible without addressing gaps in the cancer workforce and we found little evidence of serious effort to do this,” it said.

Recognizing the “key role” cancer nurse specialists, the committee highlighted data which suggests the NHS in England will be short of 3,371 of these nurses by 2030. This was an “100% increase” on the current number of cancer nurse specialists in post.

Meanwhile, the health service is also estimated to be short of 189 full-time equivalent (FTE) clinical oncologists, 390 FTE consultant pathologists and 1,939 FTE radiologists.

“There appears to be no detailed plan to address such shortages which threaten diagnosis, treatment and research equally,” stressed the report.

Also of concern to the committee was the negative impact of the coronavirus pandemic on cancer services, noting that 36,000 fewer people in England began cancer treatment during the pandemic compared to previous years.

Meanwhile, those informing the inquiry had described to the committee how they had to “ration treatment”.

jeremy hunt

The effect of Covid-19 continues to be felt in cancer services, and the most recent Omicron wave of infections saw more cancellations of vital treatments, noted the report.

This indicated the “NHS is still not able to access sufficient Covid-free treatment capacity to safeguard treatments and address the backlog”, it added.

“Without significant additional efforts we conclude there is a real risk that the gains in cancer survival will reverse,” it said.

The report offers a list of key recommendations to the Department of Health and Social Care and NHS England, including the development of a specific plan to address workforce shortages among diagnostic services, as well as both short-term and long-term shortages in key professions among all cancer care. Such a plan should also include the level of investment required to deliver sustainable long-term increases, said the committee.

It also called for actions to ensure that backlogs created by the pandemic were addressed, including analysis of the extent of the cancer backlog and estimates of the additional capacity needed in NHS cancer services by March 2023.

Health and Social Care Committee chair Jeremy Hunt said: “Earlier cancer diagnosis is the key to improving overall survival rates, however progress is being jeopardized by staff shortages which threaten both diagnosis and treatment.

“We are further concerned at the damaging and prolonged impact of the pandemic on cancer services with a real risk that gains made in cancer survival will go into reverse.”

Mr Hunt reiterated that the committee was “calling on the government and the NHS to act now to address gaps in the cancer workforce upon which success depends”.

Carol Popplestone

“To date we have found little evidence of a serious effort to do so,” he added.

Responding to the report, Royal College of Nursing chair of council and cancer nurse specialist, Carol Popplestone, said: “The committee hits the nail on the head when it says there is no detailed plan to address the shortage of the specialist nurses needed in health and care.

“Investment is vital to ensuring more nursing staff are supported to train as cancer nurse specialists, they are key to treatment being available as quickly as possible.”

Meanwhile, Minesh Patel, head of policy at Macmillan Cancer Support, said: “This report sounds the alarm to government, loud and clear, about the severe staff shortages within the NHS and sheer lack of realistic targets in place to fill the gaps.

“Hard working NHS staff were at breaking point even before the pandemic, with cancer nurses continuing to work under immense strain in a system that has never recovered.

“This is causing huge anxiety for people living with cancer, who aren’t getting the tailored and quality care they need, and face long waits for their treatment, potentially worsening their prognosis.”

In response to the report, a Department of Health and Social Care spokesperson pointed towards the development of its “10-year cancer plan” which aims to “set out how we will lead the world in cancer care”.

They claimed there were “record numbers of nurses and staff overall working in the NHS” which would help to reduce backlogs caused by the pandemic and reduce waiting times for cancer patients, and added that up to 160 community diagnostic centers would be placed across the country by 2025.

An NHS England spokesperson said: “Cancer is a priority for the NHS and has been throughout the pandemic – and we have continued to implement new ways to diagnose cancer earlier, including extending lung health checks in supermarket car parks, rolling out awareness campaigns to encourage people to get symptoms checked sooner, and trialling innovations like a blood test to detect more than 50 types of cancer before symptoms even appear.”

They said referrals for cancer checks had been “at record highs for the last 11 months – with more than 567,000 people starting cancer treatment since the start of the pandemic”.

They also pointed to the elective recovery plan, which sets out how the government and NHS England aim to tackle growing waiting lists for elective care.

The spokesperson said £3.8bn of investment into increased treatment and diagnostic capacity through this plan aimed to “ensure that we are catching and treating more cancers at an early stage and saving even more lives”.