Cancer 62 Day Patient Target List to include waiting list breakdown

Cancer 62 Day Patient Target List (CANPTL62)
NHS Digital

• The 'Cancer 62 Day Patient Target List' (CANPTL62) collection is a weekly snapshot which shows the number of patients on the cancer 62-day pathway, who are at risk of breaching the 62-day standard (two month/62-day wait from urgent GP referral to first definitive treatment). From the 23 November 2020, this collection has been remodelled to also include waiting list breakdown by suspected tumour groups 62-day screening, consultant upgrades and further granularity about the start of treatment.

Mortality due to cancer treatment delay: systematic review and meta-analysis

Mortality due to cancer treatment delay: systematic review and meta-analysis
BMJ 2020; 371 :m4087 16 October 2020

• Analysis of 34 studies of the association of cancer treatment delay and mortality concludes that "even a four week delay of cancer treatment is associated with increased mortality across surgical, systemic treatment, and radiotherapy indications for seven cancers." 

Abstract

Effect of delays in the 2-week-wait cancer referral pathway during the COVID-19 pandemic on cancer survival in the UK:

Effect of delays in the 2-week-wait cancer referral pathway during the COVID-19 pandemic on cancer survival in the UK: a modelling study
Lancet Oncol 2020 20 July 2020 https://doi.org/10.1016/S1470-2045(20)30392-2

• During the COVID-19 lockdown, referrals via the 2-week-wait urgent pathway for suspected cancer in England, UK, are reported to have decreased by up to 84%. This research examined the impact of different scenarios of lockdown-accumulated backlog in cancer referrals on cancer survival, and the impact on survival per referred patient due to delayed referral versus risk of death from nosocomial infection with severe acute respiratory syndrome coronavirus.

Abstract

Clinically-led Review of NHS Access Standards - progress report

Clinically-led Review of NHS Access Standards
NHS England 31 October 2019

• This is a progress report on the review of NHS access standards in urgent and emergency care, mental health services, cancer care and elective care. It
• 1. recaps on the proposed new standards in each of the four areas, the rationale for those proposals, and update on what we are finding through testing.
• 2. sets out the planned next steps in terms of continuing with testing and
• 3. outlines the timetable for making final recommendations and implementing any agreed new standards.
• "For urgent and emergency care, where the field testing has been running longer and will be able to conclude sooner, the intention is to support the NHS to implement any changes from 1 April 2020. For elective care and cancer, implementation is likely to be during mid 2020/21. In mental health, where completely new standards are being proposed, implementation will be to a longer timeframe, as testing is likely to continue in 2020/21 to ensure that the introduction of standards in these areas is sustainable. All timelines are subject to change and government agreement."

NHS waiting times for elective and cancer treatment

NHS waiting times for elective and cancer treatment
Public Accounts Committee 12 June 2019

• The PAC report highlights waiting time standards, the DHSC review of waiting times, the impact for patients of longer waits, bottlenecks in hospital capacity, factors which could affect plans to better manage elective care. 

The PAC findings:
1. The NHS is failing to meet key waiting times standards for cancer and elective care, and its performance continues to decline.
Recommendation: NHS England should set out, by December 2019, how, and by when, it will ensure that waiting times standards for elective and cancer care will be delivered again.

2. The Department of Health & Social Care has allowed NHS England to be selective about which standards it focuses on, reducing accountability
Recommendation: The Department of Health & Social Care and NHS England should clarify to the Committee by December 2019:
• how NHS England will be held accountable for achieving waiting times standards now and in the future; and
• what additional support NHS England and NHS Improvement will put in place to help local NHS bodies to meet waiting times standards.

3. We are concerned that NHS England’s review of waiting times will not be enough to ensure a clear understanding of, and strong accountability over, the performance of the NHS.
Recommendation: The Department of Health & Social Care should ensure that any changes to current waiting times standards:
• help to improve patient outcomes and patient experiences;
• do not water down current standards to make them easier to meet; and
• are communicated clearly to the public, so that patients understand what they can expect of the NHS.

4. The national health bodies lack curiosity about the impact for patients of longer waits and how often this leads to patient harm.
Recommendation: The Department of Health & Social Care, together with NHS England and NHS Improvement, should write to us by December 2019 on how they are going to ensure that the data on patient harm due to long waiting times are going to be routinely collected, reported and acted upon.

5. Bottlenecks in hospital capacity are having a detrimental impact on how long patients wait for treatment.
Recommendation: NHS England and NHS Improvement should evaluate and report back to the Committee on how the NHS plans to ensure that it has the required diagnostic and bed capacity to meet patient demand in the medium to long term. They should also set out, in the short term, how they will support local bodies to improve their patient flow through the health system and reduce unwarranted variation

6. The NHS still does not understand sufficiently what is driving demand for referrals for elective treatment.
Recommendation: As we recommended in March 2019, NHS England and NHS Improvement should, by September 2019, write to us to set out how they will help local bodies to better understand the demand for care, and to plan their services accordingly to better meet the needs of their local patients

7. NHS England has not yet identified how it will manage the variety of factors that could affect the success of its plans to better manage elective care.
Recommendation: The Department, NHS Improvement and NHS England should, by December 2019, clarify to us: • How they are going to develop a fit-for-purpose workforce to ensure that the ambition to reduce face-to-face appointment by one-third is going to be achieved. • How they are going to ensure access to care is maintained if the number of outpatient appointments is not reduced as planned.

Summary

NHS waiting times for elective and cancer treatment

NHS waiting times for elective and cancer treatment
NAO 22 March 2019

• This review presents data on the NHS’s performance against current waiting times standards for elective and cancer care in England, and some of the factors associated with that performance.
• " It is hard to see how the NHS will be able to recover its position on waiting times in the near future without significant investment in staffing and infrastructure."

Report conclusions

Operating theatres: opportunities to reduce waiting lists

Operating theatres: opportunities to reduce waiting lists
NHS Improvement 4 February 2019

• This report looks at unwarranted variation in theatre productivity and ways to improve how care is delivered in England
• The work, by Deloitte, found that hospitals could carry out over 291,000 more routine operations, like hip replacements and cataract surgeries, a year by improving how they schedule their surgical lists. 

About the findings: