More than one in five British cancer patients waits longer than two months to begin treatment after receiving a referral from a general practitioner. In Scotland, fewer than 80% of patients receive needed diagnostic tests -- endoscopies, MRIs, CT, scans and the like -- within three months.
Whilst I appreciate the topic of healthcare is hotly debated, it doesn't do well to post statistics without some background knowledge on how these targets and are set and measured.
One of the best examples of this is the cancer stats provided in your original post - aka the 1 in 5 patents waiting longer than 2 months for treatment stat.
From the last 2018 NHS performance figures (taking Feb 2018 as the example month), cancer referral to treatment times were as follows:
- 95.2% of people in February 2018 were seen by a specialist within two weeks of an urgent GP referral for suspected cancer. The operational standard specifies that 93% of patients should be seen within this time.
- 97.6% of patients in February 2018 received a first definitive treatment for a new primary cancer. The operational standard specifies that 96% of patients should be treated within this time (31 days).
- 81.0% of patients received a first definitive treatment for cancer following an urgent GP referral for suspected cancer within 62 days in February 2018, this equates to 9,004 patients being treated within the standard. The operational standard specifies that 85% of patients should be treated within this time.
https://www.england.nhs.uk/statisti...performance-statistics-summary-Feb_Mar-18.pdf
Now people may look at the 81% figure and target of 85% and think that is low, especially since the other two targets are in the mid 90s . This is largely due to how NHS referral and treatment times are assessed and monitored.
Essentially, once a patient is referred for suspected cancer treatment, their treatment 'clock' starts. This clock will remain 'ticking' under all circumstances unless a patient declines treatment or does not attend an appointment (in which case the 'clock' is 'paused' until they contact the hospital to re-arrange the appointment.
In the case of cancer patients, the clock will remain ticking even if a patient cancels multiple appointments, if they choose to delay treatment for a personal reason or if they are too unwell to begin a treatment regime. In those cases, if a patient chooses to take a once in a lifetime holiday before starting multiple rounds of chemo and surgery etc, they will be recorded as in breech of the target even though this was their own choice. They will also be recorded as in breech of the other two targets if they choose to delay diagnostic testing or whilst they go home to think about treatment options/seek second opinions etc.
The 85% target takes into account that the majority of patients with cancer are older and may not be in the best of health. Other complex healthcare issues they have may need stabilising or additional treatment before they are healthy enough to survive surgery/radiation/chemo. During this period, the clock that started from the GP referral is still ticking, even though the patient is undergoing medical intervention to make the suitable for cancer treatment.
One example would be:
- Dave is diagnosed with Renal Cancer
- He is in a lot of pain due to bone mets in his spine
- Dave and his doctor decide he should have surgery on his back to make him more comfortable before chemo
During this time, the clock is still ticking into a breech of target because it will only stop once Dave starts chemo for the renal cancer, even if the back surgery and subsequent recovery needs to come first.
This is absolutely not to say that some breeches don't happen for other reasons that ARE the hospitals fault - some hospitals perform far better than others in this regard. But the setting and monitoring of these targets is more complex than a simple '1 in 5 patients wait longer than 2 months for treatment' statement.
Here is a list of times when a 'pause' to the clock can and cant be applied:
• DNA of first appointment after referral resets the clock
• Patient choice pauses stop the clock for treatment
• No pause for diagnostics
• No pause for thinking time
• No pause for co-morbidities
• No pause for fertility treatment, menstruation or pregnancy
• No pause for religious requirements
• No pause for exceptional funding approval
• No pause for pandemic flu
• No pause for adverse weather
• No pause for hospital acquired infections
• No pause for a second opinion
