According to a recent report from the UK spending watchdog National Audit Office (NAO), 240,000 to 740,000 urgent referrals for suspected cancer were missed by general practitioners (GP) during the pandemic. This is because millions of patients have either avoided or have been unable to secure healthcare.
In addition, between March 2020 and September 2021, the number of patients starting treatment for cancer was 35,000 to 60,000 less than anticipated. The NAO estimated that there were 7.6 million to 9.1 million fewer referrals for elective care during this period.
The emergence of the COVID-19 pandemic saw the NHS utilizing most of its resources to treat COVID-19 patients.
“COVID-19 disruption was inevitably going to cause a sharp increase in waiting times and backlogs in a healthcare system that had been operating at very close to its maximum capacity,” states the report.
As of September 2021, the number of patients on the waiting list for electives was a record 5.83 million, up from 4.43 million in February 2020. Thirty-four percent or 1.59 million patients had been waiting for more than 18 weeks; 301,000 had been waiting for more than a year. The standard for elective care is for 92 percent of patients on the waiting list to begin treatment within 18 weeks of being recommended to a doctor.
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NHS cancer services had returned to pre-pandemic levels by June 2021. However, cancer patients who had been referred by their GP for immediate treatment faced delays; nearly 26 percent had to wait for more than 62 days. Out of the nine waiting time standards for cancer care, one states that 85 percent of patients should wait no longer than 62 days after an urgent referral by their GP.
When it comes to how many of the “missing” cases will return to the NHS for treatment, the authors of the report are unsure. It is estimated that if 50 percent of the missing referrals return to the NHS and its operations grow according to pre-pandemic plans, the elective care waiting list will be 12 million, or one in five people, by March 2025.
“We must never forget some of the actions taken in the past… have consequences beyond Covid… Whether it’s cancer, it’s heart disease, it’s mental health challenges, these are all huge issues that remain as important and sadly, we have gone backwards on all three of those things and probably more because of some of the measures that were taken,” Health Secretary Sajid Javid told talkRADIO when asked about the NAO estimates.
The NHS faces a daunting task when it comes to tackling backlogs and decreasing wait times. This year, £2 billion ($2.64 billion) has been allocated by the government to address the issue. Another £8 billion ($10.58 billion) over the next three years (2022-25) for funding cancer services and other procedures has also been sanctioned.
Eve Byrne, head of campaigns and public affairs, at Macmillan Cancer Support, told The Independent that the NAO report confirms what is usually heard “day in, day out” from people living with cancer.
“Chronic staffing shortages are already having a devastating impact on cancer patients, and we have major concerns that is only set to worsen without urgent action…Without these critical pieces of the puzzle, we risk increasing numbers of people facing later diagnoses, poorer care, and potentially worse chances of survival. This has to change,” Byrne stated.
Cancer is a disease that requires timely diagnosis and treatment as any delays significantly raise the risk of death. If GPs are led away from primary care to focus on the booster vaccination program in the UK, then the death toll due to delays in cancer diagnoses could surpass the number of COVID-19 deaths in the next few years.