This site is intended for health professionals only

Two-week wait officially scrapped under simplified cancer targets

Two-week wait officially scrapped under simplified cancer targets

The scrapping of the two-week cancer target will lead to faster diagnosis and treatment, NHS England has said in its formal announcement of the changes, which had been expected this week.

Ten current cancer performance standards will be replaced by three measures including the faster diagnosis target for 28 days from urgent referral to a diagnosis or exclusion of cancer that has been in place since April 2021.

The ‘consolidation’ of the standards has followed rigorous consultation and engagement, the Government said and will mean thousands of people who are referred for urgent checks every month will be diagnosed and treated sooner.

Under the new targets, it will be expected that:

  • Patients who have been urgently referred by their GP, have breast cancer symptoms, or have been picked up through screening should have a diagnosis (or have their cancer ruled out) within 28 days; 
  • Patients who receive a cancer diagnosis should start their treatment within 62 days from GP referral;
  • Patients should start first treatment within 31 days of receiving a cancer diagnosis and decision to treat.

NHS providers will also be expected to ensure 75% of patients are diagnosed or have cancer ruled out within 28 days of a referral with standards moving to 80% in 2025/26.

Hospitals have also been asked to aim for a 10-day turnaround when delivering diagnostic test results to patients urgently referred for suspected cancer.

Recommendations to scrap the two-week wait were first made by the Independent Cancer Taskforce in 2015.

In its consultation, NHS England said the two-week wait target ‘sets no expectation of when patients should receive test results or actually get a confirmed diagnosis’. 

GPs will still refer people with suspected cancer in the same way but the focus will be on getting a diagnosis or having the all-clear within 28 days rather than simply getting a first appointment.

It will also support new ways of testing where patients do not need an appointment first, such as straight to test pathways, teledermatology and uses of AI, NHS England said.

Labour pointed out that hundreds of thousands of cancer patients were already waiting longer than current NHS standards and the faster 28-day standard had never been met.

Their analysis showed that from October 2022 to June 2023, 623,000 patients waiting longer than 28 days for a diagnosis or to be told they did not have cancer – a total of three in every 10 patients.

Wes Streeting MP, Labour’s shadow health secretary, said: ‘Cancer patients are left waiting dangerously long for diagnosis and treatment.

‘Since Rishi Sunak became Prime Minister, hundreds of thousands of patients have been let down. Now he’s moving the goalposts and cutting standards for patients, when he should be cutting waiting times instead.’

NHS England medical director Professor Sir Stephen Powis said the NHS was already catching more cancers at an earlier stage.

‘The updated ambitions will mean the NHS can be even more focused on outcomes for patients, rather than just appointment times and it’s yet another of example of the NHS bringing cancer care into the modern era of care.’

Health minister Will Quince added: ‘The biggest factor in people surviving cancer is the stage at which they are diagnosed.

‘We have listened to the advice from clinical experts and NHS England to reform cancer standards which will speed up diagnosis for patients.’

He added that thanks to the hard work of NHS staff, record numbers of cancer checks were being done with almost three million people receiving care in the past year.

The streamlined standards have been broadly welcomed by cancer charities and medical colleges as meaningful to patients and a clear way to measure performance.

Dr Richard Roope, cancer advisor for the RCGP, said: ‘The changes in the NHS England cancer standards will simplify the monitoring of the time taken to reach a cancer diagnosis and starting of treatment for those diagnosed with cancer. 

‘These changes reflect the increasing variety of routes to investigations, which include “straight to test”.’ 

He added: ‘The changes also reflect what matters to patients and their families – the outcomes, rather than measuring the process, which has been the case previously.’

Earier this week, health secretary Steve Barclay confirmed that plans for patients to bypass the GP and directly access some diagnostic tests for suspected cancer are being considered.


Visit Pulse Reference for details on 140 symptoms, including easily searchable symptoms and categories, offering you a free platform to check symptoms and receive potential diagnoses during consultations.