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Two-week wait target to be scrapped under NHS England cancer proposals

two-week wait

The two-week wait cancer target could be scrapped under new standards being consulted on by NHS England.

The new standards would focus on the time between referral and diagnosis, rather than the time between referral and being seen by a specialist.

Currently, there are nine separate performance standards for different routes into the system, such as screening or GP referral. This includes the two-week wait standard between being referred by a GP and seen by a specialist.

But the new plan includes:

  • A 28-day faster diagnosis standard for those who have been urgently referred, have breast symptoms or who have been picked up through screening. They would have cancer ruled out or receive a diagnosis within 28 days;
  • A 62-day referral to treatment standard, where patients who receive a cancer diagnosis will start treatment within nine weeks from the date of referral;
  • A 31-day decision to treatment standard, where cancer patients receive their first treatment within a month of a decision to treat following diagnosis.

NHS England said the new plans aim to make timelines ‘easier to understand’ for patients and their families and ensure faster diagnosis and treatment for cancer.

The consultation on the new proposals opened last week and will run until 6 April.

Eleven NHS hospital trusts have tested the proposed new standard for diagnosis, including Mid Essex Hospital Services and Northampton General Hospital.

Across these pilots, the performance against the 62-day referral to treatment standard was higher (74.9%) than the control group (71.7%) when using the new measures.

NHS national director for cancer Dame Cally Palmer said: ‘Access standards have been key to improving timeliness of treatment for people with cancer since they were first introduced in 2000.

‘As we see advances in diagnosis and treatments for cancer, it is only right that these standards are modernised – so that we can ensure patients are diagnosed more quickly and are given the treatment they need as soon as possible, helping us save even more lives.’

Health secretary Sajid Javid added: ‘As part of our 10-Year cancer plan, we want to offer patients the best possible care and treatment.

‘These proposals will help us speed up diagnosis times and treatment, and save more lives.’

The proposals come in addition to the elective recovery plan targets published last month, which aimed for the number of people waiting more than 62 days from an urgent referral to return to pre-pandemic levels by March 2023.

It comes as a major Pulse survey revealed earlier this month that GPs are seeing a significant increase in breaches of the two-week wait cancer referral times, as well as the number of referrals being rejected or bounced back.

And the BMA has said it was given just ‘days’ notice of a major cancer drive that is set to increase GP workload when practice teams are ‘already saturated’.

Last month, the Government suggested that patients who think they may have cancer could be given the option to self-refer for investigation without the need for a GP referral.

Current cancer standards:

  1. Two-week wait: ‘Duty to make arrangements to provide an appointment with a specialist for those patients urgently referred for treatment for suspected cancer… within the period of 2 weeks beginning with the start date in not less than 93% of cases where that treatment is provided in that data collection period’, where treatment is defined as ‘assessment by a specialist in order to progress towards a diagnosis’
  2. A maximum one month (31-day) wait from diagnosis to first definitive treatment for all cancers
  3. A maximum 31-day wait for subsequent treatment where the treatment is surgery
  4. A maximum 31-day wait for subsequent treatment where the treatment is a course of radiotherapy
  5. A maximum 31-day wait for subsequent treatment where the treatment is an anti-cancer drug regimen
  6. A maximum two-month (62-day) wait from urgent referral for suspected cancer to first treatment for all cancers
  7. A maximum 62-day wait from referral from an NHS cancer screening service to first definitive treatment for cancer
  8. A maximum 62-day wait for first definitive treatment following a consultant’s decision to upgrade the priority of the patient (all cancers)
  9. A maximum two-week wait to see a specialist for all patients referred for investigation of breast symptoms, even if cancer is not initially suspected.

Sources: NHS Regulations and Handbook to the NHS Constitution

A version of this story was first published by Pulse’s sister title Healthcare Leader

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Iain Chalmers 14 March, 2022 6:28 pm

No “shit Sherlock”

Can’t make a vague attempt at making a fist of it then change the rules!

Couldn’t get NICE committee together quickly enough to re-write the rules, sorry guidelines, for you??

Patrufini Duffy 15 March, 2022 1:15 pm

28-62-31 all rolled on a dice at board meeting.

Vinci Ho 15 March, 2022 1:18 pm

Is this a recipe of chaos pending ?🤨😵‍💫🙄😈

paul cundy 15 March, 2022 3:29 pm

Breast symptoms, includes pain, known to be not a sign of breast cancer, so will these clinics now be overrun with young women and their mastalgic breasts?
Paul Cundy