NHS seeks views on proposed new standards for cancer

The NHS is launching a consultation on proposed new standards that will help diagnose more cancers earlier and save more lives

Developed with clinical leaders, the proposals – supported by NHS staff as well as patient groups and cancer charities – aim to simplify and update cancer standards, based on the recommendations of the Independent Cancer Taskforce.

Patients, clinicians and the public will be asked to share their views on the proposed standards over the next month, with a report setting out the changes published today.

Cancer currently has a complex set of nine separate performance standards, with different targets covering different routes into the system, for example, screening or a GP referral.

The new plan proposes ensuring patients have the same opportunity for faster diagnosis and treatment, including:

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

These new standards aim to make diagnosis and treatment timelines easier to understand for people with suspected cancer and their families, while also helping to diagnose cancers earlier and save more lives.

Before the faster diagnosis standard was introduced, access standards for cancer have remained unchanged since 2009. The current two week wait target sets no expectation of when patients should receive test results or actually get a confirmed diagnosis.

Cancer care has been prioritised throughout the pandemic with latest data showing the number of people getting checked for cancer increased by over half a million (512,110) in one year between December 2020 and December 2021.

In December alone, there were over 215,000 urgent referrals for cancer and more than nine out of 10 people started treatment within one month.

Dame Cally Palmer, NHS National Director for Cancer 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.

“These proposed changes are an important part of improving cancer care and so from today, the NHS will be inviting views from patients, staff and the public”.

Professor Peter Johnson, National Clinical Director for Cancer for NHS England, said: “We know that people having tests for possible cancer want to know the results quickly, and updating the standards to reflect this will help us to make sure we are able to deliver the best possible care.

“We are encouraging colleagues in NHS cancer services to share their views on the consultation to ensure we have standards that are better for people with cancer”.

Health and Social Care Secretary, Sajid Javid said: “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 NHS wants to hear from as many people as possible – and is seeking advice from patients, staff and the public. Please, make your voices heard”.

Under the new proposals, the NHS would focus on the time from referral to people finding out their results within a maximum of 28 days. This faster diagnosis standard has a clearer focus on measuring and incentivising early diagnosis, rather than just time to first be seen.

Areas where the new standards have been tested have shown that performance against the 62-day referral to treatment standard was significantly higher (74.9%) than the control group (71.7%) when using the new measures.

Proposals are in addition to the target announced in the elective recovery plan, published last month, which outlined the NHS aim to return the number of people waiting more than 62 days from an urgent referral back to pre-pandemic levels by March 2023.

Catherine Harper-Wynne, Chair of the Breast Cancer Faster Diagnosis Group, said: “The proposed update in standards provides a better reflection of our current clinical approach and allows for greater flexibility to offer patients the most efficient route to diagnosis, allowing us to start treatment as quickly as possible. For breast cancer patients, there is evidence, from the pilot already completed, that a higher proportion of patients had cancer ruled out within 28 days”.

Jane Lyons, CEO of charity Cancer52, said: “People with rare and less common cancers often have vague symptoms and it can take longer for their cancer to be diagnosed. So a commitment to a diagnosis in 28 days for all cancers, including those that are more challenging to diagnose, is a good step forward. Earlier diagnosis can mean more people start treatment sooner and more lives will be saved, and we support work to help the NHS meet its ambitions to diagnose more cancers faster and earlier”.

Patients have told the NHS that the focus on achieving a rapid diagnosis or ruling out of cancer is the right one, and is more meaningful to patients than the timing of a first appointment.

Anyone wishing to submit their views to the consultation can do so on our website or by email to england.reviewofstandards@nhs.net.

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