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A critical look at the new cancer standards: Professor Pat Price voices her concerns
22/09/2023

Message from Prof Price: A critical look at the new cancer standards

Professor Pat Price has devoted her life to patient advocacy and continues to look out for cancer patients as NHS England released new cancer standards. She has been an outspoken critic of the timing of the announcement and the apparent weakening of some targets when the UK faces the worst cancer treatment waiting times on record.

When the NHS said the new cancer standards would "speed up diagnosis for patients", my concern was how this would cure more patients. I agreed that we would be making some modest headway in identifying cancer patients quicker, but unless investment is made in increasing treatment capacity, those newly diagnosed patients would then be added to a long and potentially lethal waiting list for treatment. This is a road to continued poor outcomes and unnecessary deaths.

I have been vocal in calling for urgent improvements to UK cancer services. When speaking with BBC Radio 4 Today I invited Secretary of State for Health, Steve Barclay to meet with me and my colleagues to discuss practical solutions for shortening wait times and improving outcomes for cancer patients.

Price's segment begins at 1:35:16

Everyone wants simpler targets that are much easier for patients to understand. But the bottom line is that changing targets does not help patients unless we treat them better and quicker, which means we must invest in increased cancer treatment capacity.

Increase the Faster Diagnosis Standard and invest in cancer treatment capacity

The concern that I see is replacing the previous 2 week wait appointment with the new NHS cancer standard: The Faster Diagnosis Standard (FDS). Instead of patients suspected of having cancer being seen within 2 weeks, a cancer diagnosis should be made or excluded within 28 days. This is sensible in some ways, but for now the target is only set at 75%. This needs to be much higher, at around 95%, if we are to get patients through the cancer pathway on time. During the consultation phase for these changes, patients were more keen to know when their treatment was starting.

While the FDS may produce some improvements in diagnosing and ruling out cancer, which would be welcomed, it is not enough on its own. Unless we improve cancer treatment times after diagnosis, these patients just end up on growing treatment waiting lists and cancer standards remain at unacceptable levels. International research reports that for every 4 week delay in diagnosis and cancer treatment there can be an approximate 10% increase in death rate. Time matters.

What we urgently need to do is address the lack of capacity in the workforce, investment in infrastructure and coordinated planning throughout the system at all levels.

Measurement standards need to match current crisis

These changes were first suggested in 2015 to encourage faster diagnosis, but sadly do not match the current cancer crisis temperature. The issues in 2023 are vastly different than 2015. We are in the middle of the biggest cancer crisis on record. Changing what we measure now will make it more difficult to see if we’re actually improving the situation for cancer patients. In certain circumstances, with such pressure on the system, this may lead to poorer outcomes.

Debunk a false narrative

As we strive to improve cancer treatment outcomes, there is concern that this announcement may contribute to the false narrative that concrete steps are being taken to make progress. However, not enough steps are being taken. We are still traveling down the path of increasing wait times, and not meeting cancer targets sadly has become the new norm.

The solution: A radical new cancer plan

What we urgently need is more capacity to treat patients on time and the determination to harness the untapped potential of overlooked solutions to boost treatment capacity. The best way to achieve the action needed is a radical new cancer plan. Small changes will make a small difference but in the depth of the worst crisis ever we don’t need small changes we need radical change. The work is being done now to suggest those changes. This is an important space for those engaged in improving cancer treatment outcomes to have their say. The time is now to become involved in the future of cancer care.