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Workforce pressures threaten cancer treatment, MPs warn

Staff shortages are undermining efforts to provide early diagnoses, says the health and social care committee.

By Zoë Grünewald

Without sufficient action and changes to cancer services many lives will end prematurely, a cross-party committee of MPs cautioned on Monday (4 April).

In a highly critical report of cancer services in the UK, the House of Commons health and social care committee has warned that “the effect of reluctance to come forward, late diagnosis and delayed treatment” will “almost certainly” lead to many preventable deaths.

Evidence provided to the committee by the government and the NHS during its inquiry showed that the health service was not on track to meet its 2028 target to achieve diagnosis of 75 per cent of early-stage cancers. Without sufficient action, more than 340,000 people between 2019 and 2028 may miss out on an early cancer diagnosis, which the committee says is the “the single most effective way to improve overall survival rates”.

However, the report emphasises that “neither earlier diagnosis or additional prompt cancer treatment will be possible without addressing gaps in the cancer workforce”. But it had found “little evidence of a serious effort” to combat the staffing crisis. It is currently estimated the NHS will be short of 189 clinical oncologists, 390 consultant pathologists, 1,939 radiologists and 3,361 specialist cancer nurses by 2030. In light of these stark figures, the report highlights the absence of a plan for the government to tackle these workforce gaps, despite the impact that this will have on diagnosis, treatment and research.

In March, the public accounts committee warned that cancer services had already suffered “years of decline” prior to the pandemic, that “waiting times for elective and cancer treatment are too dependent on where people live”, and that there was “no national plan to address this postcode lottery”. Its chair, Meg Hillier MP, explained that the committee was “extremely concerned” about the government’s plans to tackle overwhelmed cancer services and wasn’t convinced that the Department of Health and Social Care “finally understands that its biggest problem, and the only solution to all its problems, is the way it manages its greatest resource: our heroic NHS staff”.

Today’s report by the health and social care committee once again emphasises the need for both the recruitment and retention of staff as a remedy for workforce shortages, stating that “as part of the long-term plan for the cancer workforce, the government and NHS England should develop specific proposals for improving the retention of experienced cancer staff, including targeting burnout and improving the day-to-day working conditions of staff”.

The committee also said that cancer outcomes in England “remain behind other comparable countries”, such as Canada or Australia: “[In England] 58.9 per cent of people… diagnosed with colon cancer will live for five years or more, compared to 66.8 per cent in Canada and 70.8 per cent in Australia. For people diagnosed with stomach cancer, 20.8 per cent of those in England will live for five years or more compared to 29.8 per cent in Canada and 32.8 per cent in Australia. When it comes to other cancer types, such as breast cancer, the gap has shrunk but for many others including lung cancer, pancreatic cancer and liver cancer it remains stubbornly high.”

Jeremy Hunt, chair of the health and social care committee, said: “A mother told us of her 27-year-old daughter’s five-month struggle to get a diagnosis of cancer – tragically, she died three weeks after it came. Unfortunately, many more lives will almost certainly end prematurely without earlier diagnosis and prompt treatment. That is why we are calling on the government and the NHS to act now to address gaps in the cancer workforce upon which success depends. To date we have found little evidence of a serious effort to do so.”

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