'Chronic' lack of cancer specialists failing Scottish patients

Cancer patients in Scotland are facing a “ticking time bomb" for diagnosis and treatment due to a chronic shortfall of specialist doctors, according to a leading healthcare body.

The Royal College of Radiologists (RCR) warned that Scotland has the worst shortage of clinical oncologists of any UK nation, with “stark disparities” across the country in terms of diagnostics and cancer care.

In a series of damning reports, the professional membership body warned that unless urgent action is taken to train and recruit new staff, delays endured by patients will only worsen, with staff pushed to “breaking point.”

Despite the fact that a cancer patient’s risk of death can increase by 10 per cent for every month cancer treatment is delayed, the RCR said that last year, every radiology clinical director said they had an insufficient number of radiologists to deliver “safe and effective” patient care.

The Royal College of Radiologists pointed to ‘stark disparities’ in staffing across Scotland | Getty Images

Some four in ten cancer centre leaders in Scotland also said they were concerned about staff shortages putting patient safety at risk, with one consultant clinical oncologist warning that the safe delivery of cancer treatment was becoming “increasingly impossible.”

The RCR said the “tragic situation” will only deteriorate further as demand for care continues to outpace the rate of workforce growth. It pointed out that without action to bolster the workforce, the 25 per cent shortfall of radiologists in Scotland will rise to 35 per cent by 2029.

Concern over regional disparities

It added that the geographical differences between the north and south of Scotland gave “even more cause for concern.” The staff shortage crisis is most acute in the north of the country, where an extra 34 radiologists are needed to meet current demand, compared to only nine extra radiologists in south east Scotland.

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The 19 per cent shortfall of oncologists in Scotland - higher than the UK average of 15 per cent - is predicted to rise to 31 per cent by 2029. However, in the north of Scotland, the shortage is predicted to increase even more, to 43 per cent, in the next four years.

Dr Katharine Halliday, president of the RCR, said: “Patients are being failed by a chronic lack of radiologists and oncologists. Despite the best efforts of NHS staff, there aren’t enough doctors to ensure prompt, safe and effective care, and the outlook is bleak. We are doing all we can to boost productivity, but there’s a limit to how far we can go. The reality is we simply don’t have enough staff.

Scottish Liberal Democrats leader Alex Cole-Hamilton said the reports were ‘damning’. Picture: PA | PA

“Any credible plan to cut waiting lists relies on having the headcount to meet the demand we face today, let alone tomorrow. The longer we delay action, the worse it gets. The government must train up more radiologists and oncologists to defuse this ticking time bomb for cancer diagnosis and treatment.”

The RCR added that the pressures of chronic staff shortages are causing a retention crisis, with the most experienced staff now leaving younger than ever before. In Scotland in 2024, the median age of consultant clinical radiologists leaving the NHS workforce was 38, down sharply from 58 in 2023. Alarmingly, seven in 10 leavers were younger than 45.

Amidst the staffing woes, NHS Scotland spent an estimated £20 million on workforce solutions in radiology in 2024, an approach described by the college as “unsustainable.”

Staff exodus should should set ‘alarm bells ringing’

Scottish Conservative shadow health secretary, Dr Sandesh Gulhane, said: “This damning report exposes the SNP’s chronic failure on cancer care - patients are facing life-threatening delays because of years of mismanagement.

“The dire workforce planning of successive incompetent nationalist health secretaries has pushed hardworking staff to breaking point. The exodus of cancer experts from the NHS is comprised largely of younger doctors, which is both telling and should set alarm bells ringing about treatment capacity reducing even further.

“We know how crucial early diagnosis and treatment is to patients’ survival chances, but the demand for care is outpacing capacity. Unless the SNP take action now, this crisis will only deepen.”

Scottish Labour’s health spokeswoman, Jackie Baillie, said: “These stark warnings must come as a wake-up call for this incompetent SNP government. The SNP’s failures on workforce planning have been catastrophic for our NHS – putting patients at risk and piling pressure on staff.

“Cancer is Scotland’s biggest killer but the SNP has missed its treatment time targets over and over again, and these staff shortages risk making a bad picture worse. The SNP has had almost two decades to deal with this growing crisis - it is simply not up to the job.”

‘The most damning reports into medical care in Scotland’

Scottish Liberal Democrat leader, Alex Cole-Hamilton, said the RCN studies into the oncology and radiology workforces were “among the most damning reports into medical care in Scotland that I have ever read.”

He added: “This is a matter of life and death, with early intervention being crucial to chances of survival. The government’s cancer strategy risks becoming meaningless to everyone suffering these long waits.

“What's more, access to screening programmes, diagnosis and treatment is especially bad in rural areas. To ensure patients receive early intervention, it is vital that the government stamp out this postcode lottery.

“We need serious investment in both diagnostics and staff now. The health secretary needs to pull out all the stops and prove that things can get better on his watch. Staff and patients are tired of being continually failed by a government that can’t match its words with action.”

A spokeswoman for the Scottish Government said: “We have been working across NHS Scotland to address staffing as a matter of urgency. We are supporting a dedicated group, reporting directly to health board chief executives, to find solutions to pressures on oncology services throughout Scotland.

“We are treating more patients with cancer on time, within both 62 and 31-day pathways, compared to pre-pandemic and 10 years ago.”