Cancer review suggests some Scottish patients could wait longer

A consultant studies a mammogram in the search for breast cancer. Picture: Rui Vieira/PA Wire

A Scottish Government review says targets should be varied according to the type of tumour being dealt with.

At the moment the aim is for patients of all cancers to meet a 62-day target from referral to treatment as well as a 31-day target from the decision to treat until first treatment.

But a Clinical Review of Cancer Waiting Times (CWT) Standards in Scotland has recommended that the targets should take into account the severity of the cancer.

The review, chaired by Dr Valerie Doherty and endorsed by Health Secretary Shona Robison, suggests there is a lack of evidence to suggest that there is a clinical benefit from the 62-day and 31-day CWT standards.

It said: “It would be more useful to clarify what CWT standard duration is appropriate for each tumour type, be that shorter or longer than current timings.”

The document went on to say that “individual tumour biology” should be considered when deciding whether waiting standards should be altered. Leukaemia and aggressive lung cancers were given as examples of versions of the disease, which would require immediate treatment within “a matter of days”.

It suggested that patients with less aggressive forms of the disease could be treated within a more relaxed target. “Whereas for others,” it said. “Waiting for intervals of a few months has no discernible effect on clinical outcome.”

Patients with stage one cancer, which has not spread with a tumour confined to a small area, tend not to need as urgent treatment as more severe versions of the disease.

In the foreword to the document, Ms Robison said she looked forward to turning “the Review’s recommendations into reality to ultimately improve cancer outcomes for people in Scotland”.

Dr Doherty noted that there had been a “deterioration in performance” against the 62-day standard. The latest statistics show 87.1 per cent of cases met the 62-day target, falling from 88.1 per cent at the beginning of 2017.

The report quoted expert opinion say that in most cancer cases a short delay was “not clinically significant”.

But it acknowledged that a delay could have a “major impact in terms of patient/carer anxiety”.

Cancer charities last night expressed concern about the impact that longer targets could have on patient stress.

Head of Services for Macmillan in Scotland, Janice Preston said: “Waiting to hear if you have cancer is an incredibly stressful time. Any proposed changes into how we measure cancer waiting times cannot solely focus on the clinical aspect but also the psychological impact a cancer diagnosis has.

“We would like to hear from the Health Secretary what changes she plans to take forward from this review.”

Gregor McNie, Cancer Research UK head of external affairs in Scotland, said: “It is welcome that this review commits to refining current standards to make sure patients are given the right tests and treatment at the right time.

“Waiting for a diagnosis and treatment can be an anxious time and the wellbeing of patients, no matter where they live in Scotland, must be at the heart of any reforms.

“It’s essential the Scottish Government builds on the findings of this report. In particular, we know that some patients are waiting too long for tests to find out if they do or don’t have cancer. Staff shortages are contributing to these delays and it’s essential that this is addressed urgently.”

The review was published without an accompanying press release and Labour’s health spokesman Anas Sarwar claimed it had been sneaked out to spare Ms Robison’s blushes.

As Ms Robison faced yet more calls for her resignation in a Holyrood debate, Mr Sarwar said: “Today, unbelievably, the Health Secretary sneaks out this report which shows that rather than improve their performance, the Government’s plan is to scrap the standard waiting time for cancer.

“This is shameful behaviour from a shameless Health Secretary. After trying to blame bad weather for performance yesterday, she is trying to bury bad news on cancer waiting times. Enough is enough – Shona Robison has to go.”

A Scottish Government spokeswoman: “Anas Sarwar is wrong and his claims that targets are to be removed are false. As the report itself makes clear, we will not abolish cancer targets and will consider the recommendations with advice and evidence from existing clinical and expert groups.

“All cancer patients should receive timely diagnostics and treatment and this remains a priority for the Scottish Government.”