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Move cancer services out of hospitals to restore NHS performance, says report


By Awil Mohamoud
18 August 2020

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Cancer diagnosis and treatment services should be moved away from hospitals to ‘Covid-safe’ locations wherever possible to help restore NHS performance, a leading think tank has said.

The Institute for Public Policy Research (IPPR), in a report looking into the impact of Covid-19 on NHS services, said moving these cancer services out of hospitals, particularly ones that treat Covid-19 patients, would make it safer for people to get help and encourage more patients to come forward.

The organisation commended the Government’s publicity campaign urging people to seek help earlier this year, after health trusts saw as much as an 80% drop in urgent cancer referrals, but said more needs to be done.

The IPPR said the Government must guarantee regular Covid-19 tests for all cancer staff and patients, which its calculations suggest would mean between 124,000 and 172,000 tests per week.

To quickly address the current backlog of cancer treatment, the Government may need to make ‘continued use of private sector capacity’, it added.

‘A more resilient system’

The NHS does ‘not have to revert to the pre-Covid status quo’, rather it can ‘use the disruption of the pandemic to design a better, more resilient system’, the report said.

It said that the Government should build on its recent obesity drive by forming a comprehensive new public health strategy to prevent illness, ‘as committed to in the Conservative 2019 manifesto, spanning the main causes of cancer (such as alcohol consumption and smoking) across both adults and children’. This should include restoring the public health grant, worth £1bn per year, it added.

The Government should also commit to increasing diagnostic and treatment capacity in the NHS by investing in more CT and MRI machines, as well as endoscopy and radiotherapy equipment, the report said.

Lasting impact

The dramatic decline in cancer screenings, referrals, tests and treatments during the pandemic could reduce the five-year survival rate for lung cancer from 16.2% to 15.4%, for breast cancer from 85% to 83.5%, and for colorectal cancer from 58.4% to 56.1%, the report found.

The suspension of screening programmes nationally has also led to 210,000 fewer people being screened a week, the IPPR said.

Hospitals in England also saw a 43% drop in urgent two-week wait (2WW) referrals from GPs for diagnostic tests between April and June this year, the report found, while data from May shows a 29% cancellation rate of cancer surgery, equivalent to more than 36,000 surgeries, and a 31% fall in chemotherapy treatment.

This comes as a Cancer Research UK study also showed around a quarter of GPs have seen their cancer referrals inappropriately rejected during the pandemic, with some areas seeing up to 40% turned down.

NHS England performance figures for June 2020, published last week, showed that only 52% of patients, or 1.85 million people, had started NHS treatment within 18 weeks of being referred – the lowest figure since records began in 2007, and far below the standard 92% target. More than 50,000 people had also been waiting over 52 weeks for the start of their treatment, according to the data.

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