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NHS proposes new cancer care standards which could see two-week wait target scrapped

NHS proposes new cancer care standards which could see two-week wait target scrapped
By Beth Gault
10 March 2022

The NHS has launched a consultation on new cancer standards, which could see the two-week wait target replaced, in order to ensure faster diagnosis and treatment for cancer.

The new standards would focus on the time between referral and diagnosis, rather than the time between referral and being seen by a specialist.

Currently there are nine separate performance standards for different routes into the system, such as screening or GP referral. This includes the two-week wait referral between being referred by a GP and seen by a specialist.

It is hoped that the new plans would make timelines ‘easier to understand’ for patients and their families.

The new plan includes:

  • A 28-day faster diagnosis standard for those who have been urgently referred, have breast symptoms, or who have been picked up through screening. They would have cancer ruled out or receive a diagnosis within 28 days.
  • A 62-day referral to treatment standard, where patients who receive a cancer diagnosis will start treatment within nine weeks from the date of referral.
  • A 31-day decision to treatment standard, where cancer patients receive their first treatment within a month of a decision to treat following diagnosis.

Eleven NHS hospital trusts have tested the proposed new standard for diagnosis, including Mid Essex Hospital Services and Northampton General Hospital.

Across these pilots, the performance against the 62-day referral to treatment standard was higher (74.9%) than the control group (71.7%) when using the new measures.

Dame Cally Palmer, NHS national director for cancer said: ‘Access standards have been key to improving timeliness of treatment for people with cancer since they were first introduced in 2000.

‘As we see advances in diagnosis and treatments for cancer, it is only right that these standards are modernised – so that we can ensure patients are diagnosed more quickly and are given the treatment they need as soon as possible, helping us save even more lives.

‘These proposed changes are an important part of improving cancer care and so from today, the NHS will be inviting views from patients, staff and the public.’

Health secretary, Sajid Javid, added: ‘As part of our 10-Year cancer plan, we want to offer patients the best possible care and treatment.

‘These proposals will help us speed up diagnosis times and treatment, and save more lives.

‘The NHS wants to hear from as many people as possible – and is seeking advice from patients, staff and the public. Please, make your voices heard.’

The proposals come in addition to the elective recovery plan targets which were published last month. These aimed for the number of people waiting more than 62 days from an urgent referral to be back to pre-pandemic levels by March 2023.

The consultation on the new proposals will run until 6 April 2022.

Current cancer standards:

  1. Two-week wait: ‘Duty to make arrangements to provide an appointment with a specialist for those patients urgently referred for treatment for suspected cancer… within the period of 2 weeks beginning with the start date in not less than 93% of cases where that treatment is provided in that data collection period’, where treatment is defined as ‘assessment by a specialist in order to progress towards a diagnosis’
  2. A maximum one month (31-day) wait from diagnosis to first definitive treatment for all cancers
  3. A maximum 31-day wait for subsequent treatment where the treatment is surgery
  4. A maximum 31-day wait for subsequent treatment where the treatment is a course of radiotherapy
  5. A maximum 31-day wait for subsequent treatment where the treatment is an anti-cancer drug regimen
  6. A maximum two-month (62-day) wait from urgent referral for suspected cancer to first treatment for all cancers
  7. A maximum 62-day wait from referral from an NHS cancer screening service to first definitive treatment for cancer
  8. A maximum 62-day wait for first definitive treatment following a consultant’s decision to upgrade the priority of the patient (all cancers)
  9. A maximum two-week wait to see a specialist for all patients referred for investigation of breast symptoms, even if cancer is not initially suspected.


Two week wait: Part 9 of the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012.

Eight other waiting time standards: Handbook to the NHS Constitution

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