A quarter of hospitals in breach of waiting time target for bowel cancer tests

A quarter of hospitals in England do not meet the NHS standard of less than one per cent of patients waiting more than six weeks for tests that could diagnose bowel cancer. In some hospitals, 63 per cent of patients are waiting beyond the six week waiting time target.

Figures released today by NHS England for February 2017 reveal that nearly 2,000 people are waiting longer than the six week target set by the Government. The two key tests to diagnose bowel cancer are colonoscopy and flexible sigmoidoscopy – a camera on a thin, flexible cable inserted through the anus to look at different parts of the bowel.  These tests are known as endoscopy procedures.

The five hospitals with some of the highest percentage of patients waiting more than six weeks for colonoscopy appointments are:  South of North Bristol NHS Trust (62.6%), Wye Valley NHS Trust (50.0%), North East London Treatment Centre Care UK (46.7%), Southend University Hospital NHS Foundation Trust (38.1%), Dorset County Hospital NHS Foundation Trust (32.7%)

The five hospitals with some of the highest percentage of patients waiting more than six weeks for flexible sigmoidoscopy appointments are: North Bristol NHS Trust (57.4%), Southend University Hospital NHS Foundation Trust (38.1%), Mid Yorkshire Hospitals NHS Trust (25.8%), Nuffield Health, Leeds Hospital (15.4%), Northern Lincolnshire and Goole NHS Foundation Trust (13.1%).

More than 15,900 people die from bowel cancer every year in the UK; it’s the nation’s second biggest cancer killer and the fourth most common cancer. However it shouldn’t be. It’s treatable and curable, especially if diagnosed early.

These tests can detect cancer at the earliest stage of the disease, when it is more treatable, and even prevents cancer through the removal of pre-cancerous growths (polyps) during the procedures. Nearly everyone diagnosed at the earliest stage of bowel cancer will survive but this drops significantly as the disease develops, so getting timely access to these tests is vital.

Increasing demand for these tests and a lack of capacity in hospitals is the root cause of long waiting times for appointments. The demand for colonoscopy and flexible sigmoidoscopy has been increasing dramatically over the last few years – a trend that is set to continue. It is estimated that nearly a million more of these procedures in England alone will be needed year on year to meet this increasing demand. This is due to a number of factors including an ageing population and increase in symptom awareness.

The high demand and lack of capacity for endoscopy is impacting the Government’s pledge to deliver what they’ve already committed to:

• Delivering the NHS bowel scope screening programme to people aged 55
• Introducing the Faecal Immunochemical test (FIT) to the screening programmes in England replacing the current Faecal Occult Blood (FOB) test that is used. As FIT is a test that can be adjusted to make it more or less accurate at detecting blood in the stool, it is essential that it is introduced at a level that reduces the amount of missed cancers and prevents cancer from developing. A lack of capacity at hospitals could prevent FIT being introduced at its most sensitive level as this will increase the number of people being referred for bowel cancer tests.
• Providing regular endoscopy testing for people who have a high risk of bowel cancer, in some cases up to 80%. These patients experience unacceptable delays to their planned appointments.

Asha Kaur, Head of Policy and Campaigns at Bowel Cancer UK, says:

“These figures are very disappointing. It is unacceptable that patients are being made to wait more than six weeks for endoscopy tests. How soon someone is seen determines how early a diagnosis can be made. If diagnosed at the earliest stage, nine out of ten people will survive bowel cancer yet this drops significantly as the disease develops and spreads. This is why early diagnosis is so vital.

 “The government have made some commitments to increase the capacity of endoscopy but they do not scratch the surface to meet the increase in demand.

“The government have pledged to review the current demand for endoscopy services and develop an action plan by March 2017. Although they have published the review on current demand, we’re still waiting for the action plan. They have also committed to spend £300 million on early diagnosis for cancer but it is not clear how the investment will be spent and whether endoscopy units will benefit from this.

“Given the wide ranging impact that increasing demand and a lack of capacity is having on the ability to provide timely access to tests that can diagnose bowel cancer, the case for urgent investment is clear. Investing in early diagnosis services for bowel cancer is critical to ensuring endoscopy units have sufficient workforce and infrastructure to carry out tests and that all units are working as efficiently as possible.

“That’s why we are calling for a national endoscopy strategy and a training programme as a solution to the mounting pressure on endoscopy units. We hope to work with Government, NHS England and medical professions to ensure a sustainable endoscopy service that has the capacity to meet future demand.”

• Read our blog from Asha Kaur on the impact of endoscopy capacity
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