Beating bowel cancer together

NHS England announces new recovery plan for cancer services

Tuesday 15 December 2020

The NHS has set out how it plans to return essential cancer services to pre-COVID-19 levels in a new plan. The Cancer Recovery Plan – which was developed with the Cancer Recovery Taskforce, including Bowel Cancer UK – outlines actions to:

  • restore demand for endoscopy services to at least pre-pandemic levels
  • reduce the number of people waiting longer than they should for diagnostics and/or treatment, set by the NHS, at least to pre-pandemic levels on both screening and symptomatic pathways
  • ensure sufficient capacity to manage future increased demand, including for follow-up care

A key feature of the plan includes restoration and recovery of endoscopy services to manage the backlog of tests that can diagnose bowel cancer, which soared during the pandemic. This will help reduce the delays to diagnosis – an issue that the charity has raised with the NHS, even before the pandemic. The latest figures, published in October 2020, show 52% of patients are waiting longer than six weeks for colonoscopy and flexi sigmoidoscopy (peaking at 67% in May 2020), and 35% of patients are waiting over 13 weeks for these diagnostic tests (peaking at 43% in June).

The Taskforce will implement urgent plans and measures to increase demand for endoscopy services whilst protecting capacity, especially during the winter months. These include:

  • providing £6m to develop pilot Colon Capsule endoscopy clinics across England. The clinics will use a small camera, which is swallowed by the patient, to film inside the body and identify any signs of cancer
  • cancer alliances to help restore endoscopy capacity, including substituting CT colonography (virtual colonoscopy) for colonoscopy where possible
  • enabling implementation of innovations, such as the use of faecal immunochemical testing (FIT) to prioritise patients for endoscopy, and using telephone and video calls for specialist bowel screening practitioners
  • ensuring appropriate COVID-19 free endoscopy suites so that staff and patients have confidence that services are safe
  • cancer alliances will support endoscopists to gain JAG accreditation – the gold standard for endoscopy services
  • cancer alliances will take action to retain and re-purpose the bowel scope workforce while the service remains suspended, and expand training opportunities for trainee lower GI endoscopists in the next 12 months

Genevieve Edwards, Chief Executive at Bowel Cancer UK, says: "The response to COVID-19 has come at a huge cost to people with bowel cancer and those yet to be diagnosed. Services vital for prompt diagnosis and treatment have been suspended or delayed, and the task ahead to restore them is complex.

"This Cancer Recovery Plan will help minimise further impact of the pandemic on health services for bowel cancer patients. I'm pleased that restoration and recovery of endoscopy services is a focus, as this is key to reducing delays to diagnosis.

"The truth is, there are long-standing challenges facing endoscopy services, and we need to implement a fully funded action plan, with clear and comprehensive recommendations to deal with workforce shortages and allow for future growth in demand."

The charity understands that bowel cancer screening hubs are working extremely hard to cut the backlog to pre-pandemic levels, but there is still variation across England. Additional capacity is needed to help hubs struggling to catch up, to enable them to refer people quickly for further tests.

  • Read more about how we plan to tackle the endoscopy crisis in our End the Capacity Crisis campaign
  • Become a campaign supporter and join thousands of people who are making real change happen for people affected by bowel cancer


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