Changes to cancer waiting times in England should lead to improvements in diagnosis

Today, NHS England announced proposed changes to cancer waiting times with the aim to streamline the existing nine performance standards into three key targets.

This move would see the removal of the target for patients to see a specialist within two weeks if their GP suspects they may have cancer.

The ‘two week wait’ target is to be replaced by the ‘Faster Diagnosis Standard’ which was first recorded in April 2021. This measures whether patients have cancer ruled out or receive a diagnosis with 28 days after being urgently referred for suspected cancer.

The new cancer waiting time targets:

• diagnosis of cancer within 28 days of referral
• starting treatment within 62 days of an urgent referral
• starting treatment within 31 days after a decision to treat

So, what does this mean for bowel cancer and services in England?

Why do the old targets need to be replaced?

The two-week waiting time target was brought in in 2000 but increasingly isn’t fit for purpose as the NHS and our understanding of bowel cancer as a disease has changed significantly since then.

The latest monthly waiting times from NHS England saw 15% of patients waiting longer than two weeks to be seen by a bowel cancer specialist. Yet, in the same month 43% of patients waited longer than 28 days to have bowel cancer ruled out or diagnosed. Clearly getting a diagnosis or rule out of bowel cancer isn’t as simple as seeing a specialist.

By replacing the two-week wait with the Faster Diagnosis Standard, the important information will now be captured because it will show how long it takes to diagnose bowel cancer. This should help inform NHS leaders and government on which cancer tests and parts of the country need more support or investment to meet the 28 day target.

The new cancer waiting time targets will hopefully improve patient experience, and ultimately increase early diagnosis of bowel cancer.

Making earlier diagnosis of bowel cancer a reality

We know early diagnosis saves lives because bowel cancer can be treated successfully if diagnosed at the earliest stage. This has been recognised by NHS England and the Government who have committed to diagnosing 75% of cancers at an early stage by 2028.  

The new cancer waiting time target is a step in the right direction, but many more people will need to be seen by a specialist much sooner than two weeks, if we’re to diagnose or rule out cancer within 28 days of urgent referral. This might be a challenge after a decade of underinvestment in the NHS workforce.

The recent Long Term Workforce Plan hopes to address staff shortages in England by training more staff, retaining current staff for longer and reforming the way healthcare staff work and the skills they need. But without long term and meaningful investment from the Government, to grow the workforce and capacity to undertake more tests quickly, these new targets or ambitions to diagnosis more people at an early stage will likely be hard for the NHS deliver.

Our response

Genevieve Edwards, Chief Executive for Bowel Cancer UK, says: “It’s good news for bowel cancer services that NHS England will now use the faster diagnostic standard, ensuring the way we monitor, and measure cancer pathways are fit for the future. It means that within 28 days of being referred by their GP for further investigations, patients should have a bowel cancer diagnosis or have bowel cancer ruled out.”

“This change will also help NHS policymakers and the government to identify parts of the country that may need extra support and funding to improve waiting times and speed up diagnosis.”

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