What the Government’s spending review means for our Capacity Crisis campaign

We’ve been working to address NHS staff shortages in services that diagnose bowel cancer for a number of years. This issue is impacting on initiatives that are vital to improving early diagnosis and has led to thousands of patients waiting too long for crucial tests.

To highlight the urgency ahead of Government’s 2018 autumn budget and the publication of the NHS Long Term Plan, we launched our Capacity Crisis campaign calling for a fully funded action plan to tackle staff shortages in endoscopy and pathology services in England. A year on, we’re pleased that the Government’s 2019 spending review has allocated much-needed extra funding for Health Education England to help train NHS staff.  However, this funding is not enough to address staff shortages, and ambitions set out in the NHS Long Term Plan will struggle to be achieved without significant and long-term investment into recruiting and training the NHS workforce.

We firmly believe that NHS staff shortages is the single biggest barrier to delivering the best treatment and care for bowel cancer patients. Diagnostic tests can both prevent and detect the disease at the earliest stage, when it is easier to treat. However, endoscopy and pathology services, which provide key diagnostic tests for bowel cancer, are struggling to cope as many hospitals do not have enough staff to meet the growing demand for these tests. So what’s been happening since the launch of our campaign?

Since launching our Capacity Crisis campaign:

• September 2018: Over 7,000 people including patients, NHS staff, campaigners, Members of Parliament and people with loved ones affected by bowel cancer signed our letter to the Government calling for a long-term plan and for funding to be ring-fenced to address the growing crisis.

• October 2018: We were pleased to see the then Prime Minister, Theresa May, made commitments to improve the Bowel Cancer Screening Programme and to diagnosing 75% of cancers at stages 1 and 2 by 2028 at the Conservative Party conference.
• November 2018: The NHS was high on the Government’s agenda as an extra £20 billion for the NHS was guaranteed as part of their 2018 autumn budget. This funding was welcome, but did not include money for wider health budgets, including Health Education England (HEE), that fund training for NHS staff.
• January 2019: The NHS Long Term Plan was published. The plan finally acknowledged that the NHS workforce issues needed to be addressed and announced that a separate five-year strategy, known as the NHS People Plan, would be developed to address these challenges.
• June 2019: The Interim NHS People Plan setting out the immediate vision for the NHS workforce in 2019/2020 was published. The interim plan did not outline specific measures to tackle staff shortages in endoscopy and pathology services, so we're calling on the final plan, expected to be published later this year, to include commitments on this.
• September 2019: The Government confirmed a 3.4% increase in funding for HEE, the responsible body for addressing the needs of the NHS workforce. This will include an additional £150 million for Continuing Professional Development to help support the delivery of the NHS Long Term Plan.

While progress is being made, it’s not fast enough and delays to tackling this issue has led to many patients waiting too long for vital tests.

The latest NHS waiting time targets

The lack of capacity in endoscopy and pathology units, is impacting on NHS waiting time targets, leaving patients waiting too long for tests that diagnose bowel cancer. Catherine, a bowel cancer patient, who shared her story in a previous blog tells us “I was diagnosed with stage three bowel cancer at the age of 39 after waiting nearly three months for a bowel cancer test. Increasing demand means patients like me are left waiting to be diagnosed. It’s having a real impact and could even put patients’ lives at risk”.

In the first half of 2019:

• On average, over 80% more patients each month waited more than six weeks for endoscopy tests that diagnose bowel cancer (colonoscopy and flexible sigmoidoscopy) at their hospital compared to the first half of 2018.
• On average, 20% more patients waited more than two weeks each month to be seen urgently by a specialist for suspected bowel cancer compared to the first half of 2018.
• A third (34%) of NHS hospitals on average each month were in breach of the six week NHS waiting time target for colonoscopy and flexible sigmoidoscopy tests - this is nearly a 10% increase from the first half of 2018.
• Around half (49%) of NHS hospitals on average each month are in breach of the two week NHS waiting time target to see a specialist if they’ve been referred urgently by their GP for suspected bowel cancer – this is a 4% increase from the first half of 2018.

What next?

The stark reality is that, without long-term investment in NHS diagnostic staff, ambitions in the NHS Long Term Plan to improve early diagnosis will remain unmet.The final NHS People Plan must therefore be fully-funded and include commitments to tackle staff shortages in endoscopy and pathology units both in the immediate future and long-term. You can find out more about what we want to see in the final NHS People Plan in a previous blog.

With the prospect of a snap general election seeming more likely, make sure to join us as a campaigner today to help us drive bowel cancer up the political agenda.

• Read our response to the Government’s spending review here.
• Find out more about the Capacity Crisis campaign.
• Read our blog explaining what we want to see in the final People Plan for the NHS workforce in England.
• Read about what the NHS England Long Term Plan means for bowel cancer patients here.