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Delays in investigations, diagnosis and treatment of cancer


    A blog considering recent news reports of administrative delays in patients being referred for investigations for cancer, and also that surgical treatment is being cancelled at present due to the ‘NHS crisis’.

    By Kerstin Kubiak

I have been reading a number of different reports in the news recently of concerning issues affecting patients with cancer, both that referrals to hospital for investigation and treatment, and subsequent treatment is being delayed.

Delays in referral for cancer investigation

The BBC have reported this week on the issue of ‘referral management centres’ – these are organisations introduced in 2003 to review GP referrals of patients to hospital and determine if the patient should receive hospital care. The purpose was to reduce unnecessary referrals and therefore reduce waiting times for all patients.  Whilst these centres handle all kinds of hospital referrals, it includes patients being referred with a potential diagnosis of cancer.

The BBC sent a Freedom of Information request to 209 Clinical Commissioning Groups (CCG) in England, and 61 CCGs responded to confirm that they used referral management centres. It is reported that the service offered varied from centre to centre, with staff working in the centres looking at the referrals having varying levels of clinical experience.

The research revealed that the numbers of referrals being rejected/delayed for administrative reasons, rather than clinical reasons was increasing. One of the most common reasons for the referral being delayed was due to missing information.

GPs and the British Medical Association are critical of the service provided by referral management centres, with some stating that some patients were suffering delayed diagnosis of cancer due to the “extra bureaucracy” caused by the system.

One GP reported that some referral centres have their performance assessed based on the number of referrals rejected, which potentially creates a conflict with ensuring patients receive treatment when this is needed. This follows reports in 2015 that some GP practices were also offered incentives to reduce the number of patient referrals, which my colleague wrote about at the time.

Cancelled cancer surgery

It has also been reported that a large number of patients have had their planned surgical cancer treatment cancelled due to the ‘NHS crisis’.

This is a worrying development as such treatment used to be protected due to the urgent need for the treatment, but this no longer seems to be the case and is being affected by the general lack of resources for treatment across the NHS.

A spokesperson for the Department of Health stated “NHS England has assured us that [NHS] trusts are prioritising urgent operations and treatments whilst taking steps to alleviate additional winter demand.”

Our experience

As clinical negligence lawyers, my colleagues and I have acted for a number of patients who have suffered injuries, or lost loved ones, as a result of delays in diagnosing and treating cancer, where this was avoidable with an acceptable standard of medical care. It is reported in many areas that, whilst survival rates for a number of different types of cancer are improving, the UK is still behind other developed countries.  The fact that cancer diagnosis and treatment is being adversely affected by failings in administration and by lack of resources is concerning, and requires urgent attention to protect patients from suffering such avoidable harm.


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