Pandemic Leads to 60% Fall in Urgent Cancer Referrals

Nicky Broyd

June 11, 2020

The latest figures from NHS England show the number of urgent cancer referrals made by GPs in April was down 60% on the same time last year.

Breast cancer referrals were down even more - a drop of 78%.

In a statement Sarah Woolnough from Cancer Research UK described the impact COVID-19 is having on cancer patients as "devastating" and said: "The dramatic fall in the number of urgent referrals – which is down 60% compared to the same time last year - and the drop in people receiving treatment on time in April is hugely concerning. It means that tens of thousands of patients are in a backlog needing vital cancer care."

She said, however, there was some good news: "Some services in the NHS have started to recover since April… We’re also seeing that patients in many areas are starting to contact their GPs again for telephone and online appointments."

Last week, Medscape News UK reported on charities' concerns about a cancer care backlog and since March oncologist Prof Karol Sikora has been warning about the possible problems for cancer patients caused by the pandemic.

Dr Rebecca Fisher, senior policy fellow at the Health Foundation, said: "Today’s figures are a wake-up call. More needs to be done to ensure people with cancer and other serious health conditions get the treatment they need, to avoid storing up worse health problems for the future."

'Convenient' Cancer Treatments Fast Tracked

As a result of COVID-19, changes in treatment for cancer are already underway in parts of England. Some patients will be offered newer treatments and alternative treatment delivery in an attempt to reduce hospital visits.  

Initiatives include:

Stereotactic Ablative Radiotherapy (SABR)

Fewer doses and hospital visits are needed with stereotactic ablative radiotherapy (SABR), a precision method of giving radiotherapy that needs around five out-patient visits compared to the 20-30 visits required for standard radiotherapy. Rollout was due to be completed in 2022 but SABR treatment for non-small cell lung cancer, and lung, lymph node and non-spine bone oligometastatic disease should be available in this financial year.

Cancer Buses

Four cancer buses based at North Middlesex University Hospital in London and Airedale NHS Trust in Yorkshire are providing around 60 chemotherapy treatment sessions a day for up to four patients at a time.

Chemo at Home

Hospitals have "significantly increased" provision of chemo at home delivered by local pharmacy teams and community nurses. Liverpool's Clatterbridge Cancer Centre has increased home chemotherapy by 15% during the pandemic with volunteers delivering oral chemotherapy to patients’ homes.

Superintendent Pharmacist Burhan Zavery commented: "We established the service in April to ensure eligible patients can continue oral chemotherapy treatment without visiting our site, unless it’s essential. Our delivery service has also reduced footfall into the hospital and allows us to prioritise patients who must be seen face to face in the pharmacy."

'COVID Protected' Cancer Hubs

These are being set up for treatment and online consultations.

NHS England Chief Executive, Sir Simon Stevens, said in a statement: "Hospitals are going to great lengths to deliver care and treatment for patients in a safe space, from online consultations to chemo buses and COVID-free surgical hubs. The NHS is also accelerating access to new treatment options, including SABR – a potentially life-saving form of precision radiotherapy for people with cancer."

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