NHS England are also combining some other targets together to reduce the overall number of standards, including making more patients eligible for the headline 62-day standard by combining three previously separate targets.
The data and the detail
While we support the streamlining of cancer waiting times targets, we also want to ensure that this translates into benefits for people affected by cancer. For these new standards to be used meaningfully, they need to be accompanied by high quality data and clear guidance.
With the introduction of any new way of collecting data, it takes time and effort to iron out data quality issues. To ensure that these targets meaningfully measure progress, there needs to be accurate and comprehensive data and we will be watching closely to make sure this is achieved. For example, for the FDS it is important that all eligible people are captured in the collection and reporting of the data, including all urgent suspected cancer referrals, screening referrals and people with breast symptoms.
Also, the changes announced will see three individual 62-day standards combined into one. This means that more people are set to be included in the headline 62-day standard.
However, the guidance is currently unclear about exactly which people consultants should be ‘upgrading’ for suspected cancer after other investigations. There are also some routes which may be harder to track patients through, and it’s not clear whether some people are being missed.
We want to see NHS England clarify their guidance for local health systems on which people the standards apply to, provide training for staff prior to their introduction and monitor their implementation carefully, in order to ensure the new standards are being used consistently across the country. More needs to be done to develop ways of tracking patients too. This will mean these new targets can be used in the most effective way.
While streamlining targets is beneficial for focusing efforts, it’s important that we don’t lose any of the richness of insight we currently have. The 2WW target is being replaced at a time when performance against it is among the worst on record – and the target hasn’t been met since May 2020.
To stop reporting on the 2WW altogether, at a time when services are deteriorating, could see us lose granularity on a part of cancer services which are currently struggling. We would like to see NHS England commit to continuing to collect and report on this part of the pathway in some way going forward. We also need NHS England to maintain the availability of important (anonymised) data breakdowns across all the targets, so we don’t lose the ability to see the performance of the NHS for different patient groups.
A more ambitious trajectory
Rapid diagnosis and treatment of cancer can make a difference to the chances of survival. This is why committing to ambitious targets for the time it takes for cancer to be diagnosed is so important.
The FDS is a step in the right direction, and we’re pleased that NHSE are also looking to make this target more ambitious in the future, increasing the FDS target from 75% to 80% in 2026. In the longer term NHS England should set the FDS target even higher, to ensure even more people will receive a timely diagnosis.
But targets for cancer are only as good as our ability to meet them.