NHS services for diagnosing cancer are underfunded, understaffed, and key waiting time targets are being missed, according to two new reports from Cancer Research UK.

Early diagnosis is vital in improving cancer outcomes and was a priority area in the new NHS cancer strategy, announced this summer.

“Well-resourced testing services are crucial to the early diagnosis of cancer, which in turn is vital to increase survival from the disease.” – Dr Giles Maskell, Royal College of Radiologists

The reports highlight the growing pressures on services for imaging and endoscopy – a test that uses a camera to look inside parts of the body. And, as the number of new cancer cases continues to rise, the demand for these diagnostic tests will grow.

The reports conclude:

  • There is a workforce shortage for diagnostic services, including nurse endoscopists and radiologists;
  • Too many patients are waiting too long for tests and waiting times are worsening;
  • There is a shortage of imaging equipment, and much of the existing kit is outdated and needs replacing.

The endoscopy report, produced by the University of Birmingham, predicts that more than 750,000 extra endoscopies will need to be performed each year in the UK by 2020 – around a 44 per cent rise from today’s levels. These tests are carried out to investigate a range of symptoms and diagnose many different diseases – not just cancer. There will be an increase in demand because of the ageing and growing population – meaning more people with symptoms will need testing – as well as changes being made to the national bowel screening programme.*

The second report, produced by the agency 2020 Delivery, cites an under-resourced workforce and outdated equipment as the two major concerns with NHS imaging services. Imaging tests for cancer include CT scans, MRI and Ultrasound, among others. They are vital in helping doctors to diagnose and monitor the disease, as well as a range of other health conditions. It will cost an estimated £215m** to replace old imaging equipment, with extra needed to pay for additional kit to meet the growing demand from all patients using these services.

Sara Hiom, Cancer Research UK’s director for early diagnosis, said: “The state of NHS diagnostic services is deeply concerning – and new GP referral guidelines from NICE mean that even more patients will be waiting for these tests.

“There aren’t enough trained staff, they’re often reliant on outdated equipment and in many cases they’re already operating services seven days a week. GPs do not have the access they need and that means patients are waiting too long for tests. This has to change if doctors are to diagnose more people with cancer earlier, when treatment is more effective.

“These reports looked at imaging and endoscopy capacity but the underlying themes seem to be true across all cancer diagnostic services. But these tests aren’t just for people with cancer – if the Government is looking to spend wisely then investing more in NHS diagnostic services is an obvious value-for-money choice.

“Waiting for tests and test results can be a worrying and uncertain time, and delays will only increase that anxiety. Patients need to feel reassured that suspected cancer is being taken seriously and is prioritised by the NHS because we know early diagnosis and swift treatment are crucial in giving them the best possible chance of beating the disease.”

The reports are published as Cancer Research UK calls on chancellor George Osborne to increase funding for NHS diagnostic services as part of its new campaign to diagnose more cancers early. Early diagnosis is a priority in the new cancer strategy, announced this summer. It sets out the aim that, by 2020, 95 per cent of patients referred for testing by a GP should be definitively diagnosed with cancer, or have cancer ruled out, within four weeks of referral.

Dr Giles Maskell, president of the Royal College of Radiologists, said: “Well-resourced testing services are crucial to the early diagnosis of cancer, which in turn is vital to increase survival from the disease. The earlier cancer is diagnosed, the better the chances that it can be cured.

“The concerns highlighted in these reports aren’t just limited to cancer patients – they apply to everyone who uses these services and also include patients being monitored for any changes in their condition. We need a commitment to greater investment in these services to meet the demand and increase survival.”


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For copies of the full reports, please contact the Cancer Research UK press office.

* Changes to the national bowel screening programme include the introduction of bowel scope screening – also called flexible sigmoidoscopy – as well as the roll-out of FIT to replace FOBT already announced in Scotland, with a consultation underway for the rest of the UK.

Bowel scope is a one-off test offered to 55-year-olds as part of the updated national bowel screening programme. It uses an endoscope to look for pre-cancerous changes called polyps in the lining of the bowel. The Faecal Immunochemical Test (FIT) looks for traces of blood in the stool, much in the same way as the Faecal Occult Blood Test (FOBT). But FIT is more accurate, reduces inequalities, and is simpler for people to do so is predicted to increase uptake in screening participation.

An endoscopy is general term for tests that use an endoscope to look inside different parts of the body. The endoscope is a long flexible tube which has a tiny camera and light on the end of it. There are many types of endoscopes used to look inside different parts of the body. Endoscopies are commonly performed to look at the food pipe, stomach, lungs and the small and large intestine.

** Figure from NHS Supply Chain. This represents total investment required to update CT and MRI testing equipment, which provides diagnostic tests for all symptoms, not just those related to cancer.