NHS cancer plan marks first step towards fixing chronic staff shortages

Cancer rates are increasing, meaning more people than ever are being diagnosed with the disease. And with more people to look after, the NHS is coming under growing strain to meet demand – especially as it strives to meet the priority of diagnosing more cancers earlier.

To deliver the best cancer care in the world, the NHS needs enough trained and employed staff to carry out and interpret tests that diagnose cancer. Right now, that’s not the case.

And if it’s not working now, rising rates will only make this situation worse.

That’s why we’ve been campaigning to tell the Government to stop leaving the NHS short staffed.

And it seems they’ve listened to the more than 6,000 of you who supported our campaign.

Today, Health Education England (HEE) – who are responsible for training health professionals in the NHS in England – published a long-awaited plan for how to tackle staffing issues in NHS cancer services.

The good news is that it acknowledges that more staff are needed for cancer tests, including radiologists, radiographers, endoscopists and pathologists. But with national plans now needing action in local hospitals, and a long-term plan promised, there’s certainly more to be done.

What’s in the plan?

Unveiled at the Britain Against Cancer Conference by Secretary of State for Health, Jeremy Hunt, the report suggests potential solutions to key NHS staffing issues, promising over 5000 extra staff by 2021. It focuses on two key groups of NHS staff: those who diagnose cancer and those who treat it. And it’s great news that these workforce issues are now being addressed, as we’ve been waiting two years for this plan.

The plan is being badged as phase 1, offering a series of commitments to boost staff numbers by 2021. And the plan commits to a phase 2, which we’ll be feeding into as this will agree on how the NHS and its staff will need to change over the long term.

What’s being promised around cancer diagnosis?

For now, the plan promises the following staff boost to better support cancer diagnosis in England by 2021:

• 668 extra doctors who interpret scans (clinical radiologists)
• 316 extra doctors who diagnose and treat diseases of the digestive system (gastroenterologists)
• 94 extra doctors who diagnose disease by looking at tissue samples (histopathologists)
• 2227 extra staff to scan patients (diagnostic radiographers)
• 200 existing health professionals trained to do endoscopies
• 300 radiographers trained to interpret scans

These extra trained staff will make a difference, going some way to filling existing gaps. But more will be needed to meet future demand.

It’s also not yet clear how these increases will be met when the plan doesn’t include a commitment to more funding. And with the targets being set nationally, local budgets may need to be shifted as hospitals recruit or train people in these workforce groups.

For now, HEE has said it will hit these promises in the next 3 years by:

• Making better use of existing staff: this will happen locally, with hospitals convincing people not to retire and encouraging trained people to return to work.
• International recruitment: this will involve local hospitals filling already vacant positions with international staff.
• Training existing staff to do more: this will involve getting people on to training schemes for endoscopy, radiography and biomedical sciences.
• Increasing trainee numbers over 3-15 years: this offers the potential for longer-term fixes by increasing the number of places for medical students to join a particular specialty.

What about NHS staff who treat cancer patients?

On top of the diagnosis challenge, the NHS is also facing staffing issues among those who treat cancer patients.

The plan out today attempts to address these issues. And we’ve published a report on the staff who treat cancer too.

Treatments are becoming more complex. And they can take a lot of time to plan and deliver safely and effectively. This means that HEE must invest in the staff who do this. Worryingly, our report found that while staff numbers in treatment teams are increasing, this doesn’t match the growing number of cancers being diagnosed each year.

Nearly 3 in 4 people who responded to our survey also said staffing shortages in treatment teams were affecting treatment and patient care.

Staff also feel that shortages limit their ability to do research, such as clinical trials.

We shared our report in advance with HEE, and some key issues have been taken on board.

By 2021, the plan promises:

• 243 extra cancer doctors (oncologists)
• 1560 extra trained staff to give radiotherapy (therapeutic radiographers)

As with the boost to diagnostic staff, these extra people to treat patients will go some way to filling the gaps. But more may be needed in the future to meet growing demand.

What next?

Exactly how hospitals will be expected to put these recommendations into practice remains unclear. What’s certain is they’ll need help to do it.

A crucial part of making this plan work will be supporting local hospitals. Local staff plans led by senior clinical leaders and management in different regions are due in March 2018, it’s vital these are published on time. We will be keeping an eye on how these local plans are drawn up.

HEE also commits to a phase 2, which will look at how to train and recruit staff after 2021. And this may ask for additional funding to achieve a longer term vision for the future of the cancer workforce.

These ambitions are vital to fix NHS staffing issues, particularly for diagnosis. So today’s announcement is an important first step. But with only 3 years to do it, and no new money, it’s going to be a challenge.

This is a challenge we can’t afford shy away from, as rising numbers of people will be diagnosed with cancer in the coming years. If the NHS can turn these promises in to long-term fixes, more of those cancers will be diagnosed early.

Camilla Pallesen is a policy advisor at Cancer Research UK

Get involved

Email your MP and ask them to find out what their local health teams need to make the new cancer workforce plan a reality.