“We won’t be able to care for the rising number of cancer patients and diagnose them early without more specialist staff,” says Dr Giles Maskell, consultant radiologist at Royal Cornwall Hospitals.
It’s a familiar picture: a short-staffed NHS is leaving hospitals under increasing pressure.
“Far too many patients are waiting too long for scans and results. In my own department, staff are already at full stretch,” adds Maskell.
“Extra scanners are welcome but will achieve nothing without staff to run them and experts to interpret the scans. It’s like buying a fleet of planes with no pilots to fly them.”
Put simply, the NHS is heading for a staff crisis. But what’s the true shortfall in staff? And how many might be needed in the future to achieve the Prime Minister’s commitment to diagnose more cancers early?
We’ve attempted to find out by estimating the number of cancer staff the NHS will need in the future so that people with cancer receive the best possible care. And it highlights the challenges ahead.
Based on our estimates, we think the NHS will need to double its cancer staff to cope with demand.
Share the findings of our new report with the Health Secretary, Matt Hancock, by writing to him and asking him to come up with plan to fix this pending staff crisis.
What did we do?
By 2027, around 389,000 people in England are expected to be diagnosed with cancer every year, which is an increase of over 80,000 on current levels. We wanted to estimate how many staff would be needed to diagnose and treat this many more people in the future.
It may surprise you, but workforce planning in the NHS doesn’t always consider the needs of patients in the future.
We spoke to doctors to find out how many times they need to perform certain tasks to care for people with different types of cancer, and how long each task takes.
We then used the projected number of cancer cases to estimate how much staff time would be needed to care for cancer patients in 2027 – making sure to reflect the fact that many more people will undergo tests for cancer than will go on to be diagnosed with cancer.
By asking doctors what proportion of their time they spend caring for patients with cancer, we were then able to estimate of how many staff in total would be required in the future.
What did we find out?
We estimated the staff numbers that we think the NHS will need in 2027 across four key groups who diagnose and treat cancer:
- radiologists (who interpret scans);
- gastroenterologists (who perform tests such as colonoscopies);
- therapeutic radiographers (who treat patients with radiotherapy); and
- oncologists (who treat people with cancer).
Our estimates show that across these key groups, the number of staff needs to double by 2027 – just to meet the needs of the extra people we expect to be diagnosed with cancer in the next 10 years.
There are many other crucial staff for whom we couldn’t estimate numbers, but where the NHS will likely need to boost numbers too, such as GPs, histopathologists and diagnostic radiographers.
The NHS needs more staff to help people affected by cancer
These extra staff are what we estimate will be required to provide the same level of care for increased numbers of patients in the future.
But we want more people to survive their cancer for 10 years or more in the future. To do this the NHS needs to improve care, not just maintain current standards.
The Prime Minister’s recent commitment to diagnose 3 in 4 cancers at an early stage by 2028 will be vital to this – for the most common cancers, people are 3 times more likely to survive when their cancer is diagnosed at an early stage (1 and 2) compared to a late stage (3 and 4).
The Prime Minister announced some changes to help meet this ambition, such as lowering the bowel screening age to 50. Our report considers the possible impact of these and many other changes on the staff numbers we need. For example, lowering the bowel screening age is likely to require many more colonoscopies, which means the NHS will need more staff to perform these tests.
As well as diagnosing people earlier, the NHS must make sure patients have access to the best possible treatments when they are diagnosed. Our report explores how new treatments might affect the numbers of staff the NHS needs – for example, newer types of radiotherapy like IMRT, SABR and proton beam therapy might require more radiographers to carry out more complicated planning and treatment.
We want the Government and the NHS to factor in growing patient numbers, as well as ambitions to provide better care, when developing a long-term plan for the workforce.
Doctors and other healthcare professionals take a long time to train – so if the Government doesn’t plan now to meet the needs of future patients, the NHS won’t achieve better cancer services and improve survival.
Patients now and in the future need a long-term plan for the NHS workforce, and the Government must provide investment to make it happen.
Matt Case is a policy manager at Cancer Research UK
Have your say
Ask Matt Hancock to fund a long-term plan for the workforce – without one, the NHS won’t be able to provide better care for patients in the future.
Dr Luisa Motta November 17, 2018
“We wanted to estimate how many staff would be needed to diagnose and treat this many more people in the future. It may surprise you, but workforce planning in the NHS doesn’t always consider the needs of patients in the future.” I entirely agree. What is more, it truly surprises me how histopathology is forgotten as an essential medical specialty, crucial to cancer diagnosis. Histopathologists also offer in their reports information on prognosis and predictive information relevant to treatment. How many histopathologists are required to diagnose this many more people in the future?
Nick Peel November 20, 2018
Thanks for your comment.
We agree that histopathologists play a vital role in diagnosing and treating cancer, and that staff shortages in this profession are taking their toll on the NHS and affecting patient care. But in our recent report we were unable to specifically estimate the number of histopathologists that will be needed in 2027 to meet demand. This was because there wasn’t enough data available for the profession.
As part of our campaign on NHS staff shortages, we’ve been asking the Government to train and employ more NHS staff in a range of roles, including histopathologists. And we’ve been working with other organisations to raise the profile of the profession and the challenges histopathologists face.
Nick, Cancer Research UK