Our ambassadors standing in front of the houses of Parliament.
This post was updated on Monday 2nd December to fact check claims about how many staff the NHS needs.
Disclaimer: because each nation in the UK runs it’s own health system, this election hasn’t featured lots of discussion about the health systems of Scotland, Wales and Northern Ireland. We’ve included questions about these nations when they’ve come up, but otherwise most of the questions are about the health service in England.
It’s already been a busy year for politics. But with six weeks of campaigning before the General Election on 12th December, the noise from political parties is only set to increase. And the NHS and health are becoming key areas of debate.
To help sort the hard facts from the political point-scoring, we’ll be keeping an eye out for any claims about cancer.
How many more staff does the NHS need?
In the last couple of weeks, senior NHS leaders said that a lack of doctors and nurses is putting patient safety at risk, while each of the political parties have published manifestos, outlining their suggestions for how to make sure our health system has enough staff.
The big question is: how many more staff does the NHS need?
The first job will be to fill gaps. There are vacancies across the NHS – including for cancer, where 1 in 10 diagnostic posts are unfilled. The chief executive of the NHS Confederation has said that across England, the NHS would need about 100,000 more staff to run its services.
But that’s just to meet current demand. Pressure on the NHS is going to increase as our population grows and gets older – by 2035, more than 500,000 people in the UK are expected to be diagnosed with cancer each year. So the second job will be ensuring there are enough staff to keep up. To take one example, the NHS will need 70% more radiologists in 10 years compared to current numbers to meet growing demand.
Finally, after filling gaps and keeping up with demand, we want to improve quality of care, which – you guessed it – means more staff, amongst other things.
All of this means the NHS will need to think long-term and plan properly. Nobody really knows yet how many more staff we’ll need, so we’re calling on the next Government to make a long-term, fully-funded plan so the NHS can meet these challenges, and diagnose cancer earlier.
Are waits for diagnostic tests in England at their highest for 11 years?
This waiting time includes anyone who has been referred by their GP for a diagnostic test. That could include tests to diagnose or rule out cancer, but it includes people who have been referred for other things too.
The target for NHS England is that patients should have a test within 6 weeks of being referred. And according to the 2019 figures, the proportion of people waiting 6 weeks or longer for diagnostic tests has been higher than at any point in the last 11 years.
A major reason for this is the NHS doesn’t have enough staff conducting diagnostic tests – 1 in 10 diagnostic posts in the NHS are currently unfilled.
Are more people waiting longer for urgent cancer treatment?
One claim you may have heard is that the number of people waiting longer for urgent cancer treatment has tripled over the past 9 years.
Let’s start with what it means to ‘wait longer’. If a GP suspects someone has cancer and urgently refers them to a specialist, the NHS aims to make sure they see that specialist within 2 weeks and, if needed, begin treatment within 62 days.
Over the past 9 years, the number of people in England who have waited longer than 62 days hasn’t quite tripled, but it has gone up: from around 13,400 people in 2009-2010 to around 34,200 people in 2018-19.
But, the number of people who did start treatment within 62 days has also gone up. Around 84,200 people in 2009-2010 were treated within the timeframe, which went up to around 130,000 people in 2018-19.
The rise in both numbers is because more people are being referred by their GPs. And that’s why it’s more useful to look at the proportion of people who’ve been treated on time, which has fallen from about 86% in 2009-10, to about 79% in 2018-19.
This shows that the NHS can’t keep up with rising demand, and this is partly because it doesn’t have enough staff to diagnose and treat cancer.
Are survival rates improving in England?
The short answer is that, on the whole, survival rates have been improving. In England and Wales, the number of people who survive their cancer for 1, 5 and 10 years has been going up since the early 1970s.
But while the figures are moving in the right direction, it’s important to put them into context. We recently published analysis showing that overall, UK cancer survival still lags behind comparable countries like Australia, Canada, and Ireland, with late diagnosis being a key reason.
Does waiting longer affect how likely someone is to survive their cancer?
It’s been said that the longer people wait, the less chance they have of surviving their cancer.
It’s hard to say that waiting longer always means a lower chance of survival, because there are so many factors involved. What kind of cancer someone has, or how well their cancer responds to treatment are just two things that affect whether waiting longer lowers someone’s chance of survival.
That said, we know that being diagnosed and treated early gives people the best possible chance of survival, and in that sense the claim is spot on. Late diagnosis in the UK is a major reason we fall behind comparable countries for cancer survival – around 115,000 people in England are diagnosed at a late stage each year.
Are Wales missing cancer treatment waiting time targets?
Another claim to come out of Prime Minister’s Questions was that the cancer treatment waiting time in Wales has not been met since June 2008.
Wales has missed the target of having 95% of patients start treatment within 62 days of urgent referral for cancer since around November 2008, with the exception of a few months in 2010. Currently only around 80% of patients in Wales are starting treatment within 62 days of their urgent referral.
But, to add some context, none of the UK nations are meeting their respective waiting time targets at the minute.
And Wales has just introduced new, single cancer waiting time for all patients, which says all patients should start treatment within 62 days of the first suspicion of cancer. It hasn’t set a figure for this target yet, but it’s the first UK nation to try this approach and others will be watching with interest to see if it has an impact.
Do we have more or fewer nurses and doctors in the NHS?
Lots of NHS staff numbers get thrown around and it can be confusing. A few recent claims include:
- There are 17,300 more doctors and over 17,000 more nurses on wards since 2010
- GP numbers are falling and there is a 43,000-nurse shortage in the NHS
It’s hard to say if these exact numbers are correct – though similar figures are quoted by the Nuffield Trust and the NHS. The important point is the overall situation: staff numbers are up in some professions, but there still aren’t enough staff to meet demand.
A lot of this is because our population is ageing and demand on the NHS is rising.
How much funding is the NHS really getting?
Context is key when it comes to NHS figures, perfectly demonstrated by the following 2 claims, which at first seem contradictory:
- ‘This Government are investing £34 billion in the NHS.’
- ‘The NHS has suffered the longest spending squeeze ever in its history.’
First, where has the £34 billion figure come from? The NHS long-term plan was announced in 2018, committing to £20.5 billion of investment for NHS England by 2024. And Scotland, Wales and Northern Ireland will get about £14 billion between them to mirror the increase in funding in England. All in all, that’s about £34 billion.
That said, NHS funding has been rising at a slower rate than ever before. Before 2010, NHS funding went up every year by about 3.4%. But since 2010, it’s only gone up by about 1.5% a year.
When it comes to cancer, it’s crucial the NHS has what it needs to diagnose and treat cancer early – from a full-strength workforce to top-quality equipment. The ambition in the NHS long-term plan to diagnose more cancer is fantastic, but it won’t be possible unless we have enough staff.
Joseph Ewing is a public affairs officer at Cancer Research UK
Want more facts? Have a read of our recent report ‘Cancer in the UK – 2019’, which gives an overview of prevention, early Diagnosis, treatment, data and research across the nation.