According to the latest NHS figures, about 34,000 fewer people in London have had a GP referral for suspected cancer than expected compared to 2019. This could potentially put those with suspected cancer at risk of a late cancer diagnosis that could affect their outcomes.

Although in October 2022, like in most months of this year, there was an increase in the number of Londoners that saw a specialist for suspected cancer, the national target has still been missed in London for 19 consecutive months.

The total number of people starting cancer treatment in London since the start of the pandemic is about 3,000 lower than expected[iv]. The latest Macmillan analysis estimates the NHS in London would need to work at 110% capacity for 10 months to clear the backlog of first cancer treatments.

Facts & Figures:

Number of GP referrals for suspected cancer and the two-week-wait target:

The number of people being seen by a specialist for suspected cancer in London following an urgent referral by their GP was 37,842 in October 2022. This was ~14% higher than the pre-Covid-19 average.
The total number of people who have seen a specialist for suspected cancer in London since the pandemic began is still more than 34,000 lower than expected (a drop of approximately 3.2%). However, this figure has been decreasing consistently over 2022.
This drop (3.2%) is the equivalent to urgent referrals in London having been suspended for over 4 weeks.
In October 2022 86.6% of people were seen by a specialist within 2 weeks of their urgent GP referral, against a national target of 93%. This target has now been missed for 19 consecutive months.
In October 2022, 5,058 people had their first appointment with a specialist more than two weeks after their initial urgent referral. In contrast, the monthly average before the pandemic (across 2019) was 2,300 per month. However, the numbers meeting the two-week-wait target are very similar or higher than pre-pandemic figures, suggesting there is a backlog, as the total number seen has been steadily climbing since 2018.

Waiting for first cancer treatment:

The number of people starting treatment for cancer in London in October 2022 was 3,475. This represents a rise (~11%) compared to the pre-pandemic average.
The total number of people starting cancer treatment in London since the start of the pandemic is about 3,000 lower than expected (a drop of 3%).
This drop (3%) is the equivalent to first treatments for cancer having been suspended for just over 4 weeks.
The latest Macmillan analysis estimates the NHS in London would need to work at 110% capacity for 10 months to clear the backlog of first cancer treatments.
In October 2022 95.1% of people started first treatment for cancer in London within 31 days of a decision to treat, against a national target of 96%. This target has now been missed for 15 consecutive months, but overall in 2022 this has improved a lot compared to 2020/2021.

Paola (52) who was diagnosed with breast cancer in 2017 and colorectal cancer in 2020, has undergone a range of treatments and experienced delays:

“After my first diagnosis, it took about 6 months for my records to be transferred from Cornwall to London. When I started experiencing some pain under my arm pit and my GP requested a scan to make sure it was nothing serious, months went by. I eventually had a letter through for an oncologist appointment, however the appointment kept getting cancelled. I have yet to see an NHS oncologist for over 3 years.

“In May 2020 I started to get bleeding, was in a lot of pain. By July it had become so bad that I contacted the GP. I was eventually diagnosed with bowel cancer that would have likely been picked up if they scanned me during my breast cancer treatment. [They believe] My bowel cancer tumour took approximately 8 years to grow as large as it did, so it actually came first.”

Emma Tingley, Head of Partnerships in London at Macmillan Cancer Support, said:

“Despite improvements, the latest data continues to illustrate the huge challenge still facing NHS cancer services on top of all the well-known winter challenges. Thousands of people living in London continue to experience delays to diagnosis or treatment.

“Healthcare staff across the capital work tirelessly to offer the best possible care, support people and save lives. But as more and more people enter a cancer care system that is already struggling, the Government must guarantee the NHS has all it needs to address the longstanding challenges cancer care has been facing, including significant staffing shortages. As we know the highest nursing shortages (or vacancy rates) in England are found in London[v]. Without extra funding, we are deeply concerned the situation for people with cancer is set only to go from bad to worse as patients are once again left to pay the price.

“Macmillan continues to support both professionals and thousands of Londoners with cancer or cancer symptoms who may have faced disruption to their treatment or appointments and may be worrying about the long-term implications on their health, families and future.”

For support, contact our specially trained nurses and experts on the Macmillan Support Line, 0808 808 00 00 (8am-8pm, 7 days/week) or visit macmillan.org.uk.