NHS still failing to provide acceptable level of care for all cancer patients

Cancer care has made a patchy improvement in the past six years, but the NHS is still letting many patients down, a report by two watchdog organisations said yesterday.

More than 90 per cent of patients referred to hospital by their GP are seen within two weeks, survival rates for most cancers are better and there are more specialist surgeons, the report by the Commission for Health Improvement (CHI) and the Audit Commission found. But standards of care still vary widely between hospitals.

Peter Homa, chief executive of the CHI, said: "The NHS is not providing an acceptable level of care to all patients with cancer. Some patients have benefited from additional resources and a national focus on cancer care, but many others experience unnecessary delays and poor co-ordination of services."

The survey reviewed pro-gress since the 1995 Calman Hine report recommended that all patients with cancer should see specialists, that more effort should be to detect the disease early, and that the best techniques should be used nationwide. It also followed pub- lication of the Government's NHS cancer plan a year ago.

The report said there were still big gaps in the service delivered, including poor use of equipment and a wide variation in waiting times for diagnosis, treatment, and access to hospital beds.

Although 92 per cent of urgent referrals were seen within two weeks, patients regarded as non-urgent (50 per cent of the total) could wait much longer for an appointment, and GPs varied widely in their definition of urgent. Waiting times for treatment also varied greatly depending on cancer type. Although most lung-cancer patients waited no more than a month for operations, some people waited twice that. Waits for potentially curative radiotherapy for skin cancer were up to eight weeks in 40 per cent of hospital trusts, though urgent radiotherapy could be provided within 48 hours.

The report also found that hospital discharges were not always properly planned. GPs and district nurses could be unaware a patient had gone home, sometimes without necessary services or equipment being arranged.

Despite growing specialisation in cancer among surgeons, many oncologists had to see patients outside their specialty and many patients were operated on by non-specialists.

The shortcomings were sometimes caused by bad organisation rather than lack of money, the report found. Richard Waite, senior project manager at the Audit Commission, said: "This is a question of local leadership and local will. It's not a matter of money to get multi-disciplinary teamwork going forward."

Sir Andrew Foster, controller of the Audit Commission, said: "Though there are examples of good care, many cancer patients are suffering as a result of poor communication and planning. Services are overly complex and disjointed."

Professor Mike Richards, the Government's national cancer director, said significant progress had been made. "The pace of change is quickening, but we have a long way to go," he said. "Where deficiencies have been identified, trusts have been asked to prepare action plans to put this right."