Background and History
In October 2008, the Scottish Government published Better Cancer Care - An Action Plan, where it announced it would:
- Extend the 62-day urgent referral to treatment target to include screened positive and all patients referred urgently with a suspicion of cancer (to be delivered by 2011);
- Introduce a new 31-day target for all patients diagnosed with cancer (whatever their route of referral) from decision to treat to treatment (to be delivered by 2011).
The statements in the action plan formed the basis for a revised set of cancer waiting targets, which were as follows:
- 62-day target from receipt of referral to treatment for all cancers. This applies to each of the following groups:
- any patients urgently referred with a suspicion of cancer by their primary care clinician (for example GP) or dentist
- any screened-positive patients who are referred through a national cancer screening programme (breast, colorectal or cervical)
- any direct referral to hospital (for example self-referral to A&E)
- 31-day target from decision to treat until first treatment for all cancers, no matter how patients were referred. For breast cancer, this replaced the previous 31-day diagnosis to treatment target.
Performance against these targets was achieved by December 2011; the timescale agreed by the Scottish Government. These targets are considered as National Standards from 1st April 2012.
The Cancer Waiting Times (CWT) team within ISD monitors and publishes performance on the following cancer types:
- Breast
- Colorectal
- Head & Neck
- Lung
- Lymphoma
- Ovarian
- Melanoma
- Upper Gastro-Intestinal (hepato-pancreato-biliary (HPB) and oesophago-gastric (OG))
- Urological (prostate, bladder, other)
- Cervical
A rolling programme of short term audits, looking at additional cancer types, has been taken forward by ISD. Endometrial cancer is the first tumour site to be looked at and will be monitored for management and information purposes only.
A 5% tolerance level is taken into account when measuring performance. The stated waiting time must be met for 95% of all patients covered by the target/standard. For some patients it will not be clinically appropriate for treatment to begin within the target/standard, This can occur, for example, where a series of tests needs to be done in sequence, or for a difficult diagnosis that may require a series of interventions and a period of time to resolve. The NHS Board to which a patient is initially referred is responsible for meeting 95% compliance within the 62-day target/standard. The NHS Board where the patient receives their first treatment will be responsible for meeting 95% compliance within the 31 day target/standard. This responsibility remains unchanged if an NHS Board chooses to outsource part of a patient's care.
The 31 and 62-day targets are both included as performance measures in HEAT for data up to 31st December 2011. Further information on the HEAT Performance Measures can be found on the ISD NHSScotland Performance HEAT web pages and the Scottish Government Scotland Performs HEAT web pages.
Consultation on the Ppublication of New Cancer Waiting Times Statistics
When the targets included in 'Better Cancer - An Action Plan' were launched, the existing cancer waiting times statistics at that time were replaced with a new series of figures. A consultation document was produced which summarised ISD's proposals for the new series of official statistics due to be published from June 2010. The consultation period lasted just over 10 weeks; details of the consultation results can be found in the Summary Feedback Report 
[340kb], and Detailed Feedback Report [640kb], documents.
Annual Publication of Acute Leukaemia and Paediatric Cancers
A review of all ISD statistical waiting times' publications took place in 2011. This consultation process took place between ISD, the Scottish Government and data providers to consider the user-need and frequency of a suite of waiting times' publications. The Acute Leukaemia and Paediatric Cancers publication which has been published annually since 2007 was included within this review. The outcome of the consultation is published on the website and can be found on the waiting times home page. The final recommendation was that these statistics will no longer be published by ISD; however NHS Boards should continue to ensure that data collection continues to facilitate the monitoring of performance locally. The last annual publication of acute leukaemia and paediatric cancers can be found on the Historical Data section of our web pages.
