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Cancer Waiting Times

Background

NHS National Services Scotland ISD Scotland & NHS National Services Scotland

Background

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 where the signs and symptoms are consistent with the cancer, diagnosed as per the Scottish Referral Guidelines (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 has been taken forward by ISD and will be monitored for management and information purposes only. These are available here:

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 standards are both included as performance measures in the Local Delivery Plan (LDP) standards. Further information on the LDP standards can be found on the ISD NHSScotland LDP standards web pages and the Scottish Government Scotland Performs LDP web pages.

 

© ISD Scotland 2010
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