Covid: Hundreds of thousands fewer referrals for suspected cancer in England during pandemic, reports finds

Hundreds of thousands fewer referrals for suspected cancer were made by GPs in England during the course of the Covid pandemic, new analysis has found.

This reduction has led to tens of thousands fewer people than expected being diagnosed with cancer, according to the National Audit Office (NAO).

In its latest report on NHS backlogs in England, the NAO said that it was “impossible” for the NHS to fully maintain cancer care throughout the crisis and that millions of people have “avoided seeking, or been unable to obtain healthcare” during the pandemic.

The NAO estimates that in England there were between 240,000 and 740,000 “missing” urgent GP referrals for suspected cancer during the period of the pandemic up to September 2021.

Between 35,000 and 60,000 fewer people started treatment for cancer than would have been expected, the NAO said.

By June 2021, cancer services had recovered to pre-pandemic levels, but in September “only 68% of patients requiring treatment within 62 days of urgent referral by their GP were receiving that treatment on time”, added the NAO.

In addition to the missing cancer referrals, the NAO also said that there were between 7.6 million and 9.1 million “missing” referrals for elective care over the same period.

However, the authors of the report said that it is uncertain how many “missing” cases will return to the NHS for treatment, or how quickly the NHS will be able to resume usual activity.

The waiting list would reach 12 million by March 2025 if 50% of missing referrals return to the NHS, and activity grows in line with pre-pandemic plans, estimated the NAO.

‘Things will get worse before they get better’

Meg Hillier, chair of the Public Accounts Committee, said of the report: “The pandemic has heaped yet more pressure on a care system that was already creaking under the strain.”

“Covid-19 forced the NHS to cut back on normal activity, creating a backlog of patients who are now returning.

“The report estimates there are millions of ‘missing’ patients who avoided seeing or were unable to see a doctor during the pandemic. It’s unclear how many will return or the impact this has had on their health.

“Things will get worse before they get better, with the NAO estimating that waiting lists will be even longer by 2025.

“Time will tell whether the extra funding and Government’s new recovery strategy will be enough to address the backlogs.”

Eve Byrne, head of campaigns and public affairs at Macmillan Cancer Support, said: “This report confirms what we hear day in, day out from people living with cancer. Chronic staffing shortages are already having a devastating impact on cancer patients, and we have major concerns that it is only set to worsen without urgent action.”

A spokesperson for the NHS in England said: “Treating more than half a million patients in hospital for Covid, as well as delivering a world-leading vaccination programme, has inevitably had an impact on some routine and non-urgent care, yet since the pandemic begun the NHS has performed millions of elective procedures and over 450,000 people have started treatment for cancer.

“NHS staff are now pulling out all the stops to recover elective activity levels, making good use of additional resources to open new surgical hubs and diagnostic centres, develop innovative ways of working and perform more operations, tests, checks and scans, so anyone who is concerned about their health should come forward so the NHS can help you.”

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