A REPORT released by Audit Wales has revealed that cancer care in Wales continues to struggle with significant delays in diagnosis and treatment, highlighting the need for urgent improvements. Despite increased investment in recent years, no health board has met the national target that 75% of cancer patients should begin their first treatment within 62 days since August 2020.

The report, embargoed until January 14, 2025, stresses that stronger national leadership and a sharper focus on preventative measures are critical to addressing these persistent challenges.

National targets missed

Audit Wales noted that while survival rates for cancer patients in Wales have improved, they remain poor compared to other countries. Wales has the second-highest cancer mortality rate in the UK, behind Scotland. The disparity is especially evident for individuals living in deprived areas, where outcomes are significantly worse.

Since the COVID-19 pandemic, performance has stabilized between 52% and 61% of patients starting treatment within the target timeframe. For some cancers, such as lower gastrointestinal, gynaecological, and urological cancers, waiting times exceed 100 days for certain patients, underlining the urgency of the problem.

Screening and early detection

Early detection is key to improving survival rates, with screening playing a vital role. The report praised the expansion of the national bowel screening programme, which now reaches more people using a more sensitive test. However, it pointed to opportunities to increase uptake for breast and cervical cancer screenings and urged a decision on introducing a national lung screening programme.

Rising demand and staffing challenges

The demand for cancer diagnosis and treatment in Wales is growing. Between 2002 and 2021, the number of newly diagnosed cancers rose by 22%. Suspected cancer referrals have also increased, creating additional strain on the NHS. Notably, more than 84% of these referrals ultimately determine that the patients do not have cancer.

Staffing gaps and capacity limitations further compound the issue, with waiting lists for cancer services continuing to grow. Despite Welsh Government ambitions to return waiting lists to pre-pandemic levels, the report suggests this goal is unlikely without significant increases in diagnostic and treatment capacity.

Leadership and prevention

The report emphasizes the importance of clear national leadership in addressing the challenges facing cancer services in Wales. It noted weaknesses in current oversight arrangements, particularly concerning the status of the NHS Wales Cancer Improvement Plan, launched in 2023. Clarity is needed on how this plan integrates with other initiatives to drive the required improvements.

Preventative measures were also highlighted as critical. Approximately 40% of cancers in Wales are preventable, with lifestyle factors like smoking, diet, and physical inactivity contributing to risk. Tackling these factors could save lives and reduce pressure on the NHS, as these same risks also contribute to other major health conditions.

A call to action

Auditor General Adrian Crompton stressed the importance of addressing these challenges, stating:
“Despite increased investment, too many people are experiencing unacceptably long waits for cancer diagnosis and treatment. Variations in performance persist, and insufficient attention is being placed on prevention of lifestyle factors that cause cancer. National leadership and oversight must be clarified and strengthened as a matter of urgency.”

Moving forward

The Welsh Government is responsible for setting the strategic direction and holding health boards accountable for their performance. Health boards and trusts are tasked with planning and delivering services to meet national targets.

The report is a stark reminder of the work needed to ensure timely cancer care for all. The publication serves as a rallying call for coordinated action across government, health boards, and communities.

For anyone affected by the report’s findings, details of support services can be found through the Wales Cancer Alliance.

WALES’ leading doctor Sir Dr Frank Atherton has announced he will stand down after eight and half years as the Welsh Government’s Chief Medical Officer.

Sir Frank has provided independent advice to the Welsh Government on all major issues affecting the health sector in Wales.

During his tenure in Wales, after a previous post in Canada, Sir Frank played a leading role in Wales’ response to the Covid pandemic and has supported the NHS through flu outbreaks and annual winter pressures.

Speaking about Sir Frank’s decision to stand down, Health Secretary Jeremy Miles said: “Sir Frank has provided invaluable advice and guidance, which I am hugely grateful for.

“He played a leading role in our response to the pandemic, ensuring people throughout Wales received valuable information about the virus and about how to keep themselves and their loved ones safe. I wish him all the best for the future.”

Judith Paget, chief executive of NHS Wales, said: “Frank has shown how passionate he is about improving health outcomes for the Welsh population and has led the way on improving the quality of healthcare.

“It has been a privilege to work with him and to have the benefit of his experience and commitment to new approaches.

“He has played a crucial role in being the Welsh voice around the table with other UK Chief Medical Officers, government departments and organisations”

Sir Frank has been responsible for leading the medical profession in Wales and the development of health and care research.

Speaking ahead of leaving his post, Sir Frank said: “It has been a privilege to act as CMO and a highlight of my professional career to have served the people of Wales during this incredibly challenging time.

“I would like to thank all those other civil servants, who have worked tirelessly behind the scenes, who have assisted me for almost a decade in this role.”

Frank Atherton’s successor will be announced in due course.

A WELSH NHS Confederation spokesperson has highlighted the immense pressure currently facing health and social care services in Wales due to a combination of factors, including winter viruses, staff sickness, cold weather, and an influx of severely ill patients.

Significant Challenges Across Services
Rising cases of flu and respiratory illnesses are significantly impacting NHS services, including GPs, urgent, and emergency care. Hospitals are opening surge bed capacity where possible and temporarily increasing staffing levels in community services to cope with demand. Many health boards have reinstated stricter infection prevention measures, such as mask-wearing in hospitals, and are asking unwell visitors to stay home to protect patients and staff.

High Levels of Escalation and Delays
Hospitals across Wales are operating at critical levels, resulting in long waits for care, including ambulance handover delays. Health boards are grappling with the difficult decision to postpone non-urgent treatments and surgeries, further straining efforts to reduce waiting lists. High levels of community infections, including flu, COVID-19, RSV, and norovirus, are exacerbating the situation by causing bed closures and ward cleaning to prevent the spread of illnesses. One health board, for example, has approximately 100 beds closed due to flu.

Discharge Delays Impacting Patient Flow
A persistent issue is the significant number of medically fit patients remaining in hospitals while awaiting care and support at home. This bottleneck affects the flow of patients through the system. Health boards are working closely with local authorities to expedite discharges and free up beds for those requiring hospital care.

Appeal to the Public
Healthcare staff are working tirelessly under incredibly challenging conditions. The Welsh NHS Confederation has urged the public to treat health and care staff with respect and to take steps to help alleviate pressure on the NHS:

• Take precautions in icy weather to prevent falls, particularly among the elderly.
• Ensure prescription medicines and first aid supplies are stocked.
• Check on vulnerable loved ones and practice good hand hygiene.
• Seek vaccinations for flu, COVID-19, and RSV to protect against severe illness.
• Use NHS 111 online for advice and minor ailments, and visit pharmacies or Minor Injury Units where appropriate.

“Staff are doing everything they can to provide care in these extremely difficult circumstances,” the spokesperson said. “We all have a role in ensuring NHS resources are available for those who need them most.”

For more information, visit the NHS 111 website or contact your local pharmacy for support with minor health concerns.