Due to the current coronavirus pandemic, national routine screening programmes for cervical cancer, breast cancer and bowel cancer were halted. As a result of this, and compounded by the lack of face to face appointments in GP surgeries, referrals to hospital have plummeted.

There is now a backlog of more than a million cancer screening samples with as many as 850,000 delayed MRI and CT scans still to be carried out. There are widespread concerns that this will inevitably cause delays for patients, resulting in conditions being diagnosed too late, and affecting the treatment options available to them. For some, treatment will no longer be an option. 

Cancer Research UK has expressed concern that more than 2 million people could be waiting for tests. The Vice President for Clinical Radiology, Dr Caroline Rubin, has said: “We stopped virtually all non-urgent imaging at the start of lockdown. Everything has been put on a waiting list and deferred so we have a significant backlog going forward.” The Royal Colleges of Pathologists and Radiologists have warned that treatments for all patients across the NHS could be delayed further.

There are concerns from experts that 97 per cent of labs do not have enough pathologists to carry out the work required to deal with the current backlog. There have even been reports of staff working unpaid hours. President of the Royal College of Pathologists, Professor Jo Martin, told The Independent as many as a million pathology tests could be waiting for review. She advised: “We are about a quarter of the workforce down, nationally. That’s 97 per cent of departments who don’t have enough pathologists...We don’t have the capacity to keep up even under normal circumstances. But with the additional catch-up work we will be even further behind. That means potential delays for treatment.”

Experts have raised concerns that to keep up with the backlog the number of radiology posts would need to be increased nationally by a third. Coronavirus precautions also limit the number of scans that can be performed. One NHS radiologist whose unit has more than 9,000 delayed scans told The Independent: “It is an absolute catastrophe. There are patients waiting to know if they have cancer or not and we can’t say when the scan is even going to get done. There will be delays, and a delayed diagnosis could mean a cancer patient goes from a curative to non-curative diagnosis. That’s devastating. I think it is inevitable and probably has already happened.”

According to The Royal College of Radiologists the NHS is short of 1,900 radiologists, equating to a third of the workforce. Much of the UK’s radiology equipment is over 10 years old and compared to other European countries a significantly reduced. Dr Rubin has commented, “We are extremely worried, radiologists touch every clinical pathway. Across the board people are being disadvantaged and some of them may be sitting on serious disease, including cancer.”

Pathology samples are currently sent by post or courier to other labs. It has also been reported that it would cost up to £400m to create a digital pathology service to allow lab samples to be scanned into high-resolution images. This would allow transfer of images between labs to be instant, which would also allow pathologists to work remotely.

The government and NHS England have been implored by both Royal Colleges to invest in equipment, infrastructure and to increase the number of doctors training in diagnostics. Saffron Cordery from NHS Providers, which represents hospital trusts, said “A key issue is to not only have the ability to handle the expected ‘surge’ in demand, but also the possibility that some patients conditions may have got worse during this time”. She continued, “Diagnostics are absolutely key to getting many services back up and running and providing timely access to care, and we know that our trust leaders do not underestimate the importance of this.”

There have been increasing calls for support for patients and for the public to be warned about delays, along with transparency about the impact of that. Chair of Healthwatch England, Sir Robert Francis QC, shares his concerns saying: “From the thousands of conversations Healthwatch have had with people about the impact of Covid-19, we have heard first-hand the fear and stress people have experienced when tests or treatment for cancer have been delayed…Poor communication has left individuals feeling powerless, confused and worried about their future. The NHS is already facing a backlog of work. Reports about further delays are likely to compound people’s concerns.”

He stressed that the NHS should prioritise urgent cases and be open with patients on the potential impact of any delays to treatment. A spokesperson from The Department of Health and Social Care said, “We have been clear that the NHS will get whatever funding it needs to respond to the coronavirus outbreak. On top of this, we are already providing the NHS with a record cash funding boost of £33.9bn extra by 2023-24, as well as £200m for new diagnostic machines.” A spokesperson for NHS England has also confirmed that services were already adopting digital technology for cancer so that experts can speed up results and share their knowledge more easily. The NHS has now created 21 hubs to perform urgent operations. In addition they confirm, “The NHS is making full use of the additional scanning capacity in the independent sector as well as buying additional scanners so tests can go ahead as normal in spite of the very real challenges posed by the coronavirus pandemic.”

For more information about the original news story, please click the following link: https://www.independent.co.uk/news/health/coronavirus-nhs-delays-cancer-pathology-screening-radiologists-a9554871.html

We know that it is important that those with health concerns can access the support they require at this difficult time. Should you have new or existing symptoms we would suggest contacting your GP in the first instance. Should you have concerns that a condition has been missed or there has been a delay in any cancer treatment during the Covid19 pandemic then we may be able to assist you.

Although we are, for the time being, not able to meet clients in person, our specialist clinical negligence team at Freeths is here to support and advise clients. We are available for meetings and consultations via telephone, email, FaceTime, WhatsApp, Skype and any other digital platform that works for you.

Please contact our team:

Karen Reynolds, Partner (Derby/Stoke on Trent/Birmingham): 0845 272 5677 or karen.reynolds@freeths.co.uk

Carolyn Lowe, Partner (Oxford/Milton Keynes) on 0186 578 1019 or carolyn.lowe@freeths.co.uk

Jane Williams, Partner (Leicester/Nottingham) on 0845 272 5724 or jane.williams@freeths.co.uk