Agenda item

Cancer Screening - 62-Day Treatment Target

Verbal Update

Minutes:

The Committee received a report of Homerton University Hospital Foundation Trust and welcomed Dr. Angshu Bhowmik, consultant in respiratory and general medicine and lead clinician for lung cancer, to the meeting. The Committee was given an overview of the process and pathways for healthcare services in diagnosing and treating cancer patients, from the point of GP referral to receiving treatment. The target timeframe for this process was 62 days and the expectation was to meet this target in 85% of cases. However, there were some legitimate reasons why this could not be met, for example in the case of patients who had recently had a heart attack.

 

Performance in City and Hackney against the 62-day GP standard had been inconsistent over the last 24 months. There were challenges in meeting the target, as pathways were sometimes clinically complex, and histology was often a problem. It could take up to four weeks to devise a treatment plan. Furthermore, many new drugs were available to treat cancers, but special tests were required to determine a patient’s suitability, and it could take up to six weeks to approve drug use. The pathway was stretched to the limit to enable treatments. Timescales for surgery had shortened in recent years, but timescales for chemotherapy had gotten longer. The Committee noted that the majority of treatments completed at Homerton were compliant, but patients who went for treatments at other Trusts who then breached the 62-day target still counted towards the figures for Homerton.

 

There were three broad categories of delays; pathway management, patient choice/behaviour and clinical complexity. The Committee was informed that areas for improvement to minimise or prevent delays had been identified such as changes to staffing and recruitment, particularly in specialist positions. The hospital was also looking at how quickly tissue samples were transported, as small delays in histology could make a big difference and turnaround could take up to 10 days. There were sometimes delays for the Homerton in getting their histology results back from the Royal London. However, transporting to hospitals that were not local may in some cases mean that a sample was analysed quicker, but could equally be longer, and as this would mean the analysing doctor would not be able to attend multidisciplinary team meetings, it would not be a good thing overall. There were issues with histology timescales and similar experiences in many areas of the country, but efforts were being made to improve.

 

In response to a query from a Member, Dr. Angshu Bhowmik told the Committee that private sector work was done in the hospital, but this was separately allocated and done outside of a doctor’s NHS shifts, so should not be using up any NHS resource or contributing to delays. The Committee noted concerns around histology procedures, but recognised that this was a national issue. Members suggested looking into histology in greater detail as part of the annual workplan. Whilst it was positive that there was better available treatment, this was offset if it caused longer waits. The Committee was informed that timescales for newer treatments were coming down, but there was more work to be done. New drugs had proven to be excellent treatments but currently only a small percentage of cancers were treatable with them. It was hoped this percentage would increase significantly over the next few years.

 

The Secretary of State had been made aware of the issues around cancer treatment at the moment as it was frequently raised by the BMA and other bodies. It was not felt that the targets should be relaxed, but more effort should be made to work towards meeting them. Members suggested that the CCG and INELJHOSC may also be interested in exploring the issue of histology procedures, as a turnaround of up to 10 days was a concern.

 

The Committee thanked Dr. Angshu Bhowmik for attending and for his helpful contributions to the meeting, which had explained a complicated subject in a clear and concise manner.

 

RESOLVED – That the report be noted.