'My cancer spread while I waited months for surgery': The cost of England's cancer wait times

Alan was diagnosed with lung cancer after a nodule was found in June last year.

The 70-year-old was meant to be operated on within weeks but ended up waiting nearly five months, by which time the cancer had spread, making his surgery more complex.

"I was so frustrated and angry and couldn't understand why they would leave me like that," says Alan.

On two occasions, scans were cancelled because machines had broken and for weeks he heard little or nothing from the hospital about when he would eventually have the urgent surgery.

Alan is one of thousands each month in England who are not being treated within the target timeframe.

Earlier this year, the government's National Cancer Plan, along with the NHS Planning Guidance, set out that 80% of patients in England would start treatment within 62 days from urgent GP referral by March 2027. This was to reach 85% by March 2027.

But in the months since the government announced this ambition, performance has got worse, according to NHS England data, not better.

Now, 69.9% of patients start cancer treatment within the 62 day timeframe. Previously it was 71.9%.

Prof Pat Price, a leading UK clinical academic oncologist, says the government targets "are now simply impossible to hit", after what she describes as a "complete loss of momentum".

Price attributes the current failures to a "complete lack of a plan or accountability".

The plan stated that a new independent cancer board would be established, but it is still not known who will be leading this group.

Radiotherapy UK analysis, shared exclusively with the BBC, suggests more than 3,000 extra patients would need to start treatment every month - a near 15% increase on current numbers - to achieve the March 2027 target.

That is likely to grow as referrals keep rising across nearly every cancer type.

Price says thousands of patients "are going to die unnecessarily, just because the government can't get their act together to treat people on time".

For every month a cancer patient waits before starting treatment, their chance of survival falls by around 10%.

By the time Alan had his operation, the cancer had spread to his lymph nodes and the nodule "had grown at an alarming rate", according to the lung specialist.

He has since been told the cancer has cleared awaiting his one-year review, but the operation has left him in debilitating pain. "I used to play golf and get out and about. Now I can't do any of the things I love," says Alan.

Roughly 54,000 more patients will need to start treatment within 62 days before 2029 for the government to hit its goal.

One NHS trust that is gaining traction on its waiting list numbers is Salisbury, but it is still not hitting targets.

Staff say there is no single fix, just a relentless focus on getting the basics right; making sure patients know about their appointments and turn up, keeping IT systems working, recruiting the right people, making sure surgical lists are full and expanding capacity.

Much of the visible progress has come through skin and prostate cancer, two of the most common cancers in the country.

Diane had a cancerous lump removed from her face at Salisbury District Hospital a few weeks ago, using an innovative procedure, which checks tumour margins are clear while the patient is still in surgery.

That means no follow-up operations, and it allows for complex reconstruction that leaves hardly a trace.

"It's amazing, you literally can't see I had a large cancerous lesion removed from my cheek," she tells the BBC in the waiting room.

Consultant plastic surgeon Neil Wickham checked her face, confirmed a biopsied lump on her arm was benign, and referred her to ENT for a separate lump in her neck.

It is the kind of joined-up care the government's Cancer Plan was meant to trigger in cancer units across England.

But over in pathology at the Salisbury trust, head of department Lee Phillips is feeling the pressure. His histology lab receives cancer service biopsies from across the hospital for diagnosis.

"The sheer volume of specimens we have coming in is our problem," he says.

"We need more staff and more kit if we're going to keep up with demand," Phillips says.

Radiotherapy is another bottleneck crying out for staff and kit. Like many trusts, Salisbury has no machine on site, so patients needing daily sessions over one to three weeks must travel up to an hour to Southampton, and sometimes Bath.

But staff in Salisbury also say missed appointments, whether down to late letters, illness, transport problems or anxiety, are a constant drain on a system already stretched thin.

Emilia Scutt, cancer manager in Salisbury, says that efforts to reduce missed appointments have really helped their numbers.

"We know cancer can be terrifying so we are a bit like a dog with the bone, backing up patients and supporting them wherever we can."

Trusts with the sharpest declines in performance - including Buckinghamshire Healthcare, University Hospitals Dorset, Milton Keynes University Hospital, East Cheshire, and Torbay and South Devon - told the BBC they face pressures across the board. Rising demand, workforce shortages and diagnostic bottlenecks have all played a part.

Some pointed to industrial action and staff sickness, others to reliance on outside diagnostic providers or major changes to how their systems work. All say they are investing in extra capacity, working through backlogs and redesigning pathways, and are already seeing early signs of improvement.

"If government is serious about delivering on the ambitions of the National Cancer Plan for England, it must match ambition with urgency," said Steve Haines of Macmillan Cancer Support.

He said that "visible progress" was needed on a promise to set up a National Cancer Board to oversee progress on improving waiting times and treatment.

A Department of Health and Social Care spokesperson says the National Cancer Plan "will help more people get diagnosed earlier and begin treatment sooner".

They concedes that "there is more to do, but we are determined to return cancer performance to the standards people rightly expect".

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