Cancer has remained a priority during the COVID-19 pandemic, and will remain so as NHS Scotland continues to recover and remobilise. The development of clinical guidance, such as the Framework for the Recovery of Cancer Surgery has meant that the majority of cancer treatments have continued, with some patients travelling to other areas to receive treatment.
While the 31 day cancer waiting times standard (CWT) has been consistently met throughout the pandemic (from decision to treat
to first treatment), the 62 day standard remains challenged (from urgent suspicion of cancer (USC) referral to first treatment).
The challenges facing the NHS in Scotland over the last year have been significant and the way in which care is delivered has changed. NHS Health Boards have been working tirelessly to see, assess and treat patients based on clinical urgency, with an increase in virtual consultations. Meanwhile, increased, appropriate health protection measures to keep patients and staff safe has reduced available capacity across most pathways, including cancer.
The £114.5 million National Cancer Plan, published December 2020, encompasses a wealth of work underway to redesign cancer services and increase services resilience.
The plan commits to incorporate the new ways of managing cancer pathways and services across NHS Scotland that have emerged as a result of COVID-19, by undertaking a refresh of the Framework for Effective Cancer Management. The Framework, initially developed in 2018, provided every Health Board that delivers cancer care in Scotland with the tools to effectively manage cancer patients and recover waiting times by promoting best practice, alongside hands-on expert support.
The Framework has been refreshed for NHS Scotland's Cancer Management Teams and will be accompanied by in-depth advice and support to Boards from the National Performance Manager for Cancer, who will review local cancer pathway management processes, from beginning (referral) to end (treatment). In line with this Framework, detailed recommendations and action plans will be developed in partnership with every Health Board in Scotland, to ensure it is embedded and that USC patients move timeously through their pathway, with any backlogs that have emerged as a result of the pandemic cleared.
The recently published NHS Recovery Plan commits to achieving the 62 day cancer waiting times standard over the course of the parliamentary term – this Framework will be central to these efforts and will require collective collaboration between primary and secondary care teams, with the patient and their carers needs at the centre. Only when all eight key elements of the Framework are embedded, will effective cancer management begin to be fostered.