Cancer care in ‘crisis’ prior to coronavirus pandemic due to severe staff shortages, figures show

Exclusive: Research from Macmillan Cancer Support shows NHS short of 2,500 cancer nurses before Covid-19 crisis, placing immense strains on chronically overstretched workforce and support services

Cancer care across the NHS was already at “crisis level” before the emergence of Covid-19, data has shown, due to a shortage of specialist nurses that left thousands of sick patients short of crucial, potentially life-saving support.

Prior to the pandemic – which has disrupted the diagnosis, treatment and care of millions of cancer patients in the UK – the NHS in England was short of 2,500 cancer nurses, according to research from Macmillan Cancer Support, placing immense strains on a chronically overstretched workforce while depriving patients of their full treatment.

This gap in staff means the average cancer nurse would need to work almost double (84 per cent) their contracted hours to provide the appropriate care for patients.

The impact of these shortages has been acutely felt among cancer patients, Macmillan added.

A YouGov survey of 2,000 people with cancer in the UK, carried out pre-lockdown, shows that one in five recently diagnosed patients in England (21 per cent) had not received support from a specialist cancer nurse during either their diagnosis or their treatment.

A further 5 per cent had not received any support at all – equating to more than 80,000 of those diagnosed with cancer every year. One in five (22 per cent) of those who did receive support said it was not enough to address their needs.

Hayley Parker, a patient from Lancashire, was diagnosed with throat cancer in 2014 after finding a lump in her neck. She said the support she needed “just wasn’t possible” due to staff shortages.

“It was a frightening time for me after I was told I had throat cancer,” she said. “I had so many questions about my cancer, my treatment and my future, but staff were rushed off their feet and the support that I so desperately needed just wasn’t possible.

“How could I ask them to help me when they were doing their best but so very stretched?

“I’m sure this experience of being lost and in the dark in the first few weeks before I was transferred to another hospital, led to me later being diagnosed with anxiety.”

Macmillan’s research also found that 63 per cent of those with cancer in England who say they didn’t get enough support from nurses were left uncertain about queries relating to the disease. This included not having their questions answered and being unsure how to take their medication, or which side effects to look out for.

The findings raise further questions of how the NHS, which is in the process of restarting non-Covid services, will tackle an extensive backlog of cancer cases.

An estimated 2.1 million patients are awaiting screening for breast, cervical and bowel cancer, according to Cancer Research UK, while 290,000 have missed out on referrals to confirm or rule out the presence of tumours.

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Lynda Thomas, chief executive at Macmillan Cancer Support, called on the government to “take control of the spiralling NHS staffing crisis” to ensure nurses are provided the support they “need now more than ever”.

“The NHS nursing shortage was already at crisis level ahead of the pandemic and these issues will likely have only been made worse over the last few months,” she said.

“No one should be left without anywhere to turn after a diagnosis, or to feel the anxiety of prolonged delay to treatment they desperately need, or to feel alone and unheard during such a frightening time in their lives.

“NHS staff are doing the best they can and are working incredibly hard to respond to the added challenges presented by Covid-19, working long hours in high-pressured environments to try to deliver the best level of care, but it’s just not feasibly possible.”

Throughout the pandemic, Macmillan has warned that cancer is at risk of becoming “the forgotten ‘c’”, with thousands of patients in the UK now at risk of dying from the disease due to suspended and disrupted care services.

“It’s critical that the upcoming spending review provides the investment needed for a fully funded and credible plan to address specialist cancer nurse vacancies and to grow and sustain the cancer workforce,” Ms Thomas added. “This is vital for cancer care as we urgently need to see cancer services back on track.”

The charity estimates that by 2030 the NHS will need 3,700 additional nurses to support the growing cancer population in England alone – a figure that can be likened to the current number of nurses having to spend 123 per cent above their contracted hours to provide care to all patients.

Separate data from the Royal College of Nursing (RCN) shows that 38 per cent of UK nurses across all specialities said staffing levels were worse in May and June this year compared with before the pandemic. One in three (33 per cent) said they were working even longer hours than before.

Susan Masters, the RCN director of nursing, policy and public affairs, told The Independent: “Whether in hospitals, care homes or in the community, the entire health and care nursing workforce have stepped up to care for their patients and support their colleagues.

“The pandemic is not over, but unless there is improved pay, we risk many of our members leaving the profession – at a time when the nation needs them more than ever. That is why we continue to call for a significant and early pay rise.”

An NHS spokesperson said, in response to earlier warnings from Macmillan on the cancer care situation: “Cancer services are largely now open, ready and able to receive all patients who need care, so the critical point is that anyone who is concerned about a possible cancer symptom should contact their GP practice and come forward for a check-up.”