Addressing the cancer workforce shortage

Last month the government published a long-awaited plan to increase the NHS workforce in England. The announcement is a positive step forward as the NHS tackles diagnostic backlogs and delays in treatment. But we worry that the measures might not go far enough to solve cancer waiting times in Yorkshire. In this blog post we explain why.

A comprehensive, fully funded plan to increase the NHS workforce has long been called for by cancer charities. A significant shortage of healthcare professionals means people with cancer are waiting too long to be diagnosed and treated. And when it comes to cancer, every day counts.

However, it’s clear that the measures may not do enough to meet the predicted future demand in Yorkshire.

The number of people in Yorkshire going to hospital with suspected cancer has grown by 25% in the last five years and this is expected to continue to increase. It will take a long time for trainees to filter through the system, considering the time it takes to become qualified.

Attracting people to apply for new training places may also be a problem, not for medicine which is over-subscribed, but for nursing. The retention of staff is also not properly addressed in the plan, and this could continue to be a problem in the future. Between 2020 and 2022, the rate of people leaving the NHS in Yorkshire and the North East increased by nearly 40%, while the rate of people joining increased by 13%.

The workforce is only one of the issues. It’s also important that NHS equipment and infrastructure is upgraded, more is done to tackle inequalities, investment in prevention is increased, early diagnosis is improved and more funding is available for research and development.

While the NHS struggles with staff shortages, it is also facing unprecedented demand.

This is particularly the case when it comes to the number of people coming forward with symptoms of cancer. The number of people in Yorkshire receiving urgent checks for cancer has doubled in the past 10 years. In May 2023, more than 21,000 people in the region were referred urgently to hospital for further tests after seeing their GP with possible symptoms of cancer, compared to 10,500 in May 2013.

It’s vital that people seek medical advice as soon as possible if they are concerned about any changes to their body - so it’s good news that more people are being checked for cancer. But this has also put immense pressure on diagnostic services.

The strain caused by staff shortages and an increase in people coming through the system means the hospitals are missing key targets set by NHS England to ensure people with cancer are diagnosed and treated as quickly as possible.

The latest statistics show that in May 2023, eight of the 12 NHS Trusts in Yorkshire failed to meet the target for the proportion of patients urgently referred to hospital with suspected cancer to be seen by a specialist within two weeks. In addition, 11 Trusts failed to ensure enough patients received their first treatment within two months of being referred urgently to hospital. This demonstrates that there are unacceptable delays in diagnosis.

We can also see that the speed with which people receive treatment has also been declining over time. In May 2023, five of the 12 Trusts missed the target that aims to ensure patients receive their first treatment within a month of their doctor deciding a treatment plan.

The target is for 96% of people to be treated within 31 days of a treatment plan being decided, but in May only 91% of people in Yorkshire were treated within this timeframe, compared to 99% of people in May 2013.

People in Yorkshire are more likely to get cancer and die from it than in most other parts of England. The region also has higher than average rates of late diagnosis. Having a strong NHS workforce is essential to give people the very best chance of survival.

Workforce shortages vary, with some regions facing more severe shortages than others.

When it comes to clinical oncologists, Yorkshire has the third highest vacancy rate in England. Nearly 1 in 10 positions are unfilled in our region. The same applies for radiologists.

The vacancy rate is only part of the problem. More positions need to be created in Yorkshire to reach the optimal number of clinical oncologists. The shortfall in oncologists in our region is currently 17%. Before the NHS Long Term Workforce Plan was announced, this had been predicted to grow to 26% by 2027. The shortfall in radiologists is currently 33%, and this had been due to increase to 43% by 2027.

These statistics are extremely worrying and illustrate the urgent need for a clear plan for the future.

The government has committed to providing £2.4bn over the next five years for the training and retention of NHS staff, as well as investment in technological innovation.

There are ambitions to:

1. Double medical school places for student doctors to 15,000 a year by 2031, through the expansion of existing medical schools and the establishment of new ones in areas with the greatest staffing shortages.
2. Increase GP trainee places for junior doctors by 50% by 2031.
3. Provide 24,000 more nurse and midwife student places a year – close to double the number now – by 2031.
4. Double the proportion of NHS staff trained through apprenticeships, so that more can combine paid work alongside study.
5. Launch an apprenticeship programme for doctors.
6. Improve flexible working options and career development opportunities.
7. Launch a consultation on whether five-year medical degrees could be shortened by a year.

If successfully delivered, the plan may help alleviate the current shortfall in the workforce, reduce cancer waiting times and improve cancer care – which will ultimately save lives. But questions remain about the length of time it may take for these measures to have an impact, and whether the plans do enough to attract and retain NHS staff. We need to see far more detail and evidence that the plan can work.

Moving forward, Yorkshire Cancer Research will continue to ensure that the needs and priorities of the region are heard and understood at a national level.

We will engage with local politicians and policy makers so that Yorkshire receives its fair share of the workforce funding available, and we will campaign for stronger measures – such as the creation of new medical schools - in those areas of our region with the greatest need.

We will encourage the government to consider how best to make the NHS an attractive long-term career option, where staff are supported and wellbeing is a priority, so that strong applicants are recruited to training programmes while the existing dedicated workforce is retained.

Alongside the work we’re funding to improve the prevention, diagnosis and treatment of cancer across the region, a strong NHS workforce will help ensure people in Yorkshire receive the care they deserve and go on to live long and healthy lives.