Intended for healthcare professionals


Covid-19: Urgent cancer referrals fall by 60%, showing “brutal” impact of pandemic

BMJ 2020; 369 doi: (Published 12 June 2020) Cite this as: BMJ 2020;369:m2386

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  1. Elisabeth Mahase
  1. The BMJ

The number of urgent GP referrals for cancer dropped by 60% in April compared with the same month last year, latest figures for England show.1

Government data also show that the number of people starting treatment following a GP urgent referral declined by 18% in the same period

Medical leaders said the sharp drop highlighted the “brutal” impact that the pandemic has had on non-covid-19 services and have warned of backlogs of tens of thousands of patients.

The figures, published on 11 June, show that in April 2020 there were 79 573 patients urgently referred by their GP to a consultant for suspected cancer. This compared with 196 775 in April 2020. The number of people waiting for their first treatment for cancer following an urgent referral was reported as 10 792 in April 2020, compared with 13 147 in April 2019.

Sarah Woolnough, executive director of policy and information at Cancer Research UK, said, “It’s devastating to see the impact that covid-19 is having on cancer patients and these figures show just how much the virus has affected cancer waiting times. It means that tens of thousands of patients are in a backlog needing vital cancer care.”

The figures come after it was reported that visits to emergency departments in England dropped 57% in April compared with the same month last year. There was a total of 917 000 visits to emergency departments, the lowest since data collection began in 2010.2

Meanwhile, consultant led referral to treatment waiting times, also published on 11 June, show that 239 088 fewer “admitted pathways” were completed in the NHS in England in April 2020 compared with April 2019. This represents an 85% drop. The Royal College of Surgeons of England has warned that hundreds of thousands of people have been left waiting for treatment.3

BMA council chair Chaand Nagpaul said, “These figures lay bare the brutal impact of covid-19 on our healthcare services and patient care. They show only the early weeks of the pandemic but, nonetheless, they confirm the fears of doctors that significant numbers of patients will not have got the care needed and that their conditions could have worsened.

“It’s vital that services resume as soon as possible and that the government provides the NHS with the support, resources, and capacity for this to happen safely while the pandemic continues. The longer the backlog persists, patients’ conditions will grow more acute or go undiagnosed.”

But Nigel Edwards, chief executive of the Nuffield Trust, has warned that “rationing at a level previously considered unpalatable is here to stay in the NHS.”

He said, “Operating alongside covid-19 measures will mean no return to business as usual. The health service will simply not be able to catch up by working in the way it used to. Increased infection control measures, social distancing, and practical constraints to protect staff and patients will mean we will see the waiting list grow rapidly over the autumn as the service struggles to get patients through the health system as quickly.”

The World Health Organization has warned that the pandemic has dramatically curtailed the provision of health services for non-communicable diseases across the world and called on countries to find innovative ways to ensure these services continue during the fight against the coronavirus.4

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