Waiting times for cancer patients in England after general practitioners' referrals: retrospective national survey
BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7238.838 (Published 25 March 2000) Cite this as: BMJ 2000;320:838
All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Sir,
The government has acknowledged that cancer care in Britain needs
substantial improvement. It has focussed on removing delays in access to
cancer specialists, and suggests that that this will improve outcomes.
This study reports on data collected from 98% of Trusts in England. Yet
the total number of patients detailed is less than half the number
expected to present with cancer in a single month. Furthermore, the data
suggests that the incidence of breast cancer is twice that of lung cancer.
We are concerned that this is a selected sample and applying any
conclusions widely is dangerous.
The paper demonstrates but does not comment on the far more
significant delay in the time to first definitive treatment. Solving this
will require a far more radical overhaul of the cancer patient's journey
through investigation and treatment. Serious resources are clearly needed
to bring our cancer services up to the standards of our European
neighbours. We hope that the National Cancer Director puts appropriate
emphasis on getting patients treatment - knowing you have cancer will not
cure you.
Competing interests: No competing interests
The response link to this paper does not find the responses to its
earlier electronic publication. I know there was at least one (from Karol
Sikora). Now I cannot find my way to it without downloading 14 days' worth
of responses, which makes my system hang or crash. Please link the
responses.
As the token 'clinical audit professional' on the Steering Group for
this audit, I'm very glad it has seen the light of day at last. It would
be interesting to know how, if at all, the results were fed back to the
participating Trusts and what steps they are being advised to take to
improve their performance in the light of the results.Audit that does not
lead to change where it is needed is not audit.
Competing interests: No competing interests
Strategy to reduce waiting times
In spite of pledging repeatedly by the government to end
waiting time for cancer patients,the reality is still very far from
practicality.Being the second most common causative factor in terms of
mortality,top ten malignancies are still not been handled temporally and
prioritised in direct proportion to referral from General Practitioners in
UK.We know that the Secondary prevention plays the major role in
management of cancer patients.Early diagnosis and prompt treatment can
make the real difference in cancer statistics,as what we see in USA
Strategy for managing malignancies.
To abolish the long waiting list of cancer patients in UK,I would like to
propose few of the suggestions.Usually, any General Surgeon or Oncosurgeon
operates for 1-1 1/2 days in theatre in a weekm time.There is need to
revise radically Surgeon's operating hours to 3-3 1/2 days/week.In such
case, we should rely on higher surgical trainees for running outpatient
sessions more and more.Even there is no harm in using emergency hours with
operations performed by Specialist Registrars for Ca-in-situ stage
operations.
If every suspected case of cancer would have urgent referral from GP
and Investigation performed on the same day of outpatient appointment to
confirm the diagnosis,this will hasten the feasibility and availability of
definitive treatment to cancer patients and help in breaking the vicious
circle of late presentation due to excess waiting with more psychological
morbidity.
Competing interests: No competing interests