The Queue to Save Women’s Lives Why Breast Cancer Patients Face Variations in Waiting Times Why Breast Cancer Patients Face Variations in Waiting Times ANALYSIS
By HELEN PUTTICK HEALTH CORRESPONDENT
EVERY year 3500 women in Scotland are told they have breast cancer.
For each one, the experience will be different, but Scottish Executive targets suggest that each should be able to expect a similar standard of care.
Figures published in response to a parliamentary question show just how swift access to treatment for women urgently referred to hospital by their GP varies across the country.
The worst waits to start breast cancer treatment recorded are in NHS Grampian, where the longest delay in the first six months of 2005 was 276 days – at least three times the maximum wait logged for most other parts of mainland Scotland.
Julie Fletcher, assistant general manager for acute services with the health board, admitted that the queues that built up in the region were “really awful”.
Behind the problem were two key vacancies for radiologists, doctors who interpret scans diagnosing patients and who need to be present for some types of breast tumour surgery.
The positions lay vacant for a year.
Mrs Fletcher said: “The reason we were not achieving the (waiting times) targets was because we did not have the people in place. We could not get them. Therefore there was a build-up of ladies getting longer and longer.”
This time last year, a woman urgently referred to hospital by a GP with suspected breast cancer in Grampian had to wait six weeks for her first appointment.
Non-urgent cases faced an 18-week delay. Now the timescales have been cut dramatically to 10 days for urgent referrals and six weeks for routine cases.
The proportion of patients who begin treatment within 62 days of their GP referral, the Scottish Executive’s target for the end of this year, was 32-per cent in January.
It is expected to reach 75-per cent this month.
Mrs Fletcher said it was the appointment of two radiologists, one from Poland, plus the hiring of an extra breast cancer surgeon, that have made the difference.
Shortages of radiographers and radiologists to take and study scans of tumours is a recurring theme.
In April, the Royal College of Radiologists expressed concern about the underprovision of radiology equipment and expertise on a national scale. Cancer network managers trying to meet the executive’s waiting times goals have also said the lack of such staff could cause delays.
It is not a problem unique to Scotland and it cannot be resolved overnight.
In addition, clinicians advise that the treatment journey will always be different for different people.
ProfessorAlastair Thompson, professor of surgical oncology at Dundee University, said: “Once the patient gets to the hospital, for some women who turn out to have breast cancer it is really straightforward getting their first treatment. It is black and white what treatment they need.
“For others there are many choices to be made. Because in Scotland we take the view of the patient and their families into that decisionmaking process, the women who go from not being sure there is anything wrong to having a diagnosis quite quickly then need time to get to grips with that. They then need time to digest a huge amount of information and discuss with their GP and their breast cancer nurse and doctors what the right kind of treatment is.”
NHS Lanarkshire, asked about the variation in waiting times in its own health board area, also said: “A number of factors can contribute to the inability to meet the waiting time guarantee and these will be specific to each individual patient.”
The speed of treatment will never be completely uniform for everyone, nor would that be appropriate.
However, when the charity, CancerBACUP Scotland, says that it receives calls to its helpline every week from people desperately worried about the length of time they are waiting for treatment, there is clearly a problem still there.