Almost every hospital trust in England is not meeting key waiting time targets for cancer treatment. This situation raises concerns about patient survival and the overall effectiveness of the NHS.

At a glance

NHS Trust Performance Overview

Recent analysis by the BBC reveals that nearly all NHS trusts in England are failing to meet critical waiting time targets for cancer care. Out of 121 trusts, only three are treating patients within the required 62 days. Experts warn that these delays could jeopardize patient lives, emphasizing the importance of timely treatment. Dr. Timothy Hanna, a leading cancer expert, expressed concern over the findings, stating that the failure to meet these targets is not an isolated issue but rather a widespread problem. He highlighted that timely treatment is essential for improving survival rates, making the current performance alarming. Patients like Paul, who has stage three colon cancer, illustrate the real-life consequences of these delays. After a long wait for treatment, his cancer progressed, underscoring the urgent need for improvements in the system.

Challenges Faced by NHS Trusts

Hospitals across England are grappling with overwhelming demand for cancer testing and treatment, which exceeds their current capacity. Issues such as malfunctioning scanning and radiotherapy machines, lost GP referral letters, and staffing shortages have led to last-minute appointment cancellations. The BBC's investigation covered the performance of major cancer services from September 2024 to August 2025. Hospitals are expected to meet specific targets, including diagnosing or ruling out cancer within 28 days of urgent referral and beginning treatment within 31 days for 96% of cases. Despite these targets, nearly one in four trusts have failed to meet all three benchmarks in the past year. Larger hospitals, which often handle complex cases referred from smaller facilities, are particularly affected by inherited waits.

Specific Trusts Struggling with Delays

One notable example is London's Royal Free NHS Trust, which ranks 109 out of 121 for 62-day waits. Although the trust has made some improvements, it continues to face challenges, including administrative issues that can lead to canceled surgeries. The Royal Free serves as a specialist kidney cancer center for patients in southeast England. While it has invested in new equipment, such as robotic surgery theatres, outdated radiotherapy machines hinder its ability to provide timely treatment. The trust has sought funding for a new machine but was denied. In contrast, three trusts—Calderdale and Huddersfield, East and North Hertfordshire, and Bolton NHS Trust—have successfully met the 62-day target. Their success is attributed to streamlined communication, advanced equipment, and effective teamwork.

Innovative Solutions for Treatment Delays

At East and North Hertfordshire NHS Trust, patients are experiencing a more efficient treatment process. Paul, diagnosed with prostate cancer, received timely consultations and was able to schedule his surgery quickly. The use of robotic surgery not only minimizes side effects but also allows for quicker patient turnover in the hospital. Additionally, innovative initiatives are being implemented to address capacity issues. One such program allows patients to administer certain chemotherapy treatments at home, freeing up hospital resources for those requiring more complex care. Josephine Hoskins, a patient benefiting from this program, shared how it has transformed her treatment experience. By enabling patients to manage their care at home, the initiative opens up more slots for others in need of hospital-based treatment.

Government Response and Future Plans

The government has acknowledged the pressing need to improve cancer care and is expected to release a new cancer strategy early next year. This strategy follows the designation of cancer care as a core priority in the NHS's 10-year plan published in July. A Department of Health spokeswoman emphasized the government's commitment to addressing the long-standing neglect of the NHS. Efforts include building more community diagnostic centers, offering extended appointment hours, and investing £70 million in new radiotherapy machines. However, experts like Sarah Scobie from the Nuffield Trust caution that meaningful progress may be difficult to achieve given the current financial constraints facing the NHS. The challenges highlighted by the BBC analysis suggest that significant reforms are necessary to enhance patient care and reduce waiting times effectively.