Cancer IIF not affected by scrapped two-week wait

NHS England’s decision to scrap the two-week wait target for cancer referrals will not affect any timescales for cancer-related IIF indicators, it has been confirmed.

Until last week, operational standards indicated that 93% of patients with suspected cancer should be seen by a specialist within two weeks of a referral from their GP: a target that has now been scrapped in favour of a Faster Diagnosis Standard, effective from October.

NHS England has since confirmed to Pulse PCN that the two-week target baked into the Investment and Impact Fund’s (IIF) cancer indicator will remain in place, unaffected by the scrapped national target.

The indicator CAN-02 covers: ‘Percentage of lower gastrointestinal two week wait (fast track) cancer referrals accompanied by a faecal immunochemical test result, with the result recorded in the twenty-one days leading up to the referral.’

Under the new targets system, 10 current cancer performance standards will be replaced by three measures including the faster diagnosis target for 28 days from urgent referral to a diagnosis or exclusion of cancer that has been in place since April 2021.

It will be expected that:

• Patients with an urgent referral from their GP, who have breast cancer symptoms, or have been identified via screening should have cancer diagnosed or ruled out within 28 days
• Patients with a diagnosis begin treatment within 62 days of a GP referral
• Patients should start their first treatment within 31 days of receiving a cancer diagnosis and decision to treat.

NHS providers will also be expected to ensure 75% of patients are diagnosed or have cancer ruled out within 28 days of a referral with standards moving to 80% in 2025/26.

GPs will still refer people with suspected cancer in the same way but the focus will be on getting a diagnosis or having the all-clear within 28 days rather than simply getting a first appointment.

Only two of England’s 42 integrated care boards (ICBs) were meeting the two-week window for patients to be seen by a cancer specialist by the time the target was scrapped, analysis from Pulse’s sister title Healthcare Leader has shown.

In March, NHS England confirmed it would cut 31 of the IIF targets, leaving just five remaining, with a portion of the attached funding instead handed directly to PCNs.

The indicators – which attached funding to a series of targets – often required specialised or non-GP staff on hand to properly fulfil them, clinical directors said. Criticising the decision, PCN leads at the time said many of the hires they have made under the ARRS were done in order to serve the indicators.