No-show patients hit Doncaster cancer treatment targets

Doncaster Royal Infirmary
Doncaster Royal Infirmary
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Heath bosses are failing to reach targets for cancer treatment times for patients in Doncaster - because patients fail to turn up for appointments.

The most recent official figures revealed to the NHS Doncaster Clinical Commissioning Group this week showed that targets were missed for patients getting their first referral for an outpatient appointment; receiving their first definitive treatment after referral of screening.

Dr David Crichton

Dr David Crichton

Under Government targets 93 per cent of patients should have their first outpatient appointment within two weeks of being referred urgently with suspected cancer by a GP. The most recently published figure for people living in the Doncaster area, the figure is 92 per cent. The figure for the Doncaster and Bassetlaw Teaching Hospitals Trust is 88.96.

The figure is different because the people living in Doncaster may be receiving treatment for hospitals outside the borough, and patients from outside Doncaster may be receiving treatment in the town's hospital.

But bosses have revealed that in March, almost half the breaches of the two week wait were down to people who had appointments cancelling them or just not turning up for an appointment which could potentially save their life.

The targets also state that 85 per cent of patients should have their first definitive treatment for cancer within 62 days of an urgent GP referral.

The figure for people living in Doncaster was 77.30 per cent for the most recent quarter. The Doncaster hospitals trust met its target, though, with a figure of 86.84 per cent.

Targets state that 90 per cent of patients should have their first definitive treatment for cancers with 62 days of a referral from an NHS screening service.

For patients living in Doncaster, the most recent figure is 84.60 per cent. For the Doncaster hospitals trust, the figure is 87.95 per cent.

Both Doncaster patients and the hospitals trust achieve the target of a waiting time of 31-days or less from diagnosis to first definitive treatment cancers.

In March 2017 for Doncaster Clinical Commissioning Group there were 95 breaches of the two week wait target. Some 45 were due to patient choice; 43 were due to lack of outpatient capacity; three were because of hospital cancellation; two were due to administrative error; one due to the patient not being able to be contacted; and one breach is still being reviewed to understand the reasons for the delay.

If the 45 patients who didn’t attend or changed their appointment for whatever reason, had attended within the two weeks, the Trust would have met its target.

Dr David Crichton, Chair of NHS Doncaster CCG said: “We take cancer waiting time breaches very seriously and have regular meetings with the hospital Trust to examine why they have happened and see what can be done to prevent them occurring in the future.

“This currently includes looking at how we can make best use of our outpatient capacity and also minimise the number of cancellations.

“We also intend to explore how we can reinforce to patients the importance of attending an outpatient appointment for suspected cancer within two weeks of being referred by their GP. We understand there will always be some cases where this is not possible but this is potentially one of the most important appointments you will ever get from the NHS and should be seen as such.”

David Purdue, Chief Operating Officer at the Doncaster and Bassetlaw Teaching Hospitals trust, said: “We work to national guidelines set for hospitals and try to see all urgent referrals for patients suspected of cancer within an appropriate time frame. In 2016/17 we achieved our overall target for two week referrals, however in both Doncaster and Bassetlaw we continue to see issues where first offered appointments aren’t always accepted by patients.

“To help with this objective in the future, working in partnership with our Clinical Commissioning Groups and local GPs, in April we switched from using paper-based referrals to a new digital system to ensure that all requests are received, and an appointment given, as soon as possible. I also want to highlight the importance of attending these, potentially, life-saving appointments so cancer can be detected and treated quickly, ensuring a better chance of recovery.”

Chief Operating Officer for Healthwatch Doncaster, Andrew Goodall said: "Targets are set because they are important. I don't have the details of why the targets have been missed but I would like to know the reasons, and if we could work together to improve things."