Cancer patients could suffer ‘due to lack of consultants’

A desperate shortage of clinical oncologists in the NHS is likely to have a detrimental impact on cancer patients, a report has warned.

The new study from the Royal College of Radiologists (RCR) points to a growing staffing crisis, with predictions that by 2023 the workforce will be at least 22% short of cancer consultants.

Cancer centres are currently reporting “dire” staffing levels, with dozens of posts left open.

One cancer centre has had no new applicants since 2015.

The report warns cutting-edge cancer therapies – such as immunotherapy and proton beam therapy – may not be delivered to all those who could benefit without more investment.

It found one in six UK cancer centres now operates with fewer clinical oncology consultants than five years ago.

The study said the UK is now short of at least 184 clinical oncologists – the minimum number needed to fill vacancies and cover the extra hours doctors are working to treat patients.

It said vacancies for clinical oncology posts are currently double what they were in 2013 – rising from 33 to 70 – and more than half of vacant posts have been empty for a year or more.

In 2018, there were 863 full-time equivalent clinical oncology consultants working across the UK’s 62 cancer centres.

This is up 46 on the figure the year before but the RCR said the increase is not keeping up with demand.

It said almost 1,000 people are diagnosed with cancer every day and demand for radiotherapy is going up 2% every year, while demand for chemotherapy is rising 4% a year.

The RCR said oncology trainee numbers need to at least double to close the gap between supply and demand.

The report also pointed to “clear evidence of increased stress and burnout” among doctors due to them taking on extra work to plug workforce gaps.

The report said: “We are losing expertise as consultants retire earlier and risking our workforce by asking them to work longer hours.”

Dr Tom Roques, the RCR’s medical director of professional practice for clinical oncology and lead author of the workforce report, said: “The UK is seeing more and more fantastic innovations in cancer treatment – from the introduction of new immunotherapy drugs to the NHS’s first high-energy proton beam radiotherapy centre.

“Clinical oncologists are vital to the rollout of these new therapies but we do not have enough of them and our workforce projections are increasingly bleak, which begs the question: What kind of service will we be able to provide for our patients in future?

“Today’s RCR workforce figures and forecasts show our cancer hospitals under immense strain – some centres have seen a reduction or stall in consultant numbers and many are desperate but failing to recruit, predominantly because we do not have enough consultants in training.”

The report said the percentage of consultants leaving the profession has increased over the past five years from 1.1% of the consultant workforce in 2013 to 3.6% in 2018.

This is forecast to increase to 4.6% within the next five years.

The report also said centres struggled to find locums to cover shifts.

One cancer centre stated: “Recruitment is very challenging. Almost impossible to find locums.”

Another reported: “One locum in post at the moment helping with the workload and three posts out to advert.”

The RCR estimates that, by 2023, the NHS will need a bare minimum of 1,214 full-time clinical oncology consultants.

Based on current trends, there will only be 942, it said.

The report also said overseas recruitment has not been successful due to several factors, including differences in how doctors are trained and a lack of HR expertise in the area.

In 2018, only one in three cancer centres that actively targeted the recruitment of overseas doctors managed to fill their posts.

An NHS spokesman said: “The NHS has published plans to recruit an additional 1,500 staff across seven priority cancer specialisms by 2021 and the size of that workforce has already grown by 803 since 2017.

“Cancer survival rates are also at their highest ever and, as part of the NHS’s Long Term Plan, work is already under way to ensure faster and earlier diagnosis and treatment to help save more lives.”

A Department of Health and Social Care spokeswoman said: “Improving cancer care and reducing waits is a priority for the NHS, and we recently unveiled a series of commitments as part of the NHS Long Term Plan backed by £200 million to fund new ways to rapidly detect and treat cancer.

“To ensure patients get the best possible care we have almost 400 more medical and clinical oncology consultants working in the NHS since 2010, we’re expanding medical training places by 25% and we will also launch a Workforce Implementation Plan later this year to support the NHS with the staff it will need in future years.”

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