Cancer Waiting Times (CWT)

Background

Cancer Waiting Times standards monitor the length of time that patients with cancer or suspected cancer wait to be seen and treated in England. These were first introduced through the NHS Cancer Plan (September 2000) and extended in the Cancer Reform Strategy (2007).  A review of the standards in 2010 led to confirmation in Improving Outcomes: A Strategy for Cancer (2011) that they would be retained. In 2015, the Cancer Taskforce recommended the introduction of a new 28 day Faster Diagnosis Standard, which will be shadow monitored from April 2019 and nationally reported from April 2020. An interim report from the Clinically-led Review of NHS Access Standards (March 2019) proposed a reduction in the number of cancer standards from April 2020.

All cancer waiting times standards are monitored through the National Cancer Waiting Times Monitoring Dataset (NCWTMDS) which is an information standard applicable to all cancer services providers funded by the NHS in England. Data is submitted to the National Cancer Waiting Times system. NHS England produce official monthly and quarterly reports, which can be found at the NHS statistics page:

http://www.england.nhs.uk/statistics/statistical-work-areas/cancer-waiting-times/

Operational standards

The current measures and the operational standards are:

  • Two weeks from urgent GP referral for suspected cancer to first outpatient attendance (93%)
  • Two weeks from referral with breast symptoms (where cancer is not suspected) to first hospital assessment (93%)
  • 28 days from urgent GP referral for suspected cancer, urgent referral from NHS Cancer Screening Programmes (breast, cervical and bowel) or referral with breast symptoms (where cancer is not suspected) to the date the patient is informed of a diagnosis or ruling out of cancer (operational standard to be confirmed)
  • 62 days from urgent GP referral for suspected cancer to first treatment (31 days for children's cancers, testicular cancer, and acute leukaemia) (85%)
  • 62 days from urgent referral from NHS Cancer Screening Programmes (breast, cervical and bowel) to first treatment (90%)
  • 62 days from a consultant's decision to upgrade the urgency of a patient (e.g. following a non-urgent referral) due to a suspicion of cancer to first treatment (no operational standard set)
  • 31 days from diagnosis (decision to treat) to first treatment for all cancers (96%)
  • 31 days from decision to treat/earliest clinically appropriate date to second/subsequent treatment (surgery or radiotherapy) (94%)
  • 31 days from decision to treat/earliest clinically appropriate date to second/subsequent treatment (anti cancer drug therapy, eg chemotherapy) (98%)

In 2015, the Cancer Taskforce recommended the introduction of a new 28 day Faster Diagnosis Standard. Changes to the CWT system and dataset that are being introduced from April 2018 mark the start of the implementation of this new standard, which will be fully implemented by 2020.

Guidance

Guidance documents can be found at: https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/cancerwaitingtimescwt (NHS users only)

This includes:

  • How to record the data: National Cancer Waiting Times Monitoring Data Set Guidance
  • How to upload the data: Cancer Waiting Times User Manual
  • How to view what has been uploaded: Cancer Waiting Times Reports User Manual

Further questions and queries about the Cancer Waiting Times rules or publications or what to do about errors in the data records can be sent to the Cancer Waiting Times mailbox: england.cancerwaitsdata@nhs.net  

For queries about the data submission process or the automatically generated reports contact the NHS Digital National Service Desk at ssd.nationalservicedesk@nhs.net or on 0300 303 5035