We spend millions on NHS outsourcing while cancer patients are stuck waiting for care

I know pressure is part of the job. I know NHS staff will always go further for patients than anyone could reasonably expect.

What I find increasingly difficult to accept is watching patients potentially come to harm because we simply do not have enough doctors.

For the first time, our workforce census has revealed something deeply troubling. Eight in ten radiology leaders told us they have seen patients' conditions worsen because of staff shortages. Half of cancer centre leaders said the same. These are not concerns about targets or performance measures. These are experienced clinical leaders telling us that delays are affecting patients' health.

Many of those patients are waiting for answers. Others are waiting for treatment.

Last year, nearly one million scan results took longer than a month to be reported. About one in five patients waited more than six weeks for a diagnostic scan or test. Across the UK, 9 in 10 cancer leaders reported delays to patients starting treatment, including chemotherapy and radiotherapy, because there were not enough specialist doctors available.

The pressure is not falling evenly. In some parts of the UK, particularly rural communities and more deprived areas, workforce shortages have reached alarming levels. Across the UK, the shortage of cancer doctors is twice as high in rural communities and deprived areas as in less deprived areas and urban areas. The North of Scotland now faces the worst radiologist shortage anywhere in the UK. In North Wales, cancer doctor shortages are four times higher than in South Wales. Some patients in these communities are waiting longer and travelling further for care.

The situation is even more concerning when we look ahead. Cancer incidence continues to rise, and demand for scans is growing twice as fast as the workforce needed to interpret them. At the same time, nearly half of clinical oncologists and almost two-fifths of radiologists are expected to retire within the next ten years.

Yet despite the growing demand for care, hospitals are being prevented from hiring the doctors they need.

More than half of cancer centres and nearly four in ten radiology departments experienced recruitment freezes this year – twice as many as the year before. At the same time, the UK spent a record £362 million on outsourcing, locums and overtime to manage excess demand in radiology alone.

That figure should stop policymakers in their tracks.

We are spending enough money on temporary staffing fixes in radiology to pay for more than 3,000 consultant radiologists – more than the entire national shortage of 2,300 radiologists. This short-term solution does nothing to help us meet rising demand for diagnostics.

There is nothing inevitable about this.

We need recruitment freezes on radiology departments and cancer centres lifted. We need more training places to ensure we have enough doctors for tomorrow’s patients. We need to make better use of the training capacity we already have by allocating training places using whole-time equivalent instead of headcount. Most of all, we need a long-term commitment to building the specialist workforce patients depend on.

The doctors I represent are exhausted by having the same conversation year after year. They want to spend their time caring for patients, not explaining why patients are waiting.

The warning signs are flashing. The evidence is overwhelming. The cost of inaction is being paid by patients sitting at home, waiting for a scan result, waiting for treatment, and hoping their condition does not get worse before help arrives.

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Dr Stephen Harden is President of the Royal College of Radiologists.

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