Hospitals in England told to keep performing urgent cancer surgery

NHS bosses have instructed hospitals to keep performing urgent cancer surgery despite Covid pressures, after a growing number cancelled procedures because they did not have enough intensive care beds or available staff.

They have told England’s regional directors of cancer to ensure treatment of people who need cancer surgery within four weeks gets the same priority as care of patients who have Covid.

The move was unveiled in a letter, obtained by the Health Service Journal, sent last Friday by Amanda Pritchard, the chief operating officer at NHS England and NHS Improvement. It was also signed by Cally Palmer, the NHS’s national cancer director, and Prof Peter Johnson, a highly respected specialist who is the NHS’s national clinical director for cancer.

They have acted after unease among cancer specialists that growing numbers of hospitals, including all those in London, had cancelled urgent operations. Hospitals have felt obliged to do so either because they did not have enough intensive care beds for patients who might need one after their cancer procedure or because surgical staff had been repurposed to help care for Covid patients.

Doctors voiced alarm at the scale of recent postponements of what the NHS classes as “priority two” operations. That means they should be done within 28 days to ensure that someone with cancer does not see their disease spread or become inoperable because it was delayed.

More than 1,000 cancer patients in London are now waiting to have “priority two” or “P2” urgent surgery, but none have been given a new date for when it will happen, HSJ reported last week.

A senior NHS figure told its website that Pritchard, Palmer and Johnson had issued the instruction because “NHS England wants to avoid what’s happened in London and the south-east happening in the rest of the country”.

The letter tells regional directors that they must “ensure that, where local decisions are being taken to redeploy surgical and anaesthetic staff, provision for P1 and P2 cancer surgery is prioritised alongside that for patients with Covid.”

Dr Lisa Harrod-Rothwell, the deputy chief executive of Londonwide Local Medical Committees, which represents GPs in 27 of the capital’s 32 boroughs, said: “It will come as a relief to Londoners and their GPs that hospitals are to prioritise all urgent cancer surgery. We now need to see the whole NHS in London supported to deliver this.

“GPs have obviously trusted our hospital colleagues’ clinical judgment over recent difficult weeks, with all the immense pressures they are under.”

Anyone with a possible symptom of cancer should still see their GP to have it checked out, she added.

Sir Simon Stevens, the chief executive of NHS England, told the BBC on Sunday that hospitals were “under extreme pressure” because they were treating 75% more Covid patients than in the spring.

King’s College hospital in south London and the Royal London hospital in the east end are among those that have recently cancelled urgent cancer surgery.