For over 10 years, the Royal College of Radiologists (RCR) has collected key clinical oncologist workforce data and insight from cancer centre heads of service, the clinical leads in the 60 cancer centres, across the UK. This is used to identify trends, issues and make evidence-based recommendations to improve patient care. With a 100% response rate, this year’s data reflects the workforce as it stood on 1 October 2021.
Almost everyone has been affected by cancer, which can devastate the lives of patients and their families. The 2021 census lays bare the years of underfunding of clinical oncology; it raises many concerns about a worsening situation over the next five years and beyond. If all four UK nations do not begin to focus attention and resources to create an oncology workforce which not only delivers world leading care, but also develops and implements new treatments and pathways, we will ultimately save fewer lives.
- The backlog of care from the pandemic has resulted in 50,000 patients missing cancer diagnosis and a 12% fall in radiotherapy treatment courses which are vital to cancer patients. Cancer targets were also missed with only 67% of patients were treated within two months of urgent GP referral.
- Despite the pandemic related drop in patients, the UK continued to have a 17% shortfall of clinical oncologists (CO) in 2021, which translates to 189 clinical oncologists. Without investment in the CO workforce, the shortfall is estimated to increase to 26% (381) by 2026.
- In 2021, 67% of cancer centre heads of service were concerned about workforce shortages affecting the quality of patient care compared with 52% in 2020.
- Whilst cancer incidences are only going to increase with one in two of us having cancer in our lifetimes, growth of the CO workforce has remained minimal at 3% per annum since 2016.
- There are now 943 CO whole-time equivalents (WTE) on the frontline of delivering cancer care in the UK, only 30 more in 2021 than 2020.
- 88% of cancer centre heads of service say they are concerned about delayed treatment for patients at their centre.
- 92% of heads of service are concerned about shortages in site specialities at their cancer centre.
- Only 27% of cancer centres had a dedicated on-site AOS consultant and 35% had an on-call consultant. Meaning, acute cancer care across parts of the UK does not meet safe levels.
- National shortages hide the discrepancy between oncology numbers around the country. Whilst London has the highest ratio of specialists of 5.4 per 100,000 older population, in the East Midlands and North and West Wales these figures reduce down to 2.9 and 1.5 respectively.
- 100% of cancer centre heads of service told us they were concerned about workforce morale, stress and burnout amongst their staff, further threatening workforce numbers as doctors are tempted to leave the profession.
The figures and views in this census represent an oncology workforce that is under extreme pressure. The issues were already stark before the pandemic, but the backlog of care and pressure of the pandemic have exacerbated the workforce issue further. The recommendations in this year’s report are crucial to ensuring that patients receive the treatment they need, when they need it, improving outcomes and saving lives.