Oncology workforce census

COVID-19 highlights versatility of radiotherapy, but backlog fears add to existing pressure on cancer services.

Cancer continues to be one of the leading causes of mortality in the UK. Around 1,000 new cancer cases are diagnosed each day in the UK and 1 in 2 people born after 1960 will be likely to develop cancer in their lifetime. Although data indicate that UK cancer survival rates are slowly improving, the UK still lags behind other comparable countries. The NHS England Long Term Plan has committed to improving cancer survival by increasing early diagnosis from half to three-quarters and enabling 55,000 more people to survive cancer for five years or more by 2028.

The UK cancer workforce plays a vital role in fulfilling these ambitions. Yet without meaningful and sustained investment to grow the oncology workforce, these ambitions will remain simply that. On top of this, the fallout from COVID-19 has made these targets even harder to achieve, with clinicians seeing significant delays in cancer referrals, diagnosis and treatment.

The findings from our latest annual workforce census of clinical oncologists in the UK highlight the widening gap between the future demand for cancer services and the specialist oncologist workforce who provide the service, shortages which threaten to put the Long Term Plan and cancer recovery in jeopardy. Urgent and decisive action is needed now to ensure the appropriate clinical oncologist (CO) workforce is in place so that improvements to cancer survival can be realised.

Key findings from the report:

  • The consultant clinical oncology workforce has a shortfall of 17% which is set to rise up to 29% by 2025.
  • Despite overall growth in the CO consultant workforce there were parts of the UK where a quarter of cancer centres reported no gain or a decline in 2020.
  • Over half (52%) of cancer service leaders reported that workforce shortages have negatively impacted the quality of patient care.  
  • In 2020, 55% of CO consultant vacancies remained unfilled after a year compared to 29% in 2015.
  • In the 55+ age group less than full-time working has increased from three in five CO consultants in 2015 to four in five in 2020.
  • The number of doctors starting specialist training would need to double for the next five years to close the forecast workforce gap.

This latest census shows the UK now has 991 clinical oncology consultants, which equates to 913 doctors working full-time, an increase of 46 full-time consultants compared to 2019. However, this growth has only averaged 3% over the past five years, below the 4% average annual workforce growth across all specialties in England. Workforce growth is forecast to slow down from 3% per year seen over the past five years to 2% per year over the next five years.  

COVID-19 has presented many challenges for cancer services that will continue to reverberate for some time. As cancer referrals return to pre-pandemic levels, there is concern regarding the backlog of cancer patients who may require more complex treatment on top of a growing demand for cancer services. Studies show that approximately 40,000 fewer patients in the UK started treatment for cancer than normal last year[i].

Over recent years cancer prevalence has increased by 3% per year in the UK[ii], with the need for increased cancer services provided by clinical oncologists rising alongside. 

The oncology workforce has not been able to keep up with the increasing demand and with workforce growth predicted to slow down in the next five years the future for cancer services looks evermore fragile without significant investment.  

For queries or suggestions regarding census data, please email census@rcr.ac.uk 

Download the full report (PDF)

References

[i] COVID-19 and cancer: 1 year on - The Lancet Oncology

[ii] NHS England. Modernising radiotherapy services in England – developing proposals for future service models. London: NHS England, 2016.


UK workforce census 2020 summary reports: Scotland, Wales and Northern Ireland 

  • All UK nations have significant and growing shortages of CO consultants. The current shortfall of 20% is forecast to reach 45% to 50% in Wales by 2025. Urgent mitigating action is required, as such a shortfall would have a devastating impact on patient care. 
  • Northern Ireland and Wales have a high proportion of CO consultants approaching retirement age, so retention strategies and succession planning are vital for these UK nations. 
  • Recruitment continues to prove challenging, with four in five CO consultant vacancies in Northern Ireland and Wales remaining unfilled for 12 months or more, despite significant recruitment attempts. 
  • Across the UK nations, there is wide variability in the distribution of CO consultants, with shortages particularly acute in North Wales.

Download the report for Wales (PDF)

Download the report for Northern Ireland (PDF)

Download the report for Scotland (PDF)


Previous workforce census reports (PDF)