Response to publication of Welsh Government’s cancer quality statement

Issued 22 March 2021

Cancer care in Wales at risk without a new cancer strategy, warns the Wales Cancer Alliance

Wales’s cancer services could struggle to recover after the pandemic warn 20 leading cancer charities

Cancer services in Wales could struggle to recover after the coronavirus pandemic leading to poorer care and outcomes unless a new cancer strategy is put in place, 20 leading cancer charities are warning today.

Wales could soon be the only UK nation without a cancer strategywith the Welsh Government opting to publish a brief quality statement today (Monday 22 March) instead of replacing its detailed cancer plan.

This is despite stark and repeated warnings from the 20 charities in the Wales Cancer Alliance coalition that the statement does not go far enough.

While the alliance welcomes the NHS Covid recovery plan, also published today by the Welsh Government, this plan covers the immediate recovery from the pandemic and does not have the long-term vision cancer services in Wales needs.

At a time when cancer services are under more pressure than ever due to the pandemic, the alliance is concerned people in Wales will have poorer and less personalised cancer care without a comprehensive cancer strategy.

Until the end of 2020, Wales had a Cancer Delivery Plan which had ambitions for cancer care outcomes that matched the best in Europe. This led to new innovations being introduced, such as rapid diagnostic clinics for people experiencing non-specific symptoms that might be cancer.

The strategy, which was 21 pages, has been replaced by a quality statement that is around three pages long.

Most importantly, the quality statement lacks a clear roadmap for how cancer care can improve so that Wales can catch up with the best performing countries and, ultimately, save more lives.

The Wales Cancer Alliance does not believe this is a sufficiently detailed response to the current crisis in cancer care, nor does it point to a sufficiently bold ambition for cancer services in Wales.

Wales already performed worse on cancer compared to similar countries before the pandemic.

Macmillan Cancer Support estimates that 3,500 people[i] are living with undiagnosed cancer in Wales with the backlog in screening diagnostic services continuing to grow.

Richard Pugh, Chair of the Wales Cancer Alliance and Head of Partnerships at Macmillan Cancer Support, said: “Cancer services in Wales are under more

pressure than ever before due to cancellations and delays caused by the coronavirus pandemic.

“Today the 20 charities in the Wales Cancer Alliance are warning that Wales will shortly be the only UK country without a detailed cancer strategy at a time when we can least afford to be without one.

“We are urging the Welsh Government to replace its Quality Statement with a comprehensive cancer strategy that details how our NHS will tackle the growing backlog of people needing cancer diagnosis and care and set out how people with cancer in Wales can get the personalised and timely care they need to have the best possible outcome.

Andy Glyde, Vice Chair of the Wales Cancer Alliance and Senior External Affairs Manager at Cancer Research UK, said: “It is extremely disappointing that the Welsh Government has decided that a very short quality statement is enough to address some of the biggest problems facing cancer services and people affected by the disease in Wales.

“Right now, we need to see a bold and ambitious vision, where we aim to recover from the impact of the COVID-19 pandemic, improve cancer services for people in Wales and ultimately save more lives. This document simply is not good enough.

“The World Health Organisation recommends that every country has a cancer strategy. In Wales, a plan like this would bring us into line with other, better performing nations. Together with other cancer charities, we strongly urge the Welsh Government to change its approach to fulfil this need.”

Martin Fidler Jones, Policy Officer at Tenovus Cancer Care, said “Since the start of the pandemic we have seen the number of people being sent for cancer tests fall to way below their normal levels, as people have stayed away from health services to protect the NHS.

“Early diagnosis is absolutely vital to long term survival. With thousands of people potentially living with undiagnosed cancer, we need a detailed, long term plan to get our cancer services back on track and enable us to build back better.

“Sadly, today’s publication from Welsh Government falls significantly short of our expectations as a charity and as a cancer sector.”

The Wales Cancer Alliance (WCA) is a coalition of 20 charities working to prevent cancer, improve care, fund research and influence policy in Wales.

The charities that make up the alliance are:

The Brain Tumour Charity

Breast Cancer Now

Bowel Cancer UK

British Liver Trust

Blood Cancer Alliance

Cancer Research Wales

Cancer Research UK

CLIC Sargent

Hospices Cymru

Jo’s Cervical Cancer Trust

Macmillan Cancer Support


Marie Curie

Ovarian Cancer Action

Myeloma UK

Pancreatic Cancer UK

Prostate Cancer UK

Target Ovarian Cancer

Teenage Cancer Trust

Tenovus Cancer Care

[i] Assumptions

Missed diagnoses

(1)        We assume there would have been 19,000 cancer diagnosis in 2020 if not for the pandemic. This is an estimate based on the trend of incidence in recent years (2015-2017 range between 18.9k – 19.6k) but it’s is not a projection.

(2)        We assume these diagnoses would have come about evenly across the calendar year, at around 1,583 diagnoses per month (19,000 / 12).

(3)        We assume that whatever level of change is observed to the number of people entering the SCP in a given month (as a result of the pandemic), that the same change will occur to the number of cancer diagnoses as a result. E.g. a 20% drop in number entering the SCP would see 20% fewer cancer diagnoses, or 317 fewer diagnoses (1,583 x 20%).


Missed diagnoses

•           We use the number of patients entering the SCP as reported in the monthly CWT reports from June 2019 onwards.

•           We create a ‘pre-pandemic baseline’ of the number entering SCP per working day, based on reported figures for June 2019 to Feb 2020. We see 118,871 patients in total across 191 working days = 622.4 entries per working day.

•           We sum up all of the corresponding counts for the period Mar – Nov 2020 (latest available data point) and find a total of 90,007 patients across 191 working days = 471.2 entries per working day.

•           We now compare entries during the pandemic period (471.2 per day) to the pre-pandemic period (622.4 per day) which gives us a figure of 24.3% fewer people entering during the pandemic period, specifically this period is the 9 months from March to November 2020.

•          As per the assumptions listed above, we estimate that there would have been 9 (months) x 1,583 (diagnoses per month) = 14,250 cancer diagnoses during this pandemic period. If 24.3% of these did not happen then our estimate of missing diagnoses becomes 3,460 or ‘around 3,500’.