Staff shortages, broken equipment and soaring demand are leading to "devastating delays" for cancer patients, with one in five people waiting more than 84 days to start treatment.

The latest report on cancer waiting times in Scotland shows that just 70.4% of cancer patients started treatment within the target time of 62 days of an urgent referral for tests between January and March this year.

This is down from 83.7% at the end of 2019, and remains far from the 95% target last achieved in 2012.

Both the 62-day and 31-day standards are being missedBoth the 62-day and 31-day standards are being missed (Image: PHS)

Nearly one in five (17.9%) people waited more than 84 days to start treatment, although in the Grampian region this stood at 33% as the health board admitted that demand for diagnostic tests in its radiology, endoscopy and urology services in particular "outweighs available capacity".

It also blamed annual leave around the festive season, school holidays, and staff using up their holiday allowances before the end of the financial year, plus "much higher" referrals to its colorectal cancer pathway compared to pre-pandemic levels.


Hundreds of Grampian breast cancer patients have also had to travel to Forth Valley since October last year for diagnosis, assessment and, in some cases, surgery pending the appointment of a new specialist consultant who is due to take up their post this month.

Across Scotland as a whole, the number of eligible cancer patients referred onto the pathway for diagnosis and treatment has increased by more than 15% - to 4,294 - compared to the end of 2019.

The increase is partly driven by the ageing population, but has been huge for certain cancer types.

Referral rates for patients diagnosed with prostate cancer have more than doubled, from 19 per 100,000 adults at the end of 2019 to a record high of 40 per 100,000 at the beginning of this year - coinciding with increased awareness after King Charles was diagnosed with an undisclosed form of cancer following an operation on a benign prostate enlargement.

Time from urgent referral for tests to starting treatment, prostate cancer, by health board, Jan-March 2024Time from urgent referral for tests to starting treatment, prostate cancer, by health board, Jan-March 2024 (Image: PHS) Increase in prostate cancer referrals over time, per 100,000 people (aged 16+)Increase in prostate cancer referrals over time, per 100,000 people (aged 16+) (Image: PHS)

Nearly half of men with prostate cancer are now waiting more than 84 days between being sent for tests and starting treatment, although in Grampian this was 75% and nearly 70% in Lothian and Fife.

Kate Seymour, head of advocacy for Macmillan Cancer Support, said the data "shows that far too many people living with cancer are still facing devastating delays in treatment and diagnosis, causing huge amounts of anxiety and throwing lives into chaos".

She added: "Despite the tireless efforts of NHS staff, people with cancer are being failed by a health care system that is not being given the resources it needs to support them.

"The Scottish Government must take action to ensure people living with cancer get the care they need before the situation gets any worse.

"That means bolstering the cancer workforce and investing in equipment to ensure people are diagnosed early, treated quickly and supported through all the impacts cancer can have on their lives.”

Performance against the 31-day standard - stipulating that eligible patients should begin treatment within one month of a diagnosis and decision to treat - was met by 10 of the 15 health boards, including the Golden Jubilee, with a median wait time nationally of four days.

However, in both Grampian and Highland - where compliance was lowest - around 10% of cancer patients were waiting longer than 31 days.

In feedback submitted to Public Health Scotland, health boards detailed a range of problems impacting on cancer waiting times.

Increasing demand for imaging and staff shortages in radiology are creating backlogsIncreasing demand for imaging and staff shortages in radiology are creating backlogs (Image: PA)

NHS Ayrshire and Arran cited issues with CT and MRI scanners which were "out of use due to part failure" for short periods at the beginning of the year, as well as staff shortages in pathology.

NHS Dumfries and Galloway - which is currently reliant on a single CT scanner - said it was battling a "significant backlog in imaging" as a result, in addition to a "sustained increase" in cancer referrals which was particularly impacting its prostate and colorectal pathways.

NHS Fife said the breakdown of its PET scanner had "created long delays within the lung pathway", with increased waits for surgery due to "robotic theatre capacity issues".

In Forth Valley, a "technical fault" with a bone scanner caused delays, there were workforce challenges "across all specialties", and bed capacity was described as "very challenging" - though it stressed that cancer remains "a priority in terms of surgery and diagnostics".

Scotland's largest health board, NHS Greater Glasgow and Clyde, said colorectal oncology and urology are "particularly affected" by workforce challenges, while NHS Shetland - which depends on Grampian for all off-island diagnostics, surgery, oncology appointments, radiotherapy and imaging - reported that prostate cancer patients, who require MRI scans, were facing "significant" delays.

The Scottish Government said it has invested more than £11m extra towards tackling cancer waiting times in the current yearThe Scottish Government said it has invested more than £11m extra towards tackling cancer waiting times in the current year (Image: Getty)

NHS Tayside said the number of urgent suspicion of cancer (USC) referrals to its clinics is increasing, peaking during one week at 111% higher than the pre-pandemic median.

It added: "The Urology Prostate pathway remains our biggest challenge with high demand for non-concurrent diagnostic tests and significant workforce challenges causing delays to surgical treatment."

The Scottish Government said more patients are being seen than pre-pandemic and pressure on operating theatres is affecting the 62-day standard.

A spokesman said: "To support cancer performance, a further £11.3 million of cancer waiting times funding has been made available in 2024/25.

"In addition to this, an initial investment of £30 million has been provided to target reductions to the national backlogs that built up throughout the pandemic.

"Over £1.2 million of this funding has been directed towards diagnostics and treatment for patients referred with an urgent suspicion of cancer, in order to reduce waiting lists."