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How data can help reduce cancer patient backlogs

With high levels of referrals and an ever-growing backlog, the number of patients seen following an urgent suspected cancer referral has remained at a record high since March 2021.

To compound the situation, a staggering 36,000 additional patients were expected to have come forward to start cancer treatment during the pandemic than having done so, according to the NHS 2022/23 priorities and operational planning guidance.

As a priority, NHS organisations are expected to:

  • – Improve performance against all cancer standards, with a focus on the 62-day urgent referral to first treatment standard, the 28-day faster diagnosis standard and the 31-day decision-to-treat to first treatment standard.
  • – Meet the increased level of referrals and treatment required to reduce the shortfall in number of first treatments.


The need to improve performance against cancer standards whilst simultaneously dealing with the consequential effects of the pandemic will be challenging for many; requiring a strategic review of resources, the workforce, processes and procedures to work through the backlog and achieve these priority objectives.

Reducing delays in diagnosis to drive improved outcomes

Improving access to diagnostics is high on the list of priorities. The introduction of the 28-Day Faster Diagnosis Standard in 2020  (FDS) was greatly impacted by the pandemic is designed to ensure that patients find out within 28 days whether or not they have cancer, will have a greater focus.

A report by Professor Sir Mike Richards outlined the need for community diagnostic hubs that offer tests for emergency and elective diagnostics, outside of a hospital to reduce hold-ups for patients and provide a safer COVID free environment to those at risk.

“Not only will these changes make services more accessible and convenient for patients but they will help improve outcomes for patients with cancer and other serious conditions.”

Professor Sir Mike Richards, Chair – Independent Review of Diagnostic Services for NHS England.

The implementation of these hubs should add much-needed capacity for diagnostics, but this can only be successful if there is the workforce to support it, along with a full understanding of the demand and ability to sufficiently plan capacity.

Data is king for demand and capacity

With multiple and sometimes complex diagnostic and treatment data points available, one of the most integral success factors for cancer pathway planning is having a clear view and understanding of service demand in order to align it with capacity. Information about what resource is available along with where it can be deployed and when needs to be readily accessible for NHS trusts to have a chance of diagnosing cancer patients within 28-days (FDS), treating them promptly and safely, and discharging them when ready.

“The issues we’ve seen first-hand are about capacity, productivity and data” says Debbie Johnston, Endoscopy Subject Matter Expert and Products Director at Four Eyes Insight. “Working efficiently, in the best way, utilising the resources that you have got is crucial. But the workforce and physical capacity, with outpatients, diagnostics, theatres and oncology have been severely hampered as we still recover from the pandemic.”

With data playing such a crucial role in the planning process, here’s five questions to help you identify opportunities for improvement and establish whether you could improve access to the information you need:

  1. 1. Do you have control over and access to the data?
  2. 2. Is all your data aggregated in one place to make it accessible and help you identify trends?
  3. 3. Can you easily monitor performance over time to demonstrate continuous improvement?
  4. 4. Do you have the capacity and capability to do a deep dive into the sub-components of the data?
  5. 5. Are you able to map out the patient pathway to identify why patients are waiting and what the blockages are?

How Four Eyes Insight can help

As providers continue to work toward elective recovery and reduce waiting lists, Four Eyes Insight is here to help. We use the combined power of people, data and technology to get to the root cause of inefficiencies; working collaboratively and engaging with all stakeholders to get buy-in for change from the ground up. We implement interventions that optimise elective care pathways and provide tools to monitor their effectiveness ensuring that a culture of continuous improvement to drive long term, sustainable change is embedded along the way.

Working in collaboration with an NHS Trust in the South East, our team had a rapid impact on the cancer pathway that helped to:

  • – Reduce the cancer backlog by 40%
  • – Increase 62-day compliance by 27%
  • – Reduce 104-day breached by 44%
  • – Reducing significant harm to patients


For more information. please email