A review of cancer waiting times in Scotland

Despite the tireless work of NHS staff, not all the cancer waiting time targets are consistently being met for breast cancer.

NHS Scotland has 2 cancer waiting time targets in place to help make sure that patients can be diagnosed and treated for breast cancer as quickly as possible:

• 95% of cancer patients to start treatment within 62 days of urgent suspicion of cancer
• 95% of cancer patients to receive their first treatment within 31 days from when doctors and patients agree on a treatment plan

In April, Public Health Scotland published the most recent cancer waiting times data. This data covers patients who started their first treatment between 1 October and 31 December 2024. It shows us how long it takes for patients to start their treatment for breast cancer.

On a positive note, 96.5% of patients started treatment for breast cancer within 31 days of agreeing a treatment plan.

However, only 89.4% of patients started treatment within 62 days of an urgent referral. It’s now been 4 years since this target was last met. If the 95% target had been met during this time, we estimate over 1000 more people would have had a timely diagnosis and treatment.

It’s clear that more people are accessing breast cancer treatment within 31 days of agreeing on a treatment plan, compared to people starting treatment within 62 days of their urgent referral. This suggests that there are delays at earlier stages of the treatment pathway, which prevents people getting seen and diagnosed quickly.

Even when a specialist tells someone they have breast cancer quickly, delays can still happen. Getting a full breast cancer diagnosis is crucial. This means more than Doctors saying, ‘you have breast cancer’, but also being able to tell you the type and stage of cancer to decide the best treatment. For example, knowing if a tumour has hormone receptors or is triple negative.

Scotland currently doesn’t track the time between receiving an urgent referral to getting a full breast cancer diagnosis. However, there is a target for monitoring HER2 status (a hormone receptor test) within 2 weeks of core biopsy for invasive breast cancer patients. This target is 90%. Recent data from 2020-2023 shows this target wasn’t met. This highlights that women in Scotland are waiting longer for diagnostic test results.

We know that long waits for diagnostic tests results, like HER2 status, have been made worse by increasing demand and workforce shortages. Doctors need diagnostic information like this to decide which treatment option is best for each patient. Delays in getting a full diagnosis will lead to longer waiting times for discussing treatment options, impacting the 62 day target. 

The Scottish Government Cancer Action Plan 2023-2026 committed to a clinically led review of cancer waiting times by March 2026. This review is crucial to help identify why the 62 day target continues to be missed.

We'll be calling for specific and ambitious targets for breast cancer waiting times. We want these targets to reflect the well-established way we diagnose and treat breast cancer and to help drive improvement. This includes calling for a new cancer waiting time target that measures how long it takes from referral for patients to receive a comprehensive diagnosis.

The Scottish Government need to continue to provide resources to address the issues causing delays and to dramatically cut waiting times. We’re calling on the Scottish Government to start by delivering on their commitment to complete a cancer workforce review by March 2026, which would identify the workforce NHS Scotland need to meet waiting time targets.

Over the coming months, we’ll keep you updated on how we’re using the waiting times review to push for improvements and let you know how you can support our work.