NHS treatment to target aggressive lymphoma often missed

Aggressive, high-grade lymphoma is a fast-growing type of blood cancer that often requires treatment to begin quickly. Yet nearly half (44%) of people in England and 38% in Wales are not starting treatment within the NHS target of 62 days from referral, according to a major new national audit.

The National Non-Hodgkin Lymphoma Audit (NNHLA), part of the National Cancer Audit Collaborating Centre (NATCAN) looked at waiting times for systemic anti-cancer therapy (SACT), including chemotherapy, immunotherapy and targeted therapies in 2023 in England and 2024 in Wales.

The audit found that only 56% of people with high-grade lymphoma in England began treatment within the NHS target, well below the NHS ambition for 85% of patients in England to start treatment within 62 days of an urgent referral for suspected cancer. Similarly in Wales, only 62% of people with high-grade lymphoma began treatment within 62 days, below the ambition for 75% of patients in Wales to start treatment within 62 days of suspicion of cancer.

Released during Blood Cancer Awareness Month, for the first time, the audit also identifies where delays occur along the lymphoma pathway for patients in England, highlighting key stages where patients experience the longest waits.

The audit found:

44% of people with high-grade lymphoma – a type of blood cancer – did not begin systemic anti-cancer therapy (SACT) in England, and 38% in Wales, within the NHS target of 62 days from referral.
Patients in England waited a median of 36 days from referral before seeing a haematologist.
After diagnosis, patients in England waited a median of 35 days before starting treatment.
The audit recommends NHS organisations investigate these delays to understand where improvements can be made.

Blood Cancer UK, who ensured patient perspective informed the work, says the findings highlight the need to improve outcomes for people with lymphoma and other blood cancers. The charity says reducing delays, ensuring rapid access to specialist care and treatment, increasing access to clinical trials will all be essential if survival is to improve.

Dr Rubina Ahmed, Director of Research, Policy and Services at Blood Cancer UK, said:
“Being told you have blood cancer is devastating. Once someone has a diagnosis, they deserve to receive the specialist care and treatment they need as quickly as possible. Every unnecessary delay adds to the uncertainty people experience at one of the most frightening times of their lives.

“The NHS has set clear ambitions for how quickly people with cancer should begin treatment, yet this report shows too many people with lymphoma are still waiting longer than they should. Research has transformed treatment for many people with blood cancer, but these advances only make a difference if people can access the right treatment at the right time. We need to tackle unnecessary delays while continuing to invest in research that can deliver kinder, more effective treatments and give more people the chance to live longer, healthier lives.”

Dr John Ashcroft, President, British Society of Haematology (BSH)
“For the first time, this audit allows us to see where patients are spending the longest periods of time as they move through the lymphoma pathway. Understanding these pinch points is an important step towards reducing unwarranted variation and potential delays, improving the patient experience, and ensuring people receive treatment as quickly as possible. While the audit doesn’t explain why these delays occur, it highlights where NHS organisations can look more closely at their local pathways and identify opportunities to improve care”.