‘A system on its last legs’: NHS forced to deny chemotherapy for cancer patients

Staff shortages have forced one of England’s largest NHS trusts to start rationing chemotherapy to some of its cancer patients.

Nottingham University Hospitals Trust is now limiting access to treatments for patients diagnosed with terminal cancer and those who are receiving treatments aimed at slowing the disease and buying them extra weeks or months of life.

The trust said only a small number of patients had been affected by the shortages which it said had been triggered by long term sickness and unfilled vacancies.

All affected patients have been contacted personally by bosses to explain the situation.

One doctor from the city has spoken out over what she said was a wider “broken system” in the NHS.

Dr Lucy Gossage, an oncologist at the trust wrote in a blog post: “Right now, for many of us, the care we are able to offer our patients with cancer is worse than it’s been at any point since Covid-19 first hit the UK.”

She said hospitals had been told to prioritise cancer patients into six categories from those who were able to be treated and cured through to those who were terminal and likely to see only marginal benefits from chemotherapy.

“This prioritisation system has been used intermittently across the country during the pandemic but where I work, though capacity to deliver chemotherapy has been exceptionally tight at times, we’ve never had to use it. Until now. Right now we don’t have the staffing capacity to deliver chemotherapy to all our patients and so, for the first time, the prioritisation list has come into force.

“That means that, currently, we are unable to offer chemotherapy that aims to prolong life or palliate symptoms for many people with advanced cancer. We hope this is very temporary, but it’s indicative of a system on its last legs.”

She added: “As oncologists, we’re not used to apologising for a broken system. And that, right now, is what we’re doing every day. This is not ok. Our patients are not ok. We are not ok.

“The reality is, right now, we’re not delivering a first world cancer service and we need to talk about it.”

The staffing shortages come after the trust was criticised earlier this month by the Care Quality Commission for widespread bullying and ineffective board leadership. The trust is also facing an inquiry into poor maternity care after an investigation by The Independent.

Nottingham University Hospitals Trust has spent hundreds of thousands of pounds applying for Magnet status from the American Nurses’ Credentialing Center. Magnet status is supposed to reflect world-class nursing care and improved culture.

Following its recent inspection the CQC issued the trust with a warning notice demanding it take steps to improve its governance, culture and leadership.

Medical director Keith Girling said: “Our clinical teams are prioritising care based on the likely clinical benefit. We are deeply sorry for the concern and upset this will cause.

“We are supporting the staff and actively recruiting to posts and will ensure that any service limitations are for the shortest possible period.”