Background to the statistics

1.1 The NHS Constitution for England outlines what patients can expect and their rights when they are referred on a cancer diagnosis and treatment pathway. National cancer waiting times standards measure NHS performance against the Constitution and in delivering several other metrics. These measures are considered as indicators of the quality of cancer diagnosis, treatment and care delivered by NHS organisations. Local and national organisations use them to monitor the timely delivery of services to patients.

1.2 In June 2018, the UK Prime Minister asked the National Medical Director of NHS England and NHS Improvement to review the NHS standards for accessing cancer diagnosis and treatment in the context of the NHS Long Term Plan. The goal of the review was to develop a new, simplified set of patient-centred standards appropriate to modern cancer care that are understandable both clinically and to the public.

1.3 Between March and April 2022, NHS England publicly consulted on the proposed new standards for cancer care. It published its consultation response in August 2023. The report highlighted wide-ranging support for the proposed new standards and set out the final policy recommendations and the steps that the NHS and government must take to implement them.

1.4 The new standards came into effect on 1 October 2023 and included three core measures:

• The 28-day faster diagnosis standard: People should have cancer ruled out or receive a diagnosis within 28 days (target of 75%).
• The 31-day decision to treat to treatment standard: People with cancer should begin their treatment within 31 days of deciding to treat their cancer (target of 96%).
• The 62-day referral to treatment standard: People with cancer should begin treatment within 62 days of an urgent referral (target of 85%).

1.5 NHS England publishes a range of official statistics and management information which help users to understand NHS performance in England against these operational standards. Following the introduction of the new standards, NHS England made several changes to the official statistics, including increasing the prominence of the headline statistics reporting against the new waiting times standards and producing more-granular breakdowns of tumour type for a range of cancers.

1.6 These changes were informed both by the introduction of the new standards and by feedback received in the consultation. The changes are outlined fully on the publication page for the cancer waiting times statistics and were prominently mentioned in the first statistical release following the announcement. NHS England published the first statistics reporting on the new standards in December 2023, and has continued to give details of the changes in each subsequent monthly release.

1.7 Given the new standards, the resulting changes to the statistics and the continued high profile of the statistics, NHS England requested that OSR conduct a full assessment of the statistics. To allow time for the new statistics to bed in, we commenced the assessment in autumn 2024.

1.8 In March 2025, the government announced plans to abolish NHS England, and to bring many of its functions into the Department of Health and Social Care over the next two years. At the time of this announcement, our assessment was nearing its conclusion, and so we agreed with the team that we would complete it. It will be some time before the abolition process is complete, and we envisage that the team should meet the requirements set out in this report before this. Recognising, however, that there is likely to be some uncertainty around the future of the organisation, we will continue to monitor the situation and amend our plans if necessary.