Addressing NHS Cancer Care Delays: The Role of Modern Radiotherapy

A smiling doctor rests a hand on a patient's shoulder in a clinic while a colleague looks on
Oct 16, 2026 4 minute read

England's NHS elective waiting list remains above seven million, while treatment times continue to exceed pre-pandemic levels. The latest Referral to Treatment (RTT) figures for July 2026 show a waiting list of 7.33 million cases, representing approximately 6.21 million individual patients awaiting treatment. The typical wait for patients starting treatment was 12 weeks, compared with a pre-pandemic median of 7.3 weeks in July 2019 (British Medical Association, 2026).

Cancer care figures present a similarly troubling picture. The government's National Cancer Plan and NHS Planning Guidance set a target for 80% of patients in England to begin treatment within 62 days of an urgent GP referral by March 2027, rising to 85% by March 2029. However, NHS England data cited by a BBC article from September 2026 shows that performance has declined from 71.9% to 71.2% since the targets were set (BBC, 2026).

“Government targets are now simply impossible to hit after a complete loss of momentum … thousands of patients are going to die unnecessarily, just because the government can't get their act together to treat people on time” (BBC, 2026).

Professor Pat PriceProf. Pat Price
Leading Clinical Oncologist, quoted by the BBC

The human reality behind these statistics is evident across local NHS trusts under severe strain. As the BBC coverage highlights, trusts like Salisbury face compounding pressures at every stage of the cancer pathway. Diagnostic backlogs create an immediate bottleneck, with Lee Phillips, Head of Department, noting:

“The sheer volume of specimens we have coming in is our problem … We need more staff and more kit if we're going to keep up with demand” (BBC, 2026).

Once diagnosed, patients face further operational hurdles in accessing treatment. Without on-site radiotherapy facilities, trusts like Salisbury must require patients to travel daily for up to an hour each way to access radiation facilities in Southampton or Bath, adding a significant travel burden to an already challenging care journey.

As Founder and Chair of Radiotherapy UK, Pat Price has seen firsthand both the transformative power of radiotherapy and the devastating consequences when patients cannot access it in time. The charity is campaigning to improve access for all patients to high-quality, on-time radiotherapy.

In her contributions to the 2025 Radiotherapy Impact Report, Precision targeting, global impact: cancer radiotherapy in the 21st century, Pat emphasizes that these challenges (and possibilities) extend far beyond the UK (Elekta AB, 2025).

“Today, we stand at the edge of an enormous opportunity: to unleash the full potential of radiotherapy with the right investment, planning, and commitment to ensure access for every community around the world… Every dollar invested delivers not only human benefit but also economic return, as patients return to work and communities thrive” (Elekta AB, 2025, p. 3).

NHS trusts report that efforts are underway to expand capacity, clear backlogs, and streamline care pathways, with initial progress now showing (BBC, 2026). While structural investment and workforce strategies are required to address national capacity shortages, parallel technological innovations in radiation oncology are helping to reshape how treatments are planned and delivered.

How can modern radiotherapy techniques help transform treatment delivery?

Technological progress and refined treatment approaches have markedly enhanced targeting precision and operational capacity in radiation oncology. As highlighted in the 2025 Radiotherapy Impact Report, adaptive radiotherapy tackles a fundamental obstacle in cancer care: inter-fraction changes in patient anatomy. To accommodate these variations, clinicians have traditionally applied wider treatment margins, expanding the target zone beyond the visible tumor. These margins help ensure adequate tumor coverage, but they can also increase radiation exposure to surrounding healthy tissue, creating a persistent trade-off between targeting accuracy and patient safety (Elekta AB, 2025, p. 16).

Adaptive Radiotherapy changes the equation.

By combining high-quality imaging with AI-supported planning and automation, adaptive radiotherapy enables clinicians to adjust treatment plans in near real time. Rather than relying on a single static plan, radiation delivery can be adapted daily or weekly to reflect each patient's anatomy at the time of treatment. The objective is to maintain tumor control while reducing unnecessary exposure to surrounding healthy tissue (About Adaptive, n.d.).

Adaptive radiotherapy is one part of a wider shift towards more efficient, personalized treatment. Hypofractionation offers another route to expanding capacity by administering higher daily radiation doses over fewer visits. This can shorten treatment timelines, lower overall costs and broaden access while maintaining clinical efficacy (Elekta AB, 2025, p. 41).

Hypofractionated treatment of breast and prostate cancers could eliminate 36.2 million radiation fractions every year (Elekta AB, 2025, p. 41).

This would allow an additional 2.2 million individuals to receive care for these conditions (Elekta AB, 2025, p. 41). Furthermore, transitioning 50% to 80% of standard breast and prostate radiotherapy treatments to hypofractionated schedules offers estimated cost savings ranging from US$2.76 to US$4.41 billion (Elekta AB, 2025, p. 41).

Although adopting innovative approaches to meet rising demand requires significant investment and commitment, the evidence suggests that appropriate investment could improve access, support better outcomes, and reduce the overall cost of care (Elekta AB, 2025, p. 41).

References

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