Update on breast cancer oncology services in Tayside

You may have seen stories in the media recently about the breast oncology service in NHS Tayside which have raised concerns about staffing levels and how the service is being delivered.

Here is some information about how the service is delivered along with some questions and answers about the service to reassure our patients about the level of care you can expect.

There are two main parts of the breast service. One is the breast oncology service. This is for patients who have a definite diagnosis of breast cancer. All patients who have a diagnosis of breast cancer in Tayside are receiving their treatment within Tayside.

Early breast cancer services are being supported by an NHS Grampian consultant. This has been the case for the past year. The consultant sees all Tayside early breast cancer patients. A small number of these patients see the consultant in Aberdeen for their first appointment only. This is due to their individual clinical presentation and is done in discussion with the patient. None of these patients who have gone for that single appointment in Aberdeen have raised any concerns directly with the service.

The other part of the breast service is the diagnostic service where patients are referred with a breast abnormality, usually through a GP.

NHS Forth Valley is providing additional support to this part of the service for routine referrals. Some patients are offered the option to go there if they wish the earliest possible appointment. These extra clinics will run until the end of the year.

If anyone has an urgent referral, they are seen in Tayside.

Patients should be reassured that all treatment is delivered in Tayside.

One article claims that a single oncologist will be doing the job of three people once a consultant retires in January. This is not the case.

The breast oncology service in Tayside is delivered in three stages – early breast cancer, advanced breast cancer and the breast radiotherapy service.

• The early breast cancer service in Tayside is currently delivered by an oncologist from NHS Grampian in a long-standing arrangement. This is still delivered to Tayside patients in Tayside.

• The advanced breast oncology service in Tayside is delivered by a newly-recruited NHS Tayside oncologist who has been in post since August 2021.

• The breast radiotherapy oncologist is retiring in January. There is a national shortage of breast oncologists, however we are continuing our efforts to recruit to this post, looking at all options, both permanent and locum. We may also use support from another Board – this is called mutual aid. This is a commonly-used approach where a Board provides support to another Board for a particular service. For example, NHS Tayside currently provides support to another Board for colorectal cancer services.

• The oncologists are supported by a multi-professional team.

• The main thing our communities and patients need to know is that there is still a full breast oncology service in Tayside, and that has always been the case.

If you have a diagnosis of breast cancer, you will be seen and treated and, in fact, in Tayside our teams are meeting both the 31-day and the 62-day national targets for being seen and treated. The target is 95% for both – and due to the hard work and dedication of our teams - we are achieving 100%.

Are breast oncology services in Tayside running as normal?

As has always been the case, NHS Tayside currently offers a full breast oncology service with all patients receiving their treatment here in Tayside.

Are there any delays for patients waiting for breast oncology services?

• All referrals into the breast clinic service, which have been classed by clinical teams as an urgent suspicion of cancer, are currently seen within the national target of two weeks.

• NHS Tayside is also consistently delivering the national 31-day and 62-day standards for breast cancer treatment.

• The 62-day target means that there should be no more than 62 days wait between the date the hospital receives an urgent referral for suspected cancer and the start of treatment.

• The 31-day target means that patients should wait no more than 31 days between the meeting at which you and your doctor agree the treatment plan and the start of treatment.

• 100% of patients in Tayside who are referred to us with an urgent suspicion of cancer are beginning their treatment within these targets.

What happens if my clinician leaves or retires?

Patients should be reassured that their treatment will continue to be delivered in Tayside. We will keep patients informed about their care.

Also, there were statements made around Tayside patients having to travel elsewhere for treatment – is that the case?

We can assure everyone that Tayside breast oncology patients are treated in Tayside.

What is NHS Tayside doing to recruit breast oncologists?

NHS Tayside continues to work hard to recruit to the service in the face of a national shortage and, just like in all services, we sometimes use support from locum doctors and other Boards to cover vacancies.

We are pleased to say that a new consultant breast oncologist started in August this year and recruitment is ongoing for clinical and medical oncologists.

To support the team, a consultant oncologist from NHS Grampian has been seeing all new neo-adjuvant (early) breast cancer chemotherapy patients in Tayside. The consultant takes part in the local multi-disciplinary meeting and sees around three patients per week.

NHS Tayside is part of the North Cancer Alliance which connects all the Boards in the north of Scotland and provides a regional network to ensure patients across the area have access to cancer services.

Who do I speak to if I am concerned?

You should speak to the clinicians dealing with your care who will be able to offer support and answer any questions you might have.

We hope this allays any concerns people may have following the media reports about the service.