DELAYS in diagnosis and complex cases are the key factors behind a dip in performance in Gwent against cancer treatment targets during the spring, according to a health board report.

Performance against Wales’ two key cancer treatment targets had improved during January-March, only to slip back through April-June.

The figures for June are yet to be formally published, but Aneurin Bevan University Health Board is predicting it will fall below each of those targets.

A minimum 98 per cent of patients whose cancer is not diagnosed through an urgent suspected cancer referral route - for instance as a result of tests or treatment for an unrelated problem - should begin their treatment within 31 days.

And a minimum 95 per cent of those whose cancer is diagnosed through the urgent suspected cancer referral route should begin their treatment inside 62 days.

In March, all 31-day Gwent patients began their treatment within the target time. Though April and May’s performances were above the 98 per cent minimum, they fell slightly each month - and the health board is estimating that the June figure will be around 96 per cent.

Achieving the 62-day target has proved far more challenging in Gwent and across Wales, for some time.

Ninety-two per cent of 62-day patients in Gwent began their treatment inside the target time in March. But performance fell during both April and May, and the health board estimates that the June figure will be around 82 per cent.

Performance against both the 31-day and 62-day targets improved in only two of the six health board areas in Wales during May.

In Gwent, 31-day target performance was above the all-Wales average, but the 62-day target performance was below it.

“Recovering the cancer position and eliminating the backlog has been a slow process,” states the health board report.

“Therefore the challenge will be to ensure that this does not slip further, and that actions and plans are in place to minimise the impact on performance”

Among the action being taken is the starting up of a pilot project on early diagnosis in lung cancer. This involves enabling CT scans to be arranged direct from primary care for GP practices in trial areas.

CT scans can now also be ordered directly following abnormal chest X-rays, under another pilot project.

A one-stop clinic for patients with lumps in the neck has also started up, which enables an outpatient consultation with an ENT (ear, nose and throat) surgeon, and if necessary an ultrasound scan/biopsy with a radiologist at the same time.

Another pilot project, at Nevill Hall Hospital, involves direct bookings from outpatients for endoscopies, and it is planned to roll this out to other hospitals.

Two reviews of demand and capacity are also being carried out.

One involves capacity in endoscopy services for 62-day patients, to consider the feasibility of increasing dedicated appointment slots, while the other involves ultrasound, and CT and MRI scanning, for 62-day patients, again with the aim of increasing dedicated appointment slots.