Cancer care faces ‘ticking time bomb’ because of staff shortages, doctors warn

Scottish cancer care faces a “ticking time bomb” unless action is taken to recruit more radiologists and oncologists, doctors have warned.

New reports from the Royal College of Radiologists (RCR) show that Scotland currently has a 25% shortage of radiologists and a 19% shortage of oncologists, with these shortfalls expected to rise to 35% and 31% respectively by 2029.

This is being driven, the reports say, by recruitment lagging behind a growing demand for services, and a “retention crisis” that is seeing cancer doctors leaving the NHS at a younger age than ever before.

The RCR said without action to boost staff numbers, patients will face lengthening waits for diagnosis and treatment, and the body warned that a cancer patient’s risk of death can increase by 10% for every month treatment is delayed.

Dr Katharine Halliday, president of the RCR, said: “Patients are being failed by a chronic lack of radiologists and oncologists.

“Despite the best efforts of NHS staff, there aren’t enough doctors to ensure prompt, safe and effective care and the outlook is bleak.

“We are doing all we can to boost productivity, but there’s a limit to how far we can go. The reality is we simply don’t have enough staff.

“Any credible plan to cut waiting lists relies on having the headcount to meet the demand we face today, let alone tomorrow.

“The longer we delay action, the worse it gets.

“The Government must train up more radiologists and oncologists to defuse this ticking time bomb for cancer diagnosis and treatment.”

The two RCR reports show the results of a “workforce census” of clinical radiology and clinical oncology staff in 2024.

They show regional disparities in staff shortages, with 34 radiologists currently needed to meet demand in the north of Scotland, whereas nine are needed in south-east Scotland.

The north of Scotland is also expected to see a 43% shortfall in the number of oncologists by 2029, compared with 31% across Scotland as a whole.

The reports also detail a “retention crisis” among cancer specialists, with the median age of consultant clinical radiologists leaving the NHS standing at 38 in 2024, compared with 58 the year before.

Seven in ten leavers last year were also under the age of 45.

One consultant clinical oncologist quoted in the reports said staff shortfalls were placing a “massive strain” on the workforce, and that they were “eroding goodwill and morale”.

Another described the current level of staffing as “unsustainable”, while another spoke of “significant stress” among staff, with some having to take time off because of “stress-related health issues”.

A further oncologist is quoted as saying: “Safe delivery of cancer treatment is becoming increasingly impossible.”

The RCR pointed out that recruiting more staff would also save the NHS money, as it would curb the increasing reliance on costly “short-term fixes” such as outsourcing and overtime.

It said the £20m spent on “temporary workforce solutions” in 2024 could fund 181 full-time radiologists – more than enough to fill the shortfall of 132 radiologists in Scotland.

The body also pointed to analysis showing that an extra 180 radiology trainees each year (an increase of 50% on the current figure) would save the NHS £460m after 10 years.

A Scottish Government spokesperson said: “We have been working across NHS Scotland to address staffing as a matter of urgency.

“We are supporting a dedicated group, reporting directly to Health Board chief executives, to find solutions to pressures on oncology services throughout Scotland.

“We are treating more patients with cancer on time, within both 62 and 31-day pathways, compared to pre-pandemic and ten years ago.”