Tag Archives: Failure

Boots criticised over failure to cut price of morning-after pill

Five months after Boots bowed to public pressure and promised to reduce the price of emergency contraception, it has made good on its promise in less than 3% of its stores.

After weeks of controversy last summer over its stance on the price of its generic brand of emergency hormonal contraception (EHC), levonorgestrel – during which the pharmacy chain said it could not reduce the cost in case it encouraged women to have unprotected sex – Boots relented and said the price would drop from £26.75 to £15.99 from October.

But it said on Wednesday the price had been reduced in only 69 of its 2,500 stores nationwide. A letter last month signed by more than 130 MPs expressed disappointment that cheaper prices for the morning-after pill had not been extended more widely.

The British Pregnancy Advisory Service (BPAS), which led the initial campaign asking Boots to reduce the price in line with other pharmacies, said the fact the price remained unchanged in the vast majority of branches was “absolutely scandalous”.

Boots said the delay was due to low stock as a result of “batch failure” and said it offered a free NHS service for EHC in most stores. To be eligible for a free contraceptive pill, a customer needs a prescription from a GP or family planning clinic, according to the Boots website.

“We remain committed to rolling this service out nationally,” said a Boots UK spokesperson. “Unfortunately the manufacturer has experienced a batch failure due to quality issues which means that the stock we were expecting is not now available, and we are now waiting for a new batch to be produced. We thank our customers for their continued patience and reassure them that we are doing all we can to roll this service out to all our stores as soon as possible.

“In July we launched an extended over-the-counter EHC service which includes the generic levonorgestrel in 38 Boots stores in the East Midlands. We’re pleased to confirm that we have now been able to roll this out to a further 31 stores, taking the total number of Boots stores offering the service to 69.”

The letter from MPs to Boots, written by Sharon Hodgson, the shadow minister for public health, said it was of particular importance to lower prices for the Christmas period.

Over this time, Hodgson wrote, “many women struggle to access contraceptive services and their usual family planning method. As a result, the British Pregnancy Advisory Service, reports that they see an increased number of women facing an unplanned pregnancy following the festive season.

“Clearly, pharmacy access to emergency contraception is of an even greater importance in December and January.”

BPAS tweeted that it was best to “give Boots a miss”.

bpas (@bpas1968)

It’s Boxing Day! Don’t forget – if you need emergency contraception today, you can buy it in plenty of shops for £15 or less. Still, best give Boots a miss. Use the spare cash in the sales.

December 26, 2017

The charity said in a statement it was “absolutely scandalous that Boots have failed to deliver on the clear pledge they made to roll out cheaper emergency contraception in all their stores”.

It added: “There can be absolutely no excuse for their pathetically slow pace of progress, other than the fact that they simply do not want to provide women with an affordable product. If Boots cannot source a new version of emergency contraception to sell at a lower price, then they should do the right thing and cut the price of the version they currently have in stock.

“Regardless of supply chain delays, affordable emergency contraception is entirely within their gift to give right now – and every day they refuse to do so, more women are being ripped off, or risking an unplanned pregnancy because they cannot afford Boots’ inflated price tag.”

Boots made the commitment to lower the price of its generic morning-after pill in July. It had previously caused outrage by refusing to do so in case it encouraged women to have sex. It said in a statement: “We would not want to be accused of incentivising inappropriate use, and provoking complaints, by significantly reducing the price of this product.”

Even at the reduced price of £15.99, the Boots morning-after pill would still be £2.49 more expensive than products sold by rival pharmacies including Superdrug, Tesco, Morrisons and Asda.

On Wednesday, Boots renewed its call for NHS England to make emergency contraception available to women who need it, as the health service in Scotland and Wales already does. “We are inviting our MPs to work with us to make EHC available free from pharmacies to all women in England and end the current postcode lottery on availability either due to location or age,” it said.

Boots criticised over failure to cut price of morning-after pill

Five months after Boots bowed to public pressure and promised to reduce the price of emergency contraception, it has made good on its promise in less than 3% of its stores.

After weeks of controversy last summer over its stance on the price of its generic brand of emergency hormonal contraception (EHC), levonorgestrel – during which the pharmacy chain said it could not reduce the cost in case it encouraged women to have unprotected sex – Boots relented and said the price would drop from £26.75 to £15.99 from October.

But it said on Wednesday the price had been reduced in only 69 of its 2,500 stores nationwide. A letter last month signed by more than 130 MPs expressed disappointment that cheaper prices for the morning-after pill had not been extended more widely.

The British Pregnancy Advisory Service (BPAS), which led the initial campaign asking Boots to reduce the price in line with other pharmacies, said the fact the price remained unchanged in the vast majority of branches was “absolutely scandalous”.

Boots said the delay was due to low stock as a result of “batch failure” and said it offered a free NHS service for EHC in most stores. To be eligible for a free contraceptive pill, a customer needs a prescription from a GP or family planning clinic, according to the Boots website.

“We remain committed to rolling this service out nationally,” said a Boots UK spokesperson. “Unfortunately the manufacturer has experienced a batch failure due to quality issues which means that the stock we were expecting is not now available, and we are now waiting for a new batch to be produced. We thank our customers for their continued patience and reassure them that we are doing all we can to roll this service out to all our stores as soon as possible.

“In July we launched an extended over-the-counter EHC service which includes the generic levonorgestrel in 38 Boots stores in the East Midlands. We’re pleased to confirm that we have now been able to roll this out to a further 31 stores, taking the total number of Boots stores offering the service to 69.”

The letter from MPs to Boots, written by Sharon Hodgson, the shadow minister for public health, said it was of particular importance to lower prices for the Christmas period.

Over this time, Hodgson wrote, “many women struggle to access contraceptive services and their usual family planning method. As a result, the British Pregnancy Advisory Service, reports that they see an increased number of women facing an unplanned pregnancy following the festive season.

“Clearly, pharmacy access to emergency contraception is of an even greater importance in December and January.”

BPAS tweeted that it was best to “give Boots a miss”.

bpas (@bpas1968)

It’s Boxing Day! Don’t forget – if you need emergency contraception today, you can buy it in plenty of shops for £15 or less. Still, best give Boots a miss. Use the spare cash in the sales.

December 26, 2017

The charity said in a statement it was “absolutely scandalous that Boots have failed to deliver on the clear pledge they made to roll out cheaper emergency contraception in all their stores”.

It added: “There can be absolutely no excuse for their pathetically slow pace of progress, other than the fact that they simply do not want to provide women with an affordable product. If Boots cannot source a new version of emergency contraception to sell at a lower price, then they should do the right thing and cut the price of the version they currently have in stock.

“Regardless of supply chain delays, affordable emergency contraception is entirely within their gift to give right now – and every day they refuse to do so, more women are being ripped off, or risking an unplanned pregnancy because they cannot afford Boots’ inflated price tag.”

Boots made the commitment to lower the price of its generic morning-after pill in July. It had previously caused outrage by refusing to do so in case it encouraged women to have sex. It said in a statement: “We would not want to be accused of incentivising inappropriate use, and provoking complaints, by significantly reducing the price of this product.”

Even at the reduced price of £15.99, the Boots morning-after pill would still be £2.49 more expensive than products sold by rival pharmacies including Superdrug, Tesco, Morrisons and Asda.

On Wednesday, Boots renewed its call for NHS England to make emergency contraception available to women who need it, as the health service in Scotland and Wales already does. “We are inviting our MPs to work with us to make EHC available free from pharmacies to all women in England and end the current postcode lottery on availability either due to location or age,” it said.

Jeremy Hunt accused of ‘astonishing failure’ as GP numbers fall

The number of GPs in England has fallen sharply in the past year, despite a government pledge to increase the supply of family doctors by 5,000.

The total number of full-time equivalent GPs working in England dropped by 1,193 in the year to September, figures from NHS Digital show.

The numbers have shrunk despite ongoing efforts by the NHS, ministers and GP bodies to persuade existing family doctors to stay in post and to encourage medical graduates to make a career in general practice.

The decrease raises major doubts over whether Jeremy Hunt’s pledge to increase the number of GPs by 5,000 by 2020, first made in 2015, will be delivered. Labour accused the health secretary of “astonishing failure” on a key NHS target.

“It is clear from these figures that the NHS is falling some way short of its pledge to recruit 5,000 GPs by 2020, with in fact these numbers showing that the workforce has shrunk by more than 1,000 in England,” said Dr Krishna Kasaraneni, a family doctor and British Medical Association spokesman on GP issues.

GP practices often do not have the staff they need to treat the growing demand from patients for appointments caused by the growing and ageing population.

The chair of the Royal College of GPs, Prof Helen Stokes-Lampard, said: “GPs across the country will be gravely concerned about these figures. We understand that change takes time, but we desperately need more family doctors, and we need them sooner rather than later.”

It is 18 months since Hunt unveiled a package of measures to improve GP services and numbers should be going up by now, not falling, she added.

“The government promised to get more GPs into the NHS but in fact there are now 1,300 fewer compared to 2015,” said Jonathan Ashworth, the shadow health secretary. “This is an astonishing failure of a key part of Jeremy Hunt’s plan for the NHS.”

Growing numbers of GP surgeries are shutting their doors because the profession’s serious recruitment and retention problems mean they cannot find enough doctors to hire when one leaves. Some practices are also threatening to not accept new patients because they cannot cope with the ones they already have.

GPs say the relentless nature of their jobs is also fuelling a trend towards early retirement. GPs’ workloads have risen by 16% over the last seven years but the number of family doctors has not kept pace, Stokes-Lampard added.

This shortage means that, despite surgeries offering more appointments, patients are waiting longer to get one, she acknowledged. “There is a limit to what we can do when there simply aren’t enough of us to deliver the care our patients need and deserve.”

NHS England is spending £100m in what some GPs say is a desperate attempt to hire up to 3,000 family doctors from countries overseas, such as India. However, just 38 new doctors arrived from that route in the first six months of this year.

The official workforce figures from NHS Digital also show that the total number of GPs in work also fell over the last year from 41,865 to 41,324 – a drop of 541.

A report last month by the Health Foundation thinktank found that the average number of patients each full-time equivalent GP has on their books rose 3.2% from 2014 to 2015 to stand at 1,679.

GPs have been offered more flexible working arrangements in a bid to stop them from quitting, while newly-qualified doctors are being offered “golden hellos” of £20,000 to live in and train as GPs in the mainly poorer areas where there is a shortage of doctors.

NHS England said: “While GP trainee numbers are now at an all-time high, in the meantime there are real pressures from retirements, which can partly, but not completely, be helped by expanding international recruitment.”

The Department of Health refused to say if Hunt still expected the pledge of 5,000 more GPs to be honoured.

“We know there are challenges ahead and that change won’t happen overnight but we are committed to the plans we’ve put in place to recruit more GPs,”, a spokesman said.

“There are more than 3,000 GPs in training and 500 new medical school places will be available in 2018, with a further 1,000 in 2019.”

Mother killed herself after ‘serious failure’ by mental health unit

A mother who killed herself while suffering from postnatal depression died as a result of a “very serious failure” that allowed her to leave a mental health unit unchaperoned, a coroner has ruled.

Despite having made multiple attempts to kill herself, 32-year-old Polly Ross was allowed to leave the Westlands mental health unit in Hull at about 8.30am on 12 July 2015, telling nurses that she was going to buy cigarettes. She was hit by a train at 11.10am and died instantly.

Speaking at the end of a four-day hearing, coroner Prof Paul Marks said he could not rule that Humber NHS foundation trust had been guilty of clinical neglect, but said the decision to allow her to leave the unit “had a direct causal effect” on her death.

Her mother, Jo Hogg, who was previously employed by the trust as an occupational therapist, thanked the coroner for conducting a “frank and fearless examination” of the circumstances surrounding her daughter’s death.

She said the trust had failed her daughter when she had needed their help the most and that care for women with postnatal depression in the region was “appalling”. She said that mental health services were “not joined up in a way that pays close regard to the complex needs of patients”.

The court heard how Ross, who ran a translation business in Paris before moving back to east Yorkshire in August 2012, had suffered from the extreme form of morning sickness, hyperemesis gravidarum, during both her pregnancies in 2012 and 2014. The condition has received media attention after it was revealed that the Duchess of Cambridge suffered from it during her pregnancies.

The condition caused Ross – who was described as “staggeringly intelligent” – to be hospitalised and put on a drip, which was said to have compounded her mental health issues. The inquest was told that she developed “drug-induced psychosis” after taking cannabis to relieve her symptoms and that when she asked to be admitted to a specialist mother and baby unit in Leeds, she was turned down.

In February 2015, the linguist was sectioned after a breakdown and her children were taken from her care. Over the coming weeks and months she regularly expressed suicidal thoughts and attended A&E on multiple occasions having self harmed or taken an overdose.

In a statement read to the court, Ross’s aunt Emma May, who acted as her carer after she was first sectioned, said she was certain that the few times her niece had left her home since February “were times she attempted to take her own life”. She said: “I cannot understand how she was allowed to leave the unit to buy her own cigarettes the morning she died.”

Giving evidence to the inquest, Dr Robert Kehoe, a Bradford-based consultant psychiatrist, said that while the overall standard of Ross’s care had been good, there were two serious failures on the part of Humber NHS foundation trust.

“One: there was a failure to clarify and state a plan for what should occur in the situation of a patient requesting to leave the unit,” he said. “Two: the effective decision to end the period of 15-minute observations allowed her to leave the unit at around 8.40am that day.”

Ross’s observations had been increased from once an hour to once every 15 minutes on 10 July after a ligature was found in her room. She was not sectioned at the time of her death, but Kehoe said there was “no logic” in increasing her observations only to allow her to leave the unit unescorted.

In a statement, Humber NHS foundation trust said: “We would like to offer our sincerest condolences to Polly’s mother, aunt, other family members and friends for their tragic loss. The thoughts of everyone associated with the trust continue to be with them at this sad time.

“We would also like to offer an unreserved apology to Polly’s family and friends and acknowledge that there were omissions in her care prior to her death on 12 July 2015. The trust acknowledges Prof Marks’ conclusion regarding the circumstances surrounding Polly’s death and has fully implemented all of the recommended improvements highlighted by our investigations.

“The trust will continue to reflect and learn and seek to continually improve the services we provide to patients.”

In October 2015, Marks ruled that Humber NHS foundation trust was guilty of neglect in the case of Sally Mays, 22, who killed herself after being turned away for inpatient mental health care. The same year, a coroner in Bristol raised concerns about mental healthcare for new mothers after 30-year-old Charlotte Bevan jumped off a cliff clutching her baby girl following a “chain of failures” by medical staff.

In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

My ambulance crew is forced to put a plaster over society’s failure

However good the NHS is, it is not a lot of things; it isn’t social care, it isn’t a hotel and it most certainly isn’t a miracle worker. I work as an emergency care assistant on ambulances at the weekend. I can see the amazing things the health service does, but also why it sometimes appears to be falling apart at the seams. The NHS is stretched to breaking point every day. There are a lot of reasons for this and some of them are easy to see.

I’ve lost count of the number of times I have been called to patients who aren’t really patients at all. They are desperately in need of help, but not medical help. They need social care. Or social housing. They need their basic needs to be met, but not an ambulance crew. It’s just that there is no one else who they can call on a Sunday afternoon when, for example, they are at the end of their tether. When the loneliness hits hard, the prospect of not seeing a friendly face for another week is more than they can bear.

In the past this would have been dealt with by ringing another family member, or by a carer or a respite centre to give the family a break. These days, though, families are spread far apart and cuts to local authority budgets mean social care has been decimated. There is no one to call. There is no relief or respite in sight for a lot of these people and so, in desperation, they call an ambulance.

In turn, because the ambulance crew can see that the family cannot cope, that it’s just too much, we have no choice. We take them to hospital in the hope that given a few hours of space the family feels better, more able to continue in the thankless task of caring. We put a plaster over society’s failure.

And so there goes a hospital bed. A nurse, a doctor, all of whose time is taken up, instead of looking after the sick. There goes the protected NHS budget – the one that the government has pledged to increase. Only it’s not really an increase or protected at all, because now, instead of the money being spent on social care, and coming out of local authority budgets, it is coming out of the NHS one.

Then there are the lost souls. Those who drift, who sofa surf or sleep on park benches. Many of them mentally unwell but not acutely so. They don’t need a hospital, they just need somewhere warm and safe. It takes a cold-hearted person to leave someone on a park bench when you know they have nowhere else to go and it is -3C outside. Yet again we, the ambulance crew, paid for by the NHS, spend our time and your money phoning around charities, forgotten contacts in our patient’s phone, in the hope that we can find them a warm bed for the night. If not, due to cuts in social housing, there being no easy access hostels, we take them to the warm waiting room of the hospital. As we sit there sticking plasters on the plight of the homeless, another cardiac arrest call goes unanswered. Another person dies.

Other patients are just too old; their bodies far too weak. Sometimes it happens slowly, other times it is quick. I recently went to a patient who was in his 90s and barely lucid. His daughter insisted he had been fine until he got pneumonia and was taken into hospital for a month.

There was no point telling her that maybe it was just his time to go. That he had lived longer than most people, that the hospital she was blaming for the state of her father was probably to blame, only not in the way that she thought. Years ago, her dad wouldn’t have been taken to hospital to be treated for the pneumonia that nearly killed him. He would likely have just died at home. Instead we dragged him off to A&E for more interventions. When he isn’t restored back to full health, no doubt his daughter will claim that the hospital killed him. Blame, it would seem, is easier than the truth. Sometimes we just need to allow people to die and not play God and attempt miracles.

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Labour’s failure on the NHS is prolonging this health crisis | Polly Toynbee

Remember Mavis Skeet? In 2000 the 74-year-old led the news for weeks when her operation for cancer of the oesophagus was cancelled four times, until it became inoperable and she died. Liam Fox, then shadow health secretary, exclaimed: “This is not an isolated case. The NHS is not coping!”

When does a rumbling NHS crisis erupt into a volcanic political eruption? Labour’s miserable failure to “weaponise” the NHS into a winner in Copeland makes it worth looking back.

Mrs Skeet was the tipping point for Labour. The worst flu epidemic in a decade blew away Tony Blair’s pre-election “waiting lists cut” pledge. Instead Labour stuck to a draconian Tory budget, but this one case sent Blair into the TV studios promising to match average EU spending – and Labour did. The best NHS decade followed: 7% annual budget increases saw waiting times plummet, as heart and cancer results improved.

Margaret Thatcher’s eruption came in 1987 with the NHS squeezed dry. Babies died waiting for operations at the Birmingham Children’s Heart hospital. Through gritted teeth, the NHS “safe in our hands”, she bunged it £100m and punished it with the internal market.

In this latest seismological era, political vulcanologists can’t predict exactly when the top will blow. With its lowest ever funding rises, its hardest years are still to come, despite soaring numbers of the old, hospital admissions up by 31%, and 22% more A&E patients since 2010. Staff shortages follow cuts in nurse training and worsening GP and specialist recruitment. Even if extra is found for social care, the National Audit Office suggests it won’t stem the flow of patients into hospitals.

Are things bad enough yet? The British Medical Association reports that 15,000 hospital beds have been cut in the past six years. The Royal College of Surgeons protests at cancer operations being cancelled. Ambulances frequently stack up outside hospitals. Look at all that molten lava bubbling away.

Mavis Skeet’s death in 2000 became a tipping point for the NHS under Labour. Her operation for cancer of the oesophagus was cancelled four times.


Mavis Skeet’s death in 2000 became a tipping point for the NHS under Labour. Her operation for cancer of the oesophagus was cancelled four times. Photograph: PA

Ahead of next week’s budget, Theresa May pretends the NHS has an extra £10bn – at loggerheads with Simon Stevens, the head of NHS England, who publicly disputes it. What forces a U-turn? Before it was deaths, but already two patients have died on Worcester Royal hospital trolleys, one after a 35-hour wait. Coroners have protested to the health secretary, Jeremy Hunt, after two recent deaths due to lack of intensive care beds: the case of Teresa Dennett, who died from a stroke, and Mary Muldowney, who died after a brain haemorrhage.

The war zone of A&E has featured nightly on BBC news, with a graphic documentary series on the controlled mayhem in barely coping hospitals. When is enough enough? Not quite yet, it seems. The government has been lucky, with no flu epidemic in any recent winters or any Arctic freeze-over. With beds at full capacity, it would only take a mild outbreak to tip over the NHS.

The pressure-cooker is finance: monumental debts swell by millions a month as hospitals receive absurdly frantic threats if they don’t cut back. In December they were told to free beds by cancelling operations, causing longer waiting times and lost revenue from missed operations. Look at King’s College hospital, in south London: its chair, Bob Kerslake, calls official finances “kidology”. Ordered to make a surplus this year, King’s can’t avoid a £2m loss – yet the punishment is a cut in funds, sending its deficit to £30m, and an instruction to make a £26m surplus next year: this is mirage accounting, mirrored everywhere.

So far these debts are Hunt’s and chancellor Philip Hammond’s problem: what do patients care? But if the Treasury really means to recoup the money, plus the £22bn in savings it demands of the NHS by 2020, then Vesuvius will blow. Wards and units will close, staff will be laid off, the chaos will be unprecedented. It can’t happen.

When the government is forced, kicking and screaming, to pay up, who will it blame? It will call the NHS “unsustainable” and “a bottomless pit”. (Hammond already has.) Yet more “reforms” and re-disorganisations will be hurled at it: payment for services, top-up insurance and tax rebates for private payers will resurface. The government will ignore the UK’s fall in the EU spending scale since 2010, and is now sixth out of the G7 countries, with fewer beds, doctors and nurses per capita.

Who has the political heft and credibility to defend it? Fear of Labour’s NHS moral hegemony kept Thatcher, John Major and David Cameron in check. No longer. Labour thought the NHS was its big bazooka in Copeland, where a maternity unit is under threat. But the naked desperation of Labour’s “Babies will die!” leaflets shot the very last bolt in Jeremy Corbyn’s arsenal. Each time he raises the NHS at prime minister’s questions his feeble attempt at “weaponising” sounds pathetically opportunist: May bats him away with balderdash statistics he is too incompetent to refute.

This has never happened before: polls find May more trusted than Corbyn to run the NHS by 45% to 35%. Far worse, Labour’s failure to counter the right’s message has left more people blaming the NHS crisis on migrants and patients’ bad lifestyles than Tory underfunding or rising numbers of older people. As ever the Mail and the rest carry endless NHS tourism or obese wastrel stories – but Labour has always had to fight twice as hard to get a hearing for the facts on the NHS.

Whoever follows Corbyn will now find it ferociously hard to regain that lost NHS ground. By 1997, hammering away in opposition, Labour had made the threadbare NHS the top issue and owned it. Hard-won economic credibility earned it the trust to run the NHS better. Now Ben Page of Ipsos Mori finds the NHS the second issue after Brexit, but Labour doesn’t own it, or anything else: Corbyn falls behind on everything, with every demographic, so even Labour voters prefer May.

Because the NHS crisis has so far exploded in debt rather than closures, most people’s experience is not yet bad enough to reach tipping point. Page says satisfaction is down on 2010, but not rock bottom, with always a long lag in perception. A third would pay more tax for the NHS, but the rest want savings by denying obese people and migrants.

Austerity has entered the nation’s blood stream: Page finds most people still think it necessary – despite the reckless tax cuts ahead. Banging on about “austerity” without specifics gets Labour nowhere. May’s own polling and her Copeland result tell her this – but hubris is her greatest peril. There may be no opposition, but if she and her chancellor really try to squeeze the gargantuan debt out of the NHS, all hell will break loose anyway.

London ambulance staff log calls with pen and paper after IT failure

Staff at one of the country’s biggest ambulance services had to log emergency calls manually overnight because of technical issues in the control room, delaying response times.

It is understood London ambulance service’s computer system crashed, forcing staff to record details of calls by pen and paper for nearly five hours on one of the busiest nights of the year.

A spokeswoman said staff were trained to deal with such situations and were able to prioritise responses to those in greatest need.

The deputy director of operations Peter McKenna said: “Due to technical difficulties, our control room was logging emergency calls by pen and paper from 12.30am to 5.15am.

“Our control room staff are trained to operate in this way and continue to prioritise our response to patients with life-threatening conditions, using the same triage system as usual.

“We also have additional clinicians on duty to offer control room staff clinical advice if it is needed.”

Failure to meet cancer targets shows the NHS can no longer cope

Everywhere is struggling to cope. The increasing failure to hit the waiting time targets for cancer patients reflects systems that are struggling to meet workloads. Hospitals are struggling to get people’s tests done in time, to get their diagnosis for them as soon as possible and to be able to make plans for their treatment.

Three years ago, hospitals were managing to respond to the needs of people by generally meeting NHS waiting time targets for the growing number of those being referred with suspected cancer. The fact that we were hitting the targets didn’t mean that everything was perfect, but it did indicate that the way the system was organised meant that we were coping and working to meet demand. It doesn’t feel like we are coping any more.

Patients are waiting longer for scans, biopsies, pathology results and for treatment plans to be finalised. We are largely meeting the 14-day target and the target for 31 days from diagnosis to treatment. But we are largely failing to meet the 62-day target. That’s the time between someone being referred by their GP and them having their first definitive treatment. Delays are occurring mainly between a suspected cancer patient seeing a specialist and having a definite plan for their treatment drawn up. Myself and colleagues come across this all the time; people who have waited two, three or four weeks for a CT scan or biopsy.

That matters for individual patients because they have a prolonged period of uncertainty. Do I have cancer or do I not? And if I do have cancer, will it be curable? If it was a private hospital or one of the great hospitals in the US or Europe the consultant could expect to have the answers from the tests within a week. But here it can be as long as a month.

There will be some people who get worse while they are waiting for tests to take place or for the results to come back. Their cancers will grow. In a small proportion of them their cancer may spread. If you look after people with cancer it’s a desperate situation to be asking them to wait for their tests and to be planning to see them after a month because they won’t have their results until then, and we know that’s going to be a month of terrible worry for them.

This failure to meet targets, to keep up with the growing demand for cancer care, was a foreseeable problem – and it’s getting worse. Previously we planned for what we knew was going to be the growing number of people needing tests and treatment. Now we need a lot more radiologists and endoscopists, for example, to keep up with what we know is going to be the even greater numbers of people needing cancer care in the years to come. But now it’s not just the tens of thousands of people who have not been treated within 62 days over the last two and a half years since the NHS nationally began missing that target. It’s the fact that we now have a system that’s failing, and that can’t be acceptable.

Peter Johnson is professor of medical oncology at Southampton University and Cancer Research UK’s chief clinician

Teenage girls talk about anxiety: ‘It’s always linked to failure’ – video

One in three teenage girls in England and Wales suffers from anxiety, according to a survey of 14-year-olds for the Department for Education. Orli, a 17-year-old girl from north London, talks to her friends about her anxiety, how she plans to beat it and stop the stigma surrounding it

Secret Teaching: I love teaching, but I’m tired of feeling like a failure

When I began teaching 18 years ago, I poured everything I had into it. I started at a tough inner-city Manchester school. I ran after-school football and film clubs, and produced Shakespeare plays with 8- to 11-year-olds. I was glad to be observed 10 times in a gruelling five-day Ofsted visit (it was 1998). I put so much in and got so much out – I was young, single and I didn’t care about late nights and early mornings.

A few years later I moved to another challenging school down the road, as deputy headteacher. The budget was incredibly tight which meant I had zero management time and taught all week; this was before the luxury of PPA (the time that’s set aside for teachers to do planning, preparation and assessment work). I always had a foot out of the door and an ear cocked for trouble in the corridor – even more so when I spent a term as acting headteacher when the excellent head was in hospital.

I think that’s when my downward spiral started. I’d taken on a class where I had to field chairs being thrown at me, coerce one pupil from the roof and fend off physically abusive parents. I would become frustrated and angry when things went badly (being punched by a parent, the local authority demanding that results improve) and completely elated when things went well (transforming 30% of pupils achieving level 4 into 70%, seeing special educational needs and disaffected year 6 students performing Richard III).

Within three years, I hit a wall. I went back to my hometown, to teach in a successful primary in a leafy, middle-class area. I thought it would give me a chance to work in a less stressful environment. I was wrong. The pressure – in school, from the government and families – was different, but equally debilitating.

It was an outstanding school and the local education authority (LEA) had expectations. “Yours is one of the better schools,” we were told. “For us to reach our target, we need you to up your Sats results, because the other schools in the area are rubbish.” I’m paraphrasing, but the message was clear. I made an initial impact and was expected to carry the year 6 can. It wasn’t the school or the staff’s fault, it’s just the way things were and still are.

Each morning I would wake up feeling sick to my stomach. I spent my lunchtimes alone, sitting outside in the street, struggling to eat the lunch I’d prepared. There was just so much to do.

After a spell in hospital, I was diagnosed with severe depression. School wasn’t the only factor, but it tipped the balance. I was given months off work, saw psychiatrists and other mental-health professionals and had to fight to get back into the classroom nine months later. I managed it (in large part thanks to my now-wife, who I met through this illness) but it was a pyrrhic victory.

The next eight years had some highs – days when I really thought I was “winning” and that I’d taught well – but there were also more lows. There were times when I felt I was sinking; my to-do list was never-ending and parents irrationally expected their children to be level-pegging with their peers without understanding that people children learn at different rates.

When my son was born two years ago, I realised that family is more important to me than the increasingly demanding job that teaching has become. It’s more important than juggling targets and trying to keep up with the latest short-sighted initiative from Whitehall.

Now I’m a supply teacher, and am lucky that I can survive on the money. Half the wages, 10 times the happiness. I don’t plan, I’m home by 4pm and the job just pays the bills. And my mental state is so, so much improved.

I loved teaching and I miss it profoundly. But my mental health means I just cannot juggle all the balls necessary to be good at it. I demand a lot of myself as a teacher and the demands placed on the teaching profession – by local authorities, Whitehall, governing bodies, heads, parents – mean that I feel a failure far more often than I feel that I am of worth.