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 10 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 £20 million 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 £460 million after 10 years.

Jackie Baillie, Scottish Labour’s health spokeswoman, described the reports as “shocking” and said the findings showed “just how deeply the SNP’s failure to workforce-plan is harming patients”.

She added: “Anyone with a cancer diagnosis hopes for the swiftest possible treatment, but instead radiologists are burning out and those left behind struggling to cope.

“Meanwhile, the SNP is wasting millions on agency staff that instead could be invested in training up new permanent staff.”

Scotland’s Health Secretary Neil Gray said that tackling waiting times is a “top priority” for the Scottish Government.

He told BBC Radio Scotland’s Good Morning Scotland programme: “We are investing heavily in ensuring that we have the number of oncologists and radiologists that we need.

“We’ve got a 40% increase in the number of radiologists from 10 years ago, and a 27% increase in the number of oncologists compared to 10 years ago, and we’re supporting the training of more so that we can help to address the demand that there is in the system.

“We know that there is a significantly increased demand upon cancer services.

“We are treating more people now within the cancer timelines than we were 10 years ago.

“So we need to both address the demand upon services, which is what we are seeking to do by reducing waiting times, but also seek to reduce the potential for people to have to seek cancer services by addressing the population health reasons as to why there is an increased level of cancer in society and I’ll be setting out plans for that through the population health framework that we’ll be publishing in the coming weeks.”

A Scottish Government spokesperson said: “We recognise the pressures facing oncology services as we treat more patients with cancer on time, within both standards, compared to five years ago. We are working across NHS Scotland to address staffing as a matter of urgency.

“There has been a 40% increase in consultant oncologists, from 100 whole time equivalent (WTE) 10 years ago to 140 WTE in March 2025.

“We’ve also increased consultant radiologists by 27.7% in the last 10 years.

“We are investing up to £10 million per year by 2027 in chemotherapy and oncology services – to ensure we build a sustainable workforce, with £4.6 million released in 2024/25 and £6.6 million in 2025/26.”