Hospitals have been forced to cancel and delay large numbers of endoscopies during the coronavirus surge and new rules on protecting staff and patients from infection mean the process takes longer with fewer people able to be seen in the same time.
Tiny cameras that can be swallowed and take images of inside the body to check for cancer are being sent to 11,000 NHS patients across England.
The cameras are no bigger than a pill and record two images every second, sending the data to a partner device worn around the waist.
They are a simpler alternative to traditional endoscopy where a patient has a tube put into their body with a camera to look for cancer of the colon.
NHS England said the pill cameras, known as colon capsule endoscopy, take between five and eight hours to deliver images of the bowel as patients go about their normal day.
The technology has been used for years in America and in some NHS trusts after being licensed in the US since 2001. Scottish hospitals launched a similar scheme in November.
The NHS hopes it will help catch bowel cancer earlier, making the disease easier to treat.
An initial group of 11,000 NHS patients will receive the capsule cameras in more than 40 parts of the country.
The NHS is facing a huge backlog for diagnostic testing and referrals from GPs, sparking concerns there could be significant numbers of undiagnosed cancers. The latest data for December 2020 showed 350,000 patients in England were waiting more than six weeks for a key diagnostic test such as an endoscopy. In December 2019 there were just 41,906 patients waiting longer than six weeks.
More than 200,000 patients with suspected cancer were referred by GPs in December, up 13,000 on December 2019, but by January hospitals across the country had cancelled all but life-threatening surgery, including some cancers, as numbers of Covid patients hit almost 40,000.
The pill camera technology has been used at University College London Hospital since last year.
Clinical lead Ed Seward said: “Not only does colon capsule increase our diagnostic capacity, because it doesn’t require the resources of a dedicated hospital space to do the examination, it also allows us to do the examination in the patient’s home, so patients who may be shielding or cautious about going to a hospital, can perform the procedure in the comfort of their own homes.”
NHS chief executive Sir Simon Stevens said: “As we come out of ‘peak Covid’ and the disruption of the pandemic, the NHS is now pushing ahead with genuine innovation to expand services for many other conditions. That’s why we’re now trialling these ingenious capsule cameras to allow more people to undergo cancer investigations quickly and safely.”
The NHS long-term plan committed the health service to increasing the number of tumours caught at an early stage from half to three out of four.
In total £150m has been invested in diagnostic equipment such as endoscopy kit and new MRI and CT scanners. Hospitals are also restructuring buildings to keep patients socially distanced and allow cancer care to go ahead.
Another £160m has been invested in delivering chemotherapy in patients’ homes and providing cancer care in Covid-free cancer hubs across England.
Professor Peter Johnson, NHS England’s clinical director for cancer, said: “From the cutting-edge technology of these colon capsules to Covid protected hubs and chemo home deliveries, the NHS has fast tracked new ways of treating and diagnosing cancer – all while responding to the coronavirus pandemic.
“Endoscopy services continue and thanks to the hard work of NHS staff, cancer treatment and referrals have come back to usual levels, with more than 25,000 people treated for cancer in December.”
He urged patients who may be experiencing worrying symptoms that the NHS was open and able to help and they should not delay seeking treatment.
Genevieve Edwards, chief executive of Bowel Cancer UK, said of the rollout: “This has the potential to make a huge difference for people with bowel cancer symptoms and could help the NHS to prioritise those who urgently need further tests.”
Dr Alastair McKinlay, president of The British Society of Gastroenterology, said colorectal cancer was still responsible for many avoidable deaths and the project could offer a real advantage for patients.
He added: “We welcome the opportunity for a proper service evaluation so that both the limitations and advantages of this technique can be properly assessed. We welcome NHS England’s decision to work with some of the UK’s top experts in this field to make sure that the technology has a proper evaluation.”
