Chemotherapy sessions for patients at Northern Ireland’s main cancer centre are being cancelled because it does not operate on bank holidays.
Approximately 780 patients at the Belfast Cancer Centre had treatments in April and May cancelled.
Some patients had their treatment rescheduled, but others did not.
The Belfast Health and Social Care Trust said it tried to rearrange appointments for some patients but it was not always possible.
The trust, which runs the centre at Belfast City Hospital, prioritises rescheduling patients who have cancer which has not spread (primary cancer).
This means some patients with cancer which has spread (secondary cancer) do not have their cancelled appointments rescheduled and miss them altogether.
The trust said it was aware of the “anxiety and inequity” felt by patients affected by bank holiday closures.
Chemotherapy for 304 patients will be interrupted in July and August.
This is an issue that affects all chemotherapy patients across Northern Ireland. For a system to be operating at full capacity, it also requires staff working in laboratories and pharmacies.
All these members of staff are contractually given leave on bank holidays.
Sinead Joyce, 48, who has terminal cancer, fears she was not given a fair chance as a “patient hit with bank holidays”.
The mother of two, from Belfast, was diagnosed with breast cancer in 2009.
She had several cycles of chemotherapy at the centre, which is attended by approximately 400 chemotherapy patients from across Northern Ireland every week.
‘Pleaded with staff’
Patients offered chemotherapy are given a set day they will receive it.
Ms Joyce was allocated Mondays on a weekly basis, but this meant her sessions on bank holiday Mondays were cancelled.
She said she pleaded with staff to reschedule the cancelled sessions.
“I didn’t want to miss out,” she said.
“I was worried and imagining that the cells were growing and spreading and I was not getting my medicine into me.
“I don’t know if it made a difference, but I do wonder.”
Ms Joyce said she became particularly anxious about missing sessions during a chemotherapy trial starting in March, which offered her a final chance to extend her life.
The trial was for an initial 12-week period with the potential for it to be extended if it had a positive effect.
She was distraught when she realised she would miss three of the 12 treatments due to St Patrick’s Day, Easter Monday and May Day.
Ms Joyce said the chemotherapy trial was eventually stopped when scans showed her tumours had grown.
“Every bank holiday I asked to be rescheduled, but was told no. Physically, they said there was nowhere they could put me.
“There was no pharmacy and there were no nurses – it was not possible.
“They said there was nothing to suggest that missing a treatment makes a difference.”
Ms Joyce said she was shocked to realise patients whose cancer had spread, like her, were not given the same opportunity to reschedule treatment as people whose cancer was confined to where it first developed.
Her story was one of several brought to BBC News NI by patients distressed about disruption to their chemotherapy regime.
‘Anxiety and inequity’
The Belfast Trust said it tried to reschedule appointments for some patients, but that this was not always possible due to what it described as “capacity”.
It said it received four formal complaints about the issue in the past year, although it is understood more patients have complained informally.
A spokesperson said the trust tried to reschedule chemotherapy sessions for patients with cancer which had not spread (primary cancer) – where a cure was “potentially achievable” – in the same week as their missed session, or the following week.
It said this was because of “some clinical evidence” that supported delivering “the planned dose of chemotherapy on schedule”.
It said rescheduling was based on capacity and therefore delays happened “across the spectrum of diseases and treatment intentions”.
But the spokesperson added that patients whose cancer had spread (secondary cancer patients) were not rescheduled to receive their treatment in the same week because of “less evidence”.
BBC News NI has spoken to a number of patients who did not have their treatment rescheduled at all.
The picture elsewhere in the UK
Christmas Day and New Year’s Day are the only days treated as bank holidays for chemotherapy services in Scotland.
In Wales, two of the three regional cancer service providers open on all bank holidays except Christmas Day.
The third – Betsi Cadwaladr University Health Board – does not provide chemotherapy services on bank holidays, but said all patients were accommodated in the days leading up to, or immediately following, a bank holiday to minimise the impact on treatment.
A spokesperson said the health board was exploring ways of providing chemotherapy services on Easter and May bank holidays in 2020.
NHS England was unable to respond to the query although it is understood services vary across trust areas.
The Belfast Trust said it “recognised that patients would prefer to receive planned chemotherapy” on bank holidays but that this would require “substantive service investment”.
The spokesperson added: “There are significant capacity challenges which the Northern Ireland Cancer Centre faces in treating all our patients in a timely manner and we very much regret that some patients experience deferred treatment which is not what we would wish to happen.
“We continue to do everything we can to minimise waiting times for patients and to explore how we can improve the situation for patients whose treatment falls on a public holiday.”
The Western Health and Social Care Trust also offers chemotherapy treatment to about 400 patients each month at the North West Cancer Centre in Londonderry.
A spokesperson for the Western Trust said: “Chemotherapy is currently not delivered on bank holidays, however, patients are prioritised (as clinically appropriate) to receive their treatment earlier if required.”