Lung cancer is the most common condition

Researchers investigating bowel cancer treatment in 34 hospitals in the 17 NHS Scotland regions, found that just two hospitals achieved the standard of starting chemotherapy treatment within eight weeks of surgery.

The review teams for lung cancer found that of the 31 hospitals they visited, only three met the target of making a decision about initial treatment within four weeks of diagnosis.

They also discovered that only two hospitals in the country gave CT scans to patients being considered for curative treatment within the recommended time of two weeks.

The two separate reports from both teams pointed out that many hospitals had also failed to collect "adequate information" allowing their performance to be measured against the national standards.

NHS staff were praised in the reports, which concluded that they were struggling to meet demand because of shortages of equipment and specialists.

Only 6% of lung cancer patients and 45% of those with bowel cancer survive more than five years beyond diagnosis in Scotland.

Referral system

More than 4,500 new cases of lung cancer are diagnosed in Scotland every year along with 3,500 cases of bowel cancer.

The standards against which the board was measuring performance were published in January 2001 following consultation with health professionals and the public.

The two CSBS reports, entitled Colorectal Cancer Services and Lung Cancer Services, were based on visits made to hospitals by the review teams to assess performance against the standards.

Professor Bob Steel, chairman of the colorectal cancer project group at CSBS, said a more formal referral system should be established between primary and secondary care and different hospital specialists.

A shortage of specialists was a concern

He also said most trusts lacked "robust data" for measuring performance.

However, the major issue was cutting waiting times.

Dr Anna Gregor, chairwoman of the lung cancer project group, said lung cancer was the most common form of cancer and the only one whose survival rate had not improved over the last two decades.

She said her teams discovered the same problems with the informal referral process and noted particular difficulty in receiving CT scans quickly enough.

She added: "We have to reduce waiting times and improve access to some critical investigations in particular CT scanning.

"Multi-disciplinary working has to be recognised as a key standard in quality care and this needs to be formalised and networks need to be developed."

Dr Gregor also warned that the NHS had developed "critical shortages" of doctors and nurses and specialists in key areas like radiotherapy.