The Health Board has worked well to manage increasing service demand without a corresponding significant worsening of waiting times performance. However, actions to improve cancer services have not yet led to lasting improvement. Performance is still well below the 75% target. In 2025–26, only 61% of patients started treatment within 62 days. The overall average performance also hides wide differences between services. In particular, urology and gastrointestinal pathways are underperforming. 

The Health Board has taken steps to manage immediate pressures. These include running extra clinics, filling staff vacancies, and changing care pathways. These actions have helped to steady demand in the short term. Whilst they have improved capacity for treating breast and skin cancer, they have not dealt with deeper capacity problems. As a result, overall performance has not improved. The Health Board expects to meet national targets by late 2026–27, but current progress suggests it is not on track.

The Health Board has strengthened its cancer service leadership and operational oversight. This has helped to increase focus on cancer care. However, gaps in reporting, limited use of intelligence, and weak Board and committee scrutiny mean that progress is slow. The Health Board is proactively taking steps to improve cancer prevention and screening, but we are concerned that the scale of these initiatives might not be sufficient to have the required impact.

The Health Board understands the challenges it faces. However, its approach is mainly reactive rather than planned ahead. Whilst its working on updating its cancer strategy, it does not have a clear, detailed improvement plan. This makes it harder to respond to rising demand and to meet treatment targets. This is a growing concern, as cancer service costs are rising faster than inflation and there is no clear long-term financial plan.