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NHS must improve access to screening to save lives

Offer more locations and evening and weekend appointments for breast, cervical and other cancer checks

Louise Prime

Wednesday, 16 October 2019

Screening services should offer evening and weekend appointments for breast, cervical and other cancer checks and offer people the option of being screened near their work or other convenient location rather than insisting they attend their own general practice, an independent new report has recommended. The Royal College of GPs (RCPG) said it welcomes the expansion of evidence-based screening programmes, but pointed out that GPs would need additional resources before they could create more flexibility.

NHS chief executive Simon Stevens and health and social care secretary Matt Hancock last November commissioned Professor Sir Mike Richards to look at overhauling national screening programmes as part of the NHS’s ambition to diagnose cancers earlier and improve survival – and today NHS England published his Report of the independent review of adult screening programmes*, in which he called for a major overhaul to the design of screening programmes. NHS England said upgrading cancer screening could save thousands more lives. Sir Mike’s 22 recommendations include:

  • Women should be able to choose appointments at doctors’ surgeries, health centres or locations close to their work during lunchtime or other breaks rather than having to attend their own GP practice.
  • Local NHS areas should look at ways that they can provide appointments at locations that are easier to access, as people lead increasingly busy lives.
  • Local screening services should put on extra evening and weekend appointments for breast, cervical and other cancer checks.
  • More action to drive uptake through social media campaigns and text reminders – and for nationwide rollout of local initiatives that have successfully boosted uptake. Examples include a scheme in south-west London in which phone/letter follow-up of people who did not attend bowel cancer screening led to a 12% increase in attendance, and another in Stoke-on-Trent that posted in Facebook community groups to achieve a 13% increase in first-time attendances for breast screening.
  • A major overhaul to the design of screening programmes.
  • Across all screening programmes, patients should receive results within a standard timetable.
  • Establishing a single advisory body, bringing together the current functions of the UK National Screening Committee on population screening and the National Institute for Health and Care Excellence (NICE) on screening for people at elevated risk of serious conditions.
  • NHS England to become the single body responsible for commissioning and delivery of screening services, ending any existing confusion on who does what.
  • Breast screening providers should aim to invite people at 34-month intervals after their previous appointment so that all participants can be screened within 36 months.

Sir Mike said: “Screening programmes are a vital way for the NHS to save more lives through prevention and earlier diagnosis and currently they save around 10,000 lives every year – that is something to be immensely proud of. Yet we know that they are far from realising their full potential – people live increasingly busy lives and we need to make it as easy and convenient as possible for people to attend these important appointments.

“The recommendations in this report are intended to help deliver the commitments set out in the NHS Long Term Plan and will hopefully save even more lives.”

The RCGP welcomed Sir Mike’s finding that pioneering general practice schemes have increased uptake and agreed they should be more widely adopted, but warned that GPs don’t currently have the resources to do so. College chair Professor Helen Stokes-Lampard said: “Evidence-based screening can be a vital tool in spotting early signs of certain cancers and in some cases, can have a very positive impact on survival rates.

“Offering women more flexibility over access to cervical screening could potentially break down barriers for some people.

“It’s good to see innovative schemes in general practice that have helped increase uptake of some evidence-based screening programmes being highlighted in this report – and we would welcome their further adoption and wider roll-out across the country where possible.

“Sir Mike’s report is timely and certainly a step in the right direction but general practice is already stretched to its limits so we would need additional resources before we could create more flexibility in the services we currently offer, and ensure GPs and our teams can also continue to offer high-levels of all other forms of care.”

*Richards M. Report of the independent review of adult screening programme in England. NHS England 2019. Publication reference 01089. Published online 16 October 2019.

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