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Breast cancer screening fiasco set to put even more strain on understaffed units

Include workforce issues in review, Royal College of Radiologists urges government

Caroline White

Friday, 04 May 2018

The computer failure that has resulted in hundreds of thousands of women not being called for breast screening over the past decade in England is going to put even more strain on understaffed screening units, the Royal College of Radiologists (RCR) has warned.

The government has commissioned an independent review to avoid any further serious glitches in the delivery of the screening programme, and this should include workforce issues, the College insists.

Since 2009, approximately 450,000 women around the age of 70 didn’t receive final breast screening invites, and it is estimated that up to 300 women may have had their lives shortened as a result.

Dr Caroline Rubin, RCR vice-president for Clinical Radiology and a practising breast radiologist, said that the College had been reassured that Public Health England was doing everything it could to help trusts arrange catch up appointments for women who have been missed, as well as setting up support for affected patients.

From now on until the end of May, the NHS will send letters to all those women who are affected and are registered with a GP. In those letters, women aged under 72 will be invited to a catch-up screening appointment within the next six months.

Those aged 72 and over will be given access to a helpline where they will be advised as to whether a screening appointment is necessary.

But she pointed out: “However, this does mean breast screening units across the country may have to arrange additional appointments for thousands of missed patients, which will undoubtedly put even more strain on units that are already stretched to the limit due to staff shortages."

A 2016 survey* carried out by the RCR revealed that one in four breast screening units were operating with two or fewer radiologists, with no extra cover.

She said that health and social care secretary, Jeremy Hunt’s announcement of an independent review into the incident and IT aspects of the screening programme was very welcome.

“However, the RCR would strongly advise that the investigation’s remit be broadened to analyse urgent workforce pressures within the programme,” she said, adding that the College would be keen to offer advice and assistance to the review team.

“The RCR is working hard to support our breast radiologist members and the units they work in, including exploring options for training more breast radiologists and breast clinicians,” she continued.

But she said: “Ultimately, we need funding for more training posts for radiologists to ensure the screening programme – and the NHS as a whole – has the vital imaging doctors it needs to keep up with the ever-increasing imaging demand.”

Baroness Delyth Morgan, chief executive at Breast Cancer Now, echoed her sentiments, describing the thousands of missed appointments as a “colossal systemic failure.”

She added: “It is right that Public Health England are offering the option of catch-up screening for those affected, and hope that women will choose to take this up. With the diagnostic workforce already at crisis capacity, significant investment – including the recruitment of over 200 mammographers and at least 50 radiologists – is now needed to ensure the Screening Programme can continue to run effectively.”

The review, which will be chaired by Lynda Thomas, chief executive of Macmillan Cancer Support and Professor Martin Gore, consultant medical oncologist and Professor of cancer medicine at The Royal Marsden, is expected to report in six months.

*The breast imaging and diagnostic workforce in the United Kingdom, RCR, April 2016.

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