This site is intended for health professionals only

At the heart of general practice since 1960

pulse june2020 80x101px
Read the latest issue online

The waiting game

NHS England launches 'major overhaul' of national cancer screening programmes

GP experts have called on NHS England to target cancer screening so that the most appropriate patients benefit, as it embarks on a 'major overhaul' of national programmes.

NHS England said it will report next summer how it will improve the national screening programmes for cervical, breast and bowel cancer.

The programmes have suffered two scandals this year, including this week's revelation that primary care support provider Capita failed to pass on nearly 48,000 letters regarding cervical cancer screening to patients.

Earlier this year, the Government admitted that due to an IT error dating back to 2009, 450,000 women missed their cancer screenings.

NHS England said the review will make recommendations on a number of issues, including new technology, how programmes should be delivered and potential changes to outsourced services.

It said the review, which will be led by former CQC chief inspector of hospitals Professor Sir Mike Richards, also forms part of the Government's ambition to increase early detection of cancer.

NHS England said Sir Mike would 'lead a major overhaul of national cancer screening programmes as part of a renewed drive to improve care and save lives'.

‘Increasing early detection of cancers when they are easier to treat is at the heart of the NHS’s long-term plan to upgrade services and make sure patients benefit from new technologies and treatments,’ the statement added.

NHS England’s national medical director Steve Powis said: ‘Screening is a vital and effective tool in our fight against cancer. However, recent issues with breast and cervical cancer screening have shown that we need to look closely at these existing programmes.’

Sir Mike, a consultant oncologist, said: ‘This review provides the opportunity to look at recent advances in technology and innovative approaches to selecting people for screening, ensuring the NHS screening programme can go from strength to strength and save more lives.’

GP experts welcomed the review, especially in light of recent failures.

Imperial College London head of primary care Professor Azeem Majeed, a GP in south London, said: ‘We have seen a number of errors with screening programmes; e.g. people not being invited or not getting the results of their tests because of inadequate administrative systems.

‘A review is therefore timely and can look to examine all screening programmes rather than just looking at each programme by itself.’

BMA GP Committee clinical and prescribing lead Dr Andrew Green said he hopes the review will focus on balancing benefits and potential harms to patients.

He said: ‘A thorough review of cancer screening programmes is to be welcomed, so that we understand better what interventions make a difference, and what the costs are of any benefits, both in financial terms and through unintended harms.

‘Should screening activities be found to fall short of the recognised standards NHS England must have the courage to say these are not available on the NHS, and not dodge the issue as they have done with PSA testing.’

Non-GP experts also told Pulse they hope the review will focus on improving patient targeting.

Cancer Research UK director of early diagnosis Sara Hiom said it should ‘consider the emerging technologies available to look beyond just age, to consider lifestyle, genetics and other factors to pinpoint people who would benefit from screening and those who could avoid it’.

Dr Emma Crosbie, senior lecturer at the University of Manchester and honorary consultant gynaecological oncologist, said it was important that the programmes ‘select the right patients for cancer screening and adopt new evidence-based screening tools as they become available’.

And Professor Stephen Duffy, an expert in cancer awareness, screening and early diagnosis, said he expects the review to look at ‘the IT systems for calling people to screening, participation rates by demographic and geographic groups [and] capacity issues in the programmes’.

Scope of NHS England's review

NHS England's cancer screening programme review will look at how:

  • screening policy should be modified in the future;
  • best to integrate screening programmes with other initiatives;
  • screening programmes should be commissioned, delivered and quality assured in the future - including possible changes to currently outsourced provision;
  • to ensure that the necessary workforce is trained to deliver the programmes;
  • to introduce new screening technologies and update IT.

Source: NHS England


Readers' comments (2)

  • Vinci Ho

    Nobody has any doubt about the principle of early detection and treatment of cancers . That has to move on with innovations and new technologies.
    Problem is still on implementation .
    As I always say , incompetence is worse than malevolence. After all these ‘incidents’ , you wonder if NHS England is humbled enough to learn any lesson ?
    Is it fit for purpose?

    Unsuitable or offensive? Report this comment

  • NHS England,not patients not patients associations,not their representatives,a medical trade body.

    The first question,ideally to the public is do you want this,bearing in mind you get nothing for free,the money has to come from somewhere,you will wait longer to see a doctor when you are ill.One of the tragedies of the NHS is that the public are not required to consider this.

    Screening is not medicine,it is plucking ordinary people off the street,going about their normal business and doing something for them,on the understanding they may benefit.It is not shared decision making,patient centred or individually tailored,it is the opposite of normal practice.

    The patient information leaflets need to be explicit as to how often the test does what it says on the tin.They need to avoid medical jargon and talk about how often the test is wrong,forget sensitivity and specificity etc.

    We are trying to stop people who are going to die of bowel cancer dying of bowel cancer

    If you have the test and you were going to die of bowel cancer there is an 84% chance you will still die of bowel cancer.

    How much frontline everyday clinical care are you prepared to give up for that ?

    Unsuitable or offensive? Report this comment

Have your say