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Vascular screening muddle is going to envelop all practices

The national programme of vascular checks is finally going to get the 'national bit'

By Richard Hoey

The national programme of vascular checks is finally going to get the 'national bit'



Vascular screening (or checks, or risk assessment, or whatever you fancy calling it) is one of those classic Gordon Brown muddles, and I'm not just talking about the name.

It was the brainchild of Sir Muir Gray, ex-director of the National Screening Committee, but by the time the Prime Minister announced out of the blue that screening would go ahead for everyone aged 40 to 74, the NSC had rather gone off the idea.

Ever since then, it's been a scheme driven far more by political expediency than by clinical evidence.

And with local autonomy all the rage these days, vascular checks duly became the first national screening programme to be almost entirely lacking the ‘national' bit.

PCTs were pretty much allowed to get on with it as they saw fit, and we ended up with a potpourri of different schemes, some involving pharmacists, others private firms, some systematic and others opportunistic, some based at practices and others sited at an assorted mix of workplaces, shopping centres and leisure centres.

Except it now seems the Department of Health has woken up to the fairly obvious truth - that this is a nonsensical way to run a screening programme, and that opportunistic screening that selectively attracts the worried well is entirely at odds with a programme that's supposed to narrow health inequalities.

Pulse reveals this week that the DH is now working on a ‘minimum dataset' that all PCTs will need to put together, and which will mean practices end up involved - directly or indirectly - with screening, whether they like it or not.

With the minimum dataset has come a requirement for practices and PCTs to start sharing vast amounts of cardiovascular clinical information, and hence the involvement of Connecting for Health.

That of course can only mean one thing, or rather three things – stratospherically ballooning costs, constant rows over confidentiality and an admirably flexible approach to deadlines.

Don't expect a fully fledged vascular screening programme any time very soon.

Do expect plenty more muddle - and controversy - to come.

By Richard Hoey, Pulse editor

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