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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