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PCTs to scale back vascular screening plans



By Lilian Anekwe

Exclusive: More than half of PCTs in England are considering scaling back their vascular screening programmes by switching from population-wide screening to schemes targeting at-risk groups, a Pulse investigation reveals.

Responses obtained under the Freedom of Information Act show half of trusts in England are currently screening the entire local population aged between 40 and 74, as originally set out in Department of Health directions, while just over a third are employing targeted schemes in at-risk groups.

But many PCTs are turning their backs on universal screening. Responses from 135 trusts show 55% said they were considering switching strategies and 16% had already switched from universal to targeted screening.

In April, two analyses published in The Lancet and the BMJ questioned the value of universal screening for cardiovascular disease in primary care, warning that the strategy did not target the right people and might be a waste of NHS resources.

Those findings, plus the worsening financial climate, appear to have prompted a widespread rethink among PCTs.

NHS Norfolk said: ‘Last year we targeted those on GP registers who were known to have a likely risk, but this year we are using market stratification to identify those likely to be at risk by postcode area and then contact [them] through [their] GP.’

NHS Derbyshire County said financial cuts could prompt a future switch in strategy when the trust came to review it ‘in light of the wider financial climate’.

Dr Tom Marshall, senior lecturer in public health and epidemiology, said targeted screening was ‘common sense’.

‘The current system does not give any priority to one group over another. It’s just common sense to prioritise at risk people for assessment first. When the task is as large as this one it makes sense to target efforts. If you target the right people and offer them treatment screening it is not just cost effective, it’s cost saving.’

Vascular screening is a flagship DH policy