You know who’s in charge of Clinical Excellence, don’t you? Of course you do. It’s everywhere, isn’t it, NICE – like an omnipresent manic street preacher evangelically doling out guidance, press releases and bulletins to an increasingly bewildered and bored audience.
Who’s in charge of screening, though? Aha! Did you even know there’s a National Screening Committee? Well, there is. It comprises some Great and Good, as you expect, and they do stuff on screening, also as you’d expect.
But they fly very much under the radar, don’t they? Maybe that’s because they have fewer things to pontificate on than NICE, and work in less controversial territory. Or maybe they’re just shy.
Whatever. I find the low profile disappointing. I have a bit of a thing about screening, adhering very firmly to the wise and often quoted view that, ‘The only certainty about screening is its potential to cause harm’*. So my issue with the NSC is that it’s too quiet. I want its informed and evidence-based view on various ‘initiatives’ that sound to me like screening-through-the-back-door.
The only certainty about our National Screening Committee is that it remains hidden and undetected
It’s not for lack of opportunity. We’ve just had the story about a charity-based young persons’ cardiac risk screening programme, my local CCG is considering an atrial fibrillation screening initiative and the new NICE guidance recommending spirometry for incidental findings on X rays or scans sounds like reverse-engineered screening, too.
Where is the voice of reason saying, ‘We do have a National Screening Committee, you know,’ or, better, ‘Hang on, let’s evaluate this?’ or, even better still, ‘No you fools, stop now!’
Do you hear me, NSC? Speak up, please. Because, currently, the only certainty about our National Screening Committee is that it remains hidden and undetected, as if in some sort of pre-clinical state. In which case maybe we need to screen for irony.
* I have tried to trace this comment to its source and have drawn a blank, which raises the possibility that I made it up. I do often quote it, though.
Dr Tony Copperfield is a GP in Essex