Government losing grip on health screening, MPs warn

10 May 2019 Seamus Ward

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In a report on screening in England, the committee added that the Department of Health and Social Care, NHS England and Public Health England did not know if all eligible people had been invited to participate in national screening programmes. It focused on four of the 11 national programmes – bowel, breast and cervical cancers and abdominal aortic aneurism.Meg Hillier

None of the four programmes met their targets for ensuring the eligible population was screened in 2017/18 and the committee said the national bodies were unaware of the barriers preventing attendance. Performance varied and the Department accepted the IT system that supports the screening programmes was unfit for purpose.

It was particularly concerned that thousands of women had not been invited for breast and cervical screening – others had waited too long for their results. Just 55% of women received their cervical screening results within 14 days. The Department told the committee the 14-day target is a customer service ambition, not based on clinical need – the MPs said women were unaware of this, and delays in receiving their results led to undue stress and worry.

The committee called for action on the screening programmes:

  • By the summer Parliamentary recess, the national bodies should set out steps they will take to understand why performance is so poor in some areas and publish a plan to address these inequalities
  • Before the recess, NHS England should explain how it will hold providers to account and detail targets to improve performance
  • NHS England must raise awareness of the screening programmes and ensure the public knows the 14-day target is not based on clinical need
  • The current national review of screening should scrutinise oversight arrangements; roles and responsibilities; and quality assurance.
  • Public Health England and NHS England must take a more integrated approach to IT
  • NHS England should publish a clear plan for its project to bring the IT system that supports cervical screening back in house, remove the backlog of samples and roll out a new testing regime in six months. The committee said it was ‘extremely doubtful’ this could be achieved on time.

 

Committee chair Meg Hillier (pictured) said the benefits of screening could not be underestimated, but millions were missing out on the programme. ‘Our inquiry has exposed a health service that is losing its grip on health screening programmes. Many individuals waiting for delayed results will suffer avoidable anxiety, stress and uncertainty. Those delays also stretch far beyond the Department’s target waiting periods,’ she said.

‘The government’s understanding of variation across the country and the barriers facing different demographics of the population is patchy at best, which constrains their capacity to act.

‘Ultimately, this is a question of health equality. The government has a duty to ensure that everyone has access to health screening.’