Recommendation 4

HM Government Acknowledged

Through our NHS screening programmes we are able to reduce mortality and morbidity from cancer and other conditions in the population who appear healthy and have no symptoms, by detecting conditions at an earlier, more treatable stage and, in the case of cervical screening, helping to prevent cancer from developing. Each year, this means inviting over 15 million people for screening, with over 10 million taking up the invitation. In total, this saves around 10,000 lives every year and enables many others to make better informed decisions around their health. There have been important changes in screening programmes in recent years. This includes the introduction of primary Human Papilloma Virus (HPV) screening in cervical screening in 2019, as well as continued work to evaluate self-sampling for HPV to enable individuals to test at home. Despite the challenges of the pandemic, the age from which people are eligible for bowel screening has started to be reduced, beginning with 56 year olds. We know, however, that there is significant further work to be done to improve the uptake and coverage of our screening programmes, further reduce inequalities in access, reduce waiting times, improve integration with diagnostic assessment and treatment services, and improve the digital platforms that some of our screening programmes rely on. Professor Sir Mike Richards’s independent review of National Adult Screening Programmes was published on 16 October 2019, and examined the provision of screening in England and provided recommendations for improvement. The recommendations have formed the basis of much of the work the Department, NHS England and NHS Improvement (NHSEI) and formerly Public Health England have undertaken to improve the delivery of screening programmes in England. Many of the recommendations have already been delivered. First, there has been a transition of functions and accountabilities formerly held by Public Health England into the Office for Health Improvement and Disparities (OHID) and into NHSEI, both regionally and centrally. Former PHE programme delivery staff, the Screening Quality Assurance Service, and the Clinical and Research Advisory Committees are now embedded within NHSEI. This has bolstered the organisational resilience of NHSEI in the operational delivery and commissioning of screening programmes, with the transfer of programme specific expertise in delivery, quality assurance and research. As a result of the transition, NHSEI runs the IT systems screening services use for production and publication of patient facing information, the screening helpdesk and data analytical functions. We have set up individual webpages for the screening Research Advisory Committees that guide research for each programme to ensure that approval processes are clear. These committees advise on new research proposals, develop research questions for the programme and advise researchers on whether they have met legal requirements to receive personally identifiable data. The Digital Transformation of Screening Programme was initiated in 2019 to address the Richards Review recommendation to develop future-proofed, interoperable digital systems that support improvements in the design, uptake and coverage of screening programmes. Work continues to deliver this important programme. Effective public communication about the importance of screening is vital. A national campaign to improve cervical screening coverage ran in early 2022 and plans for a bowel cancer screening campaign are in progress. Finally, we are reforming the UK National Screening Committee (UK NSC) which advises Ministers and the NHS in all four UK countries on national screening. The UK NSC will have the ability to start making recommendations on national targeted and stratified screening alongside population level programmes. This will allow the NHS to provide more personalised programmes, based on predictive analysis of individual risk factors, leading to better outcomes for groups at higher risk of having or developing specific health conditions. The UK NSC with its expanded remit and Terms of Reference was relaunched on 20 May and the first meeting of the new committee is planned for 24 June 2022. COVID Backlog Recovery While there was no national direction to pause screening services, local services took the decision to pause services temporarily to support the pandemic response at its height. NHSEI has made significant progress in tackling the backlog of invitations caused by the pandemic. In bowel screening, the backlog of invitations was completely removed by January 2022 and, despite the pandemic, the expansion of the home testing programme has started with 56 year olds and with further rollout planned. The breast screening programme is in the process of recovering, with the backlog in invitations being reduced each month. 11 providers have completely removed the screening invitation backlog and a further 54 (out of 75) are due to recover c