Working with the London Assembly to improve breast screening uptake in London

We have worked with the London Assembly to spread awareness of the barriers behind improving screening uptake in the region, as well as discussing how the Mayor of London can support.

The NHS has two targets for breast screening uptake in England, and the average uptake in London hasn’t hit either target in at least 25 years. In some areas of London, fewer than 1 in 2 women will attend their breast screening appointment when first invited.

This means that the women in London who don’t attend their screening when invited may have their breast cancer diagnosed later on, when it's at a later stage and treatment can be less successful.

Many of these women in London who don’t attend also come from communities that already experience worse outcomes in breast cancer and in healthcare more generally, such as ethnic minority women, women from more socioeconomically deprived backgrounds or women experiencing homelessness.

For the last year we’ve undertaken research to understand what can be done to improve breast screening uptake in London. This research has been compiled into a briefing for the NHS in London called No one left behind: opportunities to improve breast screening in London.

NHS services in London have been trying to improve breast screening uptake for decades, however there are a range of barriers which prevent progress. We’ve heard that when something works, it’s hard to replicate every year. This is because funding is only given to the responsible services on a yearly basis, so it’s harder to do long-term planning.

Data is also a big barrier to improving uptake. Accurate and consistent data is needed for services to understand who is not attending and why, but this data is not always correct or not always shared between services.

The London Assembly is the political body for Greater London, and acts to hold the Mayor of London, Sadiq Khan, to account. It also has several committees which investigate issues important to Londoners and influence the development of policy regionally.

By telling the London Assembly Health Committee about the issue of low uptake in screening, we were able to persuade them to make breast cancer screening one of their main health priorities of the year. This meant that we could go to City Hall to give evidence on the issues and work together towards meaningful change.

We were joined at the evidence session by representatives from OUTPatients, a LGBTQ+ cancer charity, and Black Women Rising, who support Black women and women of colour through cancer.

We were asked by the Assembly Members about a range of issues, from how to improve the invite process for breast screening, to how screening outreach and engagement could be better designed to target those least likely to attend their screening appointments.

We know that staff across breast cancer screening services and many others across the NHS are working tirelessly to improve screening uptake in London. We look forward to continuing to work with them to spread awareness and improve outcomes for women across the capital.

However, we are urging all parts of the healthcare system in London, from primary care to the Mayor of London, to collaborate and have breast screening at the heart of their ambitions that focus on prevention and address health inequalities.

You can read our briefing, No time to waste: opportunities to improve breast screening in London here.

You can also watch back the livestreamed London Assembly Health Committee evidence session here.

We have funded a new study to explore how breast screening could be made more comfortable, by working with women from different ethnic backgrounds living in North East London.

Our consensus statement on health inequalities in breast screening was developed alongside a group of organisations and experts that work to combat health inequalities, and outlines ways the NHS can make screening more accessible and inclusive for those who face additional barriers.