The National Audit Office (NAO) has today published its new report into the management of health screening, finding that the proportion of eligible adults receiving screening is inconsistent across different areas in England and that services are not operating to the ‘agreed standards’.
The report covers four of the 11 screening programmes in England – breast cancer, bowel cancer, cervical cancer and abdominal aortic aneurysm – all of which failed to meet the ‘standard’ target for the percentage of eligible people attending screening appointments in 2017-18.
For breast cancer screening, the standard target for coverage – that 80% of women eligible for screening should be screened within the previous 36 months – was only met in one out of 227 CCGs in 2017-18, while 141 CCGs did meet the minimum threshold of 70%.
The programme also measured round-length, the time between a woman’s breast screening appointments, which should be roughly every three years. Overall, round-length performance for breast cancer was found to be 92% nationally – with no local providers meeting the standard target (100%) and 57 out of 79 meeting the lower (90%) threshold.
Following the recent breast screening invitation error, the NAO’s report concluded that the breast screening programme had “relatively clear governance structures”, but “lacked a senior responsible owner to ensure the system was functioning correctly”.
Baroness Delyth Morgan, Chief Executive at Breast Cancer Now, said:
It is extremely worrying that that NHS performance targets for breast screening are continually being missed. With the established standards not being met, some women will be waiting more than three years between their screening appointments, and this is completely unacceptable.
The earlier breast cancer is detected, the more likely treatment is to be successful. The NHS Breast Screening Programme remains critical to early diagnosis in this country, preventing 1,300 deaths from breast cancer every year in the UK – and we need to support even more women to make the most of it.
This worrying report also highlights once more that the breast screening programme is being held back by a lack of clear ownership and leadership, as well as by its aging and complex IT systems.
As set out in the NHS Long Term Plan, we need to do everything we can to improve attendance and ensure the future of this world-class service – and we hope the upcoming review of NHS cancer screening programmes will address these critical issues. With breast cancer incidence continuing to rise, we need to invest in new technology, IT infrastructure, and in recruiting and training new experts, to enable NHS services to cope with increasing demand over the next decade.