All-Party Parliamentary Group on Breast Cancer report finds stark inequalities in NHS services across England – with more than a quarter of mammography posts vacant in the West Midlands.

  • While the West Midlands is still meeting national targets for screening attendance, the number of women attending mammograms in the region has fallen sharply over last decade
  • West Midlands above the national average for the early detection of breast cancer, but some areas are outperforming others – with Birmingham Cross City CCG leading the way
  • Craig Tracey, MP for North Warwickshire and co-chair of the APPG on Breast Cancer calls on NHS England and PHE to take immediate action to address variation

Shortages in the breast cancer workforce in the West Midlands have reached a critical level with more than a quarter of mammography posts vacant, according to a new report by the All-Party Parliamentary Group on Breast Cancer (APPGBC) – and supported by leading charity Breast Cancer Now.

The landmark report, A Mixed Picture: An Inquiry into Geographical Inequalities and Breast Cancer uncovers the true extent of the ‘postcode lottery’ in breast cancer diagnosis, treatment and care across England, with women in worst-affected areas found to be more than twice as likely to die from breast cancer under the age of 75 than those elsewhere in the country.

Following a year-long inquiry (October 2016 - November 2017), which gathered evidence from NHS leaders, clinicians, patients and charities, the report found that while overall outcomes for breast cancer are improving, stark geographical inequalities exist across England in screening, early detection and access to treatment and services.

With the report’s publication, Craig Tracey, MP for North Warwickshire and co-chair of the APPGBC has today called for NHS England and Public Health England to intervene to address the geographical variation in breast cancer services across England.

Shortages in breast cancer workforce hit the West Midlands, with over 25% of posts vacant

The Inquiry heard serious concerns from NHS leaders about the “demographic time bomb” facing the breast cancer workforce. Current vacancy rates, coupled with a mammographic workforce approaching retirement, are affecting the health service’s ability to cope with increasing breast cancer incidence among an ageing population.

Worryingly, more than a quarter (25.5%) of mammography posts were unfilled in the West Midlands. This exceeds the England average of 19.4%, and is a stark contrast to the North East and Yorkshire & the Humber, where just 8.63% of posts were vacant.

These shortages can severely impact the speed at which patients are diagnosed and therefore treated. But despite staffing pressures, 92.7% of West Midlands patients were seen by a specialist within the recommended two weeks, compared to just 84.5% in the South West and 88.1% in the East Midlands.

Screening attendance inconsistent across England – with uptake in West Midlands falling 5.1% in the last decade

The report revealed that in the West Midlands in 2016-17, 71.2% of women invited to screening attended within six months, surpassing the national target of 70%. However, the report worryingly shows that, despite meeting the national target, screening uptake in the West Midlands has fallen sharply by 5.1% in the last ten years, reflecting the concerning countrywide decline.[if !supportFootnotes][iii][endif]

Women between the ages of 50 and 70 are invited for routine mammograms every three years as part of the NHS Breast Screening Programme. A major independent review in 2012 showed that NHS breast screening prevents 1,300 deaths from breast cancer each year, with around a third of all breast cancers in the UK – roughly 16,000 cases a year – diagnosed through the Programme.

Despite local variation in early detection, West Midlands is performing better than other regions in England

Despite some variation between CCGs, overall the West Midlands performed above the national average (71%) for early detection, with 73.6% of breast cancers detected at early, more treatable stages (