Following the serious failure in the Breast Screening Programme what will the effect be on the breast cancer workforce?

Tuesday 15 May 2018      Policy and campaigns blog
Woman having a mammogram screening

Due to an ‘serious failure’ with the National Breast Screening Programme revealed last week, an estimated 450,000 women aged between 68-71 have not been invited to their final screening appointment since 2009. 

The Health Secretary has committed to taking ‘major steps' to expand the capacity of the screening programme, and offering ‘catch up’ screening appointments to those affected within six months.

At Breast Cancer Now we are seriously concerned about capacity issues within the breast cancer screening workforce, as first highlighted in our Good Enough? report. The catch-up appointments necessary to correct this error could risk pushing the already stretched workforce to breaking point. 

What are the ‘major steps’ the Government needs to take to reinforce the screening workforce – now and for the future?

We are not yet sure how many women under 72 will be invited for a ‘catch-up’ screening appointment and how many extra appointments there will be from women older than 72 who will self-refer for a mammogram. It is the government’s intention for this to occur within the next six months, and to not affect routine screening for women.

However there is not a pool of mammographers and breast radiologists who can be called upon to deliver this. The likelihood is that this will fall upon those already working in the stretched workforce.

Breast Cancer Now is calling on the government to: 

Urgently increase capacity within the breast screening programme – by recruiting more:  

  • mammographers: these are the people who takes the image of the breast – the mammogram. They tend to be a qualified radiographer with a further year’s training in breast specific imaging.  
  • breast radiologists: these are the doctors who will examine the mammogram for any sign of cancer. If breast cancer is suspected or diagnosed, they play a key role in staging the cancer, advising on biopsies, surgery and radiotherapy

These two roles are vital to the National Breast Screening Programme. 

But they are in short supply – and if urgent action isn’t taken, the situation could worsen.

There is already a 20 per cent shortfall in mammography staff to deliver the screening programme, the equivalent of 215 full time staff. Only 18% of breast screening units are adequately resourced with regard to their local uptake.  

It is a similar story amongst breast radiologists. A Royal College of Radiologists report  in 2016 highlighted a 13 per cent vacancy rate amongst consultant breast radiologists, the equivalent of 54 full time staff. It also exposed that 25% of units had less than two radiologists and no flexibility for cover.  

On top of this, in both professions there is significant geographical variation in the where there are shortages, with areas such as particularly acute staffing pressures in the North East, Yorkshire and Humber region, the West Midlands and London. 

That’s why we are calling for commitments to appoint more than 200 mammographers and 50 breast radiologists. These numbers are the minimum required, and would fill the existing gaps in the breast cancer screening workforce, easing pressure as more diagnostic tests are performed over the coming months. 

Alongside this, it’s essential that we see steps to improve retention of current workforce – to make sure expert staff remain within our NHS. This should look at pay, workloads and career progression to ensure that those who have the training and experience are inspired to continue working for the NHS and continue providing the best care and support to women through the screening programme. 

Longer term, we need to see concerted efforts to model the breast screening workforce in full. This will give us a full picture of the workforce, where the gaps are and where the gaps are coming. This valuable insight will allow for sustainable planning for the future. 

We believe that if these ‘major steps’ aren’t taken, the extra demand on the screening programme could push overstretched staff to breaking point. We need to see urgent action to ensure that every woman affected by this error has the opportunity to have a screening appointment – and we have a robust, realistic and fully resourced workforce that is fit for the future.