Cancer Screening Offering High Quality Service to Women in Scotland
Cancer screening services that are used by more than half a million women in Scotland every year are working well and helping to save lives.
The first ever national reviews have found that cervical and breast screening services in Scotland are of a high standard and are helping to prevent women in Scotland dying from cancer.
The reviews were carried out by NHS Quality Improvement Scotland into the separate cervical and breast screening programmes in Scotland. They found that both programmes have effective systems in place to reduce the risk of error and provide services that are of high quality and are responsive to the needs of women.
However, the reports published today (November 24) also found that these services face pressures that are leading to delays in issuing test results to women and arranging follow-up appointments for those who need them. Only three out of 15 NHS boards in Scotland were able to show that they issued results of cervical smear tests within the recommended period of 4 weeks of the test being carried out. Only five were able to offer appointments within 8 weeks for those who required follow-up investigations.
A similar situation exists with breast screening. Only one screening centre was able to show that it met the standard of issuing results within 15 working days or 3 weeks. No centre met the standard of issuing appointment letters within 15 days for those recalled for assessment. However, all centres were able to offer an appointment date within 5 days of letters being sent out.
The reports acknowledge that screening services are aware of these problems and are taking action to address them. However, they recommend that where delays are known to occur, plans should be developed to speed up the process.
A national screening programme for cervical cancer was introduced across Scotland in 1987. Since then there has been a 32% reduction in cases of cervical cancer and a 43% reduction in deaths. The screening programme is helping to prevent around 250 cases of cervical cancer every year. Attendance rates are high with 87% of eligible women being screened in the last 5 years. Around 450,000 cervical smears are processed every year.
Breast screening was introduced in 1988 when the UK became the first country in the world to introduce a national programme. Breast screening has been shown to reduce deaths by up to a third among women aged 50-64 and the report says the screening programme is actively contributing to a reduction in deaths in Scotland. All six breast screening centres in Scotland were found to be meeting all the essential criteria for detecting cancer at an early stage when it can be successfully treated. Around 74% of eligible women attend for breast screening - around 114,000 a year - although there are problems with uptake rates in some parts of Scotland, particularly deprived inner city areas.
Both the cervical and breast screening services were found to achieve most of the standards laid down by NHS Quality Improvement Scotland. However, considerable variation was found in the way in which the performance of cervical screening services is monitored around the country, which made it difficult to assess performance in some places. This will be addressed with the introduction of a Scotland-wide call and recall system which is expected to be in use by 2006. The report says the development and roll out of this system should be completed as soon as possible.
The reports also say that cervical screening services are often stretched and that breast cancer screening services are “currently at capacity”. This is reflected in the delays in reporting results which is highlighted in the report as one of the major issues needing to be addressed.
The chairman of NHS Quality Improvement Scotland, Lord Naren Patel said: “Women in Scotland can be assured that cancer screening services are of a high standard. Most cervical cancer deaths now occur in unscreened women and there is a similar trend in breast cancer. This is powerful evidence of the effectiveness of screening and should encourage women to make best use of the services available to them.
“However there are further improvements that can be made, particularly in the time it takes to report results and in other areas, such as involvement of the public. These services have shown themselves capable of adjusting to change in the past and I feel confident they will meet the challenges currently facing them.
“Screening is helping to prevent and detect cancer and all eligible women should be encouraged to attend. However, it is even more important that they take measures to protect their health to try to prevent cancer developing in the first place. Smoking is a major factor in cervical cancer and stopping smoking is the first thing that women should do if they want to improve their health.”
The reports include sets of questions that women may want to ask of screening services to be assured that the services are meeting the standards that have been set for them.
Ends
NOTES TO EDITORS
The reports and standards are available on the NHS QIS website:
Please see the News section or click on Publications on the left-hand column, and select either ‘National Overview’, ‘Local Reports’, or ‘Standards’ from the drop-down Publications Type menu on the publications page.
For breast screening, the reports cover: General [includes: organisation; specification; communication; audit]; Call-Recall and Safeguarding;The Screening Process; The Assessment Process; Surgical Referral; Cancer Yield [maximising detection rates]
For cervical screening, the reports cover: General; Call-recall and Failsafe; Smear-taking; Laboratory Reporting; Colposcopy
NHS QIS Remit:
NHS Quality Improvement Scotland (NHS QIS) has been established to improve the quality of healthcare in Scotland. To do this, it will set standards and monitor performance, and provide NHSScotland with advice, guidance and support on effective clinical practice and service improvements.
The clinical standards it develops, defined in partnership with members of the public and healthcare professionals, follow the ‘patient journey’ as they move through different parts of the NHS. This NHS QIS system of assuring quality is designed to complement the duty that has been laid upon the board of each NHS body by the Health Act 1999 to monitor and improve the quality of healthcare which it provides to individuals (clinical governance).
NHS QIS is independent from government. Although it is accountable to the Scottish Executive for delivering its work programme and for the public money it spends, NHS QIS reaches its own conclusions on the quality of services being provided by the NHS, and publishes its findings.
Background:
Established on 1 January 2003, NHS Quality Improvement Scotland is a Special Health Board, built on the expertise developed within the:
• Clinical Standards Board for Scotland
• Clinical Resource and Audit Group
• Health Technology Board for Scotland
• Nursing and Midwifery Practice Development Unit
• the Scottish Health Advisory Service.
Chaired by Lord Patel, the Board has a broad membership that includes NHS staff and members of the public. Dr David Steel is Chief Executive.
NHS Quality Improvement Scotland Chairman Lord Patel, Chief Executive Dr David Steel, and Interim Director for Standards and Reviews Jan Warner, are available for interview. To arrange an interview, please contact:
Patrick Maitland-Cullen, Communications Section, NHS Quality Improvement Scotland, Tel: 0131 623 4297 (dl) or 07968 494 164 (mobile), or Nicola Buist Croft, Communications Section, NHS QIS, Tel: 0131 623 4291 (dl).