News

Cancer screening in the news and HPV implementation in England

Cancer screening programmes have been much in the news in the last few weeks. 



Issues with the English Breast screening programme and IT issues (http://www.bbc.co.uk/news/health-43973652), and the Irish Cervical screening programme (CervicalCheck) (https://www.irishexaminer.com/breakingnews/ireland/cervicalcheck-scandal-most-of-the-209-women-in-audit-contacted-842464.html)  have been well publicised.

Such problems not only harm the women the programmes are meant to be helping, but they can lead to a public loss of confidence in the programmes, and also with those involved with them. Both seem to be due to a combination of human, system and oversight problems.

No one ever intends for such problems to occur, but if history teaches us anything it is that such problems do occur, and sadly too often.

The Kent and Canterbury cervical screening incident in England in the 1990s occurred at a time of increased market competition and poor oversight.  A major overhaul of the running of the English CSP happened after this and has helped make the CSPs in the UK amongst the best, if not the best, in the world. Whilst few would argue with the decision to convert to a primary HPV cervical screening programme, many are becoming increasingly frustrated with the current state of affairs as to its implementation in England.

There is an ongoing series of “engagement events” led by NHSE (https://www.contractsfinder.service.gov.uk/Notice/4adfa8e5-cb0b-421b-80c1-cb8d51bd5723) to canvass views of potential providers on a whole host of topics related to this. There is very little being asked now that wasn't raised or known about several years ago, but we seem to be going down to the wire on actual detail. Scotland has gone through a far more visible process and has recently agreed its lab configuration, as has Wales.

Many laboratories are experiencing workforce and backlog problems with the current English CSP, and have done for a year or so in many cases, and planning for any future delivery of CSP is difficult in the extreme in the absence of robust plans to work to.

Current mitigation plans may help some labs with their workloads, but cannot, and never could, help all those with problems. There is also growing concern about the delivery of the Primary Care IT systems, of which the call/recall system is part, and have been highlighted by the BMA over many months now (https://www.bma.org.uk/collective-voice/committees/general-practitioners-committee/gpc-current-issues/capita-service-failure).

Staff in cervical cytology laboratories are largely demoralised by a lack of detail, visible plans and pace of action. Many staff are unsure as to what their roles will become, or if they will even be involved in the CSP in the future. Many qualified, competent staff with cytology skills are being, and will continue to be, lost for good to the NHS if plans for staff retention and development are not urgently put in place. Cytology in general in this country could be affected for many years by the proposed CSP changes.

As an association, the BAC is as frustrated as many of our members about the current situation in England, if not more so. We are doing whatever we possibly can to voice our concerns and be listened to, and working with other professional organisations (https://www.rcpath.org/resourceLibrary/president-s-e-newsletter---may-2018-.html) who also share our concerns. Given we are told everything will be in place across England by the end of 2019 we do not have long. We all need to ensure everything is in place and working so as to not lead to unnecessary harm. If ever there was a time to make sure we ensure the CSP is fit for purpose, it is now.

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