Issue - items at meetings - Screening Services

Report of the Strategic Director, Resources, on city screening performance (copy attached)

46.1    This item was introduced by Dr Peter Wilkinson and Ms Martina Pickin from the NHS Sussex Public Health team.

46.2    In response to a question from Cllr Marsh on the likely impact on local screening uptake of the recently announced national review of breast cancer screening, Dr Wilkinson told members that it was possible that the national review would lead to a fall in breast screening uptake locally.

46.3    In answer to a question from Cllr Bennett on the use of mobile screening centres in the city, Dr Wilkinson told the committee that the use of mobile screening units had been discontinued in Brighton and Hove at the time when the screening services was experiencing problems with its performance; it being decided to provide screening for all Brighton and Hove women from the main screening centre. Work is ongoing to determine whether this change has had an impact upon screening rates, particularly in the areas of deprivation (e.g. Hollingbury) close to where mobile centres were previously located. Consideration would be given to reintroducing mobile screening units to certain areas if it was found that there has been a significant worsening of access for certain communities.  However, the use of new digital equipment means that the previous sites may no longer be suitable or available.

46.4    In response to questions from Cllr Follett on bowel cancer screening, Ms Pickin informed the committee that it was uncertain whether this year’s targets would be met, as there was currently only one quarter’s data from which to extrapolate (although this showed good performance). She is currently trying to obtain data which differentiates between new screening referrals and returning users. It is  assumed that the latter are more likely to take up the offer of screening if they have done so previously. Hence combining the data could give a skewed picture with regard to how successful the screening programme was in terms of encouraging new users to present.

46.5    In answer to a question from Cllr C Theobald on why the city rate for cervical screening still lagged behind national and regional comparators, Dr Wilkinson told members that this was likely to be due to socio-demographic factors. For example, the national discontinuation of screening for women under 25 was likely to have an impact on uptake figures for 25-30 year old women (as people who have used screening services before are more likely to present to services than are people who have never previously been screened), and this would impact disproportionately upon Brighton & Hove, given the relatively large number of women of this age in the city.

46.6    In response to a question from Cllr Barnett concerning self-referral for screening, Dr Wilkinson told members that people in some groups could self refer for screening in instances where they were not part of the targeted cohort; for instance, men over 65 years could self-refer to the aortic aneurysm programme. Rates of self-referral will vary from programme to programme, and are likely to depend in part on the publicity a particular programme is receiving at the time.

46.7    In response to a question from members as to the effectiveness of the ‘Albion in the Community’ bowel cancer campaign, Ms Pickin told the committee that there was as yet no outcome data available, but the inputs (eg number of volunteers trained to deliver the early awareness message, number of events attended, number of community talks given) would suggest the campaign reach was wide.

46.8    The Chair thanked Dr Wilkinson and Ms Pickin for their contributions, noting particularly that the committee welcomed the comprehensive report they had compiled.

46.9    RESOLVED – That members:

(1)       Note the report and its appendices;

(2)       Agree that recent city performance in breast screening is encouraging, and request an update on progress in 12 months’ time (via a letter to the Chair if performance continues to be unproblematic).