• Major review highlights England missing out on screening innovations due to “serious and ongoing delays”
  • Sir Mike Richards’ interim report criticises approval process for delaying implementation of innovations
  • Full report on screening programmes due to be released this summer

England has missed out on the latest advances in cancer screening because of “serious and ongoing delays” in how they are implemented, according to a major review of screening programmes.

The interim report from former national cancer director Sir Mike Richards’ ongoing review of cancer screening warned the process for approving new techniques was beset with “poor planning and resourcing leading up to, during and after the decision to progress has been made”. 

The approval process consists of a panel of screening experts, the UK National Screening Council, assessing new developments and deciding which ones should be adopted by NHS screening programmes. Public Health England then pilots the new approaches and, usually, NHS England oversees implementation.

But this process leads to delays in getting the latest innovations to the public, the report said.

“Early planning for implementation is particularly lacking, with little clarity on who is responsible,” the report continued. “Service specifications may be written, for example, but associated service planning is suboptimal leading to uncertainty around key issues such as workforce planning, procurement, impact on existing services and the financial consequences of implementation. The result is serious and ongoing delays.”

The review also raised concerns with the time NSC takes to decide whether to recommend changes. 

The interim review warned England lagged behind other countries “when it comes to how quickly we mobilise ourselves to implement advances in screening programmes”.

Sir Mike, former chief inspector at the Care Quality Commission, will now consider what recommendations to make to improve this situation for the second part of his review. He is due to release the full report this summer.

Diagnosing more cancers at an earlier stage is a key government target for the NHS. NHS England commissioned Sir Mike to review the breast, bowel and cervical screening programmes late last year and report on the schemes’ strenghth and weaknesses as well as what could be done to improve uptake and incorporate new technology and techniques. 

FIT for purpose?

Sir Mike’s interim report highlighted how the problems identified had already caused delays in rolling out new tests to the public.

In particular, it pointed out how delays in the procurement process for faecal immunochemical testing for bowel cancer screening meant rollout was expected to begin next month, despite NSC recommending the change more than three years ago, in January 2016. 

While the current system requires people to take six stool samples, FIT needs just one. FIT also allows people to take samples at home. Research suggests it will mean more people take part in the national bowel screening programme. 

HSJ reported earlier this year that the rollout of FIT, which had been announced for autumn 2018, had been delayed because supplier contracts for testing kits had not been signed in time.