Report calls for improvements in breast screening
Clearer leadership needed
in management of adverse
A report on women in Scotland who were
identified as having not been called for routine breast screening
appointments has made a series of recommendations to improve the
The report – entitled ‘Review of the
Scottish Breast Screening Programme December 2016’ – has been
produced by Healthcare Improvement Scotland.
The report follows the identification of 3,831
women who had not been sent a routine invitation to be screened.
National Services Division (NSD) is responsible for commissioning
and performance managing the national Scottish Breast Screening
The report states that it was unclear who was
responsible for the handling of the issue and that clearer
leadership is needed from NSD to ensure the appropriate management
of adverse events.
The report concludes that the new IT system in
place will help to address a number of issues, but it will require
ongoing monitoring to ensure that any future risks are
appropriately dealt with.
All women identified as not being called for
their routine appointment at their local breast screening centre
have been contacted and offered the chance to make a fresh
appointment. By November 2016, 41% of women had still to take up
that offer. This is a significantly lower uptake than would be
expected for breast screening in Scotland.
NSD, in conjunction with the Scottish Breast
Screening Centres, have been asked by Healthcare Improvement
Scotland to urgently review whether every reasonable step has been
taken to enable this group of women the opportunity to attend a
screening appointment. We have been informed by NSD that they have
established an adverse events team to ensure that every reasonable
step has been taken to enable these women to have the opportunity
to attend breast screening.
The breast screening programme is for women
aged between 50 and 70 years and runs on a 3 year rolling cycle.
Women aged 71 and over are able to attend through self referral to
their local screening centre. If any women are unsure if they
should have been invited for an appointment, they should
contact their nearest breast screening centre.
The report makes five recommendations for NSD
and SBSP and cover the following areas:
- an adverse event management
team should be established to urgently review whether every
practical step has been taken to offer the women identified the
opportunity to attend a breast screening appointment within a
reasonable time frame
- the need for effective
governance arrangements to ensure roles, responsibilities and lines
of accountability are clear
- a clear and structured
adverse event management process with supporting guidance should be
put in place
- a mechanism should be
established to manage ongoing IT issues
- improvements should be made to
the current risk management arrangements.
Healthcare Improvement Scotland will continue
to monitor how NSD follows up with this group of women.
Professor Stephen W. Duffy,
Chair of the Review Group and Professor of Cancer Screening at the
Wolfson Institute of Preventive Medicine, said: “Effective and
timely breast screening for women is crucial in the early diagnosis
of breast cancer. Clearly the vast majority of women in Scotland
receive their invitation to be screened in a timely manner, but
it’s important that all women are given the opportunity to be
screened at the earliest opportunity. This report clearly
demonstrates that more needs to be done to ensure that this happens
for every woman eligible for screening in Scotland.”
Claire Sweeney, Interim
Director of Quality assurance for Healthcare Improvement Scotland,
said: “In Scotland we are working hard to develop a culture
where people receive the best possible care every time they
encounter our health and social care system, and that when issues
occur there is an open culture of learning. We are encouraged by
the response of NSD to our report’s findings and recommendations.
Although the new IT system will help ensure that every woman
eligible for screening is invited to attend, ongoing monitoring
will be required to ensure that the system is working effectively
for all women. We will continue to closely track the
Published date: 21 December