Agenda item

Dr Tim Davies, Consultant Screening & Immunisation Lead, NHS England/Pubic Health England to give a presentation on the benefits to achieved from screening programmes.  The uptake on screening services in Leicester is generally below the national average.  

Dr Tim Davies, Consultant Screening & Immunisation Lead, NHS England/Pubic Health England gave a presentation on the benefits to be achieved from screening programmes.  The uptake on screening services in Leicester was generally below the national average.

During the presentation Dr Davies commented that:-

• All screening programmes had false positive and false negative results, and the effectiveness of any screening programme was to have low numbers of both these false results.

• Cervical Screening rates in Leicester were declining more rapidly than the decline in the national average and were now 64.3% compared to the Central Midlands rate of 72.9% and the national rate of 71.7%.

• The uptake from younger women was lower than older women.  There was now collaborative working between all health agencies and providers to address this in Leicester by both national and local publicity campaigns.  Locally, UHL was working actively with GP practices and offering in-house and community clinics to improve the take up. In addition, there was a student led social media campaign, local business/community venues were being asked to display posters and there was an active Don’t Fear the Smear campaign asking women who have taken the test to take a selfie and post on their social media account with the # and to tag 5 of their friends to spread awareness.

• Traditionally, all smears were examined under a microscope and those showing minor changes were then tested for human papilloma virus (HPV), this was changing to all smears being tested for HPV first and only those showing a positive result would be examined under a microscope.  This would enable the number of test laboratories to be reduced from around 45 to 9.  There would be one test laboratory in the West Midlands and one in the East Midlands.  UHL had not bid to be a test a laboratory and mitigations would be put in place whilst people changed from one test to the other and the new arrangements were fully implemented.  The new practice and arrangements should be in place by the end of 2019.

• Breast Screening rates again lower than the national rate but whereas the national rate had remained fairly static over the last 8 years; the rate in Leicester had pronounced fluctuations within it.  Leicester’s current rate was now 65.8% compared to the Central Midlands’ rate of 73.9% and the national rate of 72.1%.

• The City was divided into 3 areas for the 3-year screening programme and the fluctuations in uptake were reasonably predicable depending upon which part of the city was being screened each year.

• Bowel Screening in Leicester showed men had a lower uptake but higher levels of positive results and women had a higher uptake with lower levels of positive results.

• The test was changing from April 2019 from one where 2 samples are taken on 3 separate occasions and these are then sent in a sealed envelope for testing in a laboratory; to one where a single sample is taken.  It was felt that this would improve the uptake of the test, especially in households with multiple occupants where an individual may find embarrassment with storing the stool sample card for 3 days in a bathroom shared with others.

In response to a question, Dr Davis commented that the previous test for bowel cancer produced a higher than average level of positive results resulting in a patient having a colonoscopy.  Projections showed that if there was an 7% increase in the uptake of the new tests and the forecast level of slightly lower positive results, then this would have a negligible effect upon the number of colonoscopy procedures carried out.  A 10% increase in the uptake could have an impact on the colonoscopy service.

Dr Davies was thanked for his presentation.