NHS England should look at integrating screening invitations with GP records and speeding up the implementation of new technologies as part of its review into cancer screening programmes, charities have said.
The review into England’s three screening programmes was announced last month, with a focus on technology.
Professor Sir Mike Richards will lead the review, which will include feedback on current and future IT systems and opportunities for the use of AI and other technology to aid the screening process.
Responding to the announcement cancer charities have called for greater investment in robust IT systems to improve dwindling attendance numbers and a focus on artificial intelligence (AI) in the future.
Baroness Delyth Morgan, chief executive at Breast Cancer Now, told Digital Health she hoped new technologies like tomosynthesis – an x-ray technique that detects cancer – and ultrasound for women with dense breasts could be introduced into the NHS if there is sufficient evidence.
“This landmark review represents a vital opportunity to ensure our screening programmes are fit for the future and able to harness research progress to detect more cancers earlier,” she said.
“Investment in robust IT systems will be required to link screening invitations to GP records, help improve attendance and ensure the screening programme is equipped to incorporate new and emerging technologies as soon as possible.
“With the volume of data being captured by the programme, advances in AI have great potential to alleviate some of the pressures on the workforce by reducing the need for mammograms to be read twice.
“We need the review to ensure that we have the processes and technologies in place to enable the NHS to make the most of these opportunities.”
Deborah Alsina, chief executive of Bowel Cancer UK, called for the review to provide clear recommendations on how the “fragmentation of screening responsibilities” can be resolved to provide more joined up care.
“We have already seen the more accurate screening test, the Faecal Immunochemical Test (FIT), delayed, in part due to the lack of clarity around the division of responsibilities between arm’s length bodies, in particular between NHS England and Public Health England,” she told Digital Health.
“Ensuring rapid adoption of new and transformative technology should also be a priority for this important review.
“Research in this area moves at pace and it is vital that the screening programme keep up with this to ensure eligible populations have access to the best screening methods that can improve prevention and early detection of bowel cancer.”
Alsina also stressed the importance of embracing AI.
“In the near future, AI technologies will be capable of ordering tests, compiling medical notes, and completing administrative tasks. This would help streamline the administrative side of screening programme, such as the call and re-call functionality,” she said.
“AI could enable us to risk stratify screening programmes so that the current one size fits all approach is phased out in favour of a more personalised screening programme based on individual risk. This could enable us to maximise use of NHS resources and ensure we both prevent or detect more cancers early.”
Why the review is important
In May 2018 the then-secretary of state for health and social care, Jeremy Hunt, revealed that nearly half a million women might have missed their final breast cancer screening invitation due to a “computer algorithm failure”.
An independent review following the announcement subsequently found checks were not made to ensure IT systems could deliver a new specification or a trial algorithm.
Though the review stated it has “not found that any one person to blame”, it adds that its investigations has uncovered the IT systems being used are “overly complex” and “dated”.
As a result, it was recommended the IT systems used in the breast cancer screening programme be made simpler to use and any new systems introduced to support the programme should follow the principles set out in Hancock’s tech vision, including a full commitment to interoperability.
7 March 2019 @ 17:40
Currently the breast cancer screening programme send out unsolicited appointments to women due for screening. This appointment may well not be at a time or place that’s convenient but rescheduling it damm nigh impossible. This may have been the only way to do it 10 years ago but it’s really easier to imagine how this could be done via the Internet in a way that would allow women to choose a time and place that suits them – Improving take-up and reducing now-shows at a stroke
11 March 2019 @ 11:15
Quite right Ewan. It’s easy to imagine all sorts of things if there is a willingness to make the investment to achieve them. That’s the bit that is lacking.
I happen to know for example, that breast screening runs off IT systems that are nearly 20 years old, and cervical screening off systems more than 30 years old.
Difficult to see how to move these programmes into the digital age without a big cash injection, but neither NHS England or Public Health England have been willing to do this.
6 March 2019 @ 13:47
I doubt they could make up a more dysfunctional and toxic governance/IT structure than the current arrangement, although I expect if they gave Andrew Lansley a second shot he could come up with something even less likely to deliver coherent services.
You could add to this litany the report from Jo’s Trust in June last year (Computer Says No) that clearly identified looming IT problems in the cervical screening programme and gave a very clear articulation of what women want and expect.
Lots of organisations have been calling PHE and NHS England out on this for some years, whilst they’ve had their fingers in their ears singing la la la and playing pass the parcel. Let’s hope Prof Richards can bang some heads together.