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NHSE to take over screening programmes from PHE

Public Health England is to be stripped of its responsibility for the national cancer screening programme, the government has confirmed

Health and social care secretary Matt Hancock confirmed 16th October 2019 the programme, responsible for 10 million scans a year, would become the responsibility of NHS England.

Mr Hancock said PHE would continue to “host world-class scientific and expert advice on screening, building on its current role as host of the UK national screening committee. This expert advice will inform the delivery of national screening services by the NHS.”

He made the announcement as Sir Mike Richards’ review of adult screening programmes was released. It came in response to a number of prominent failures of national screening programmes, with disputes about responsibility and accountability.

Sir Mike said screening programmes save roughly 10,000 lives a year but the way accountability was currently structured “creates confusion, delays and risks to patient safety”.

He recommended: “Following decisions by ministers, NHSE should assume sole responsibility for the delivery of screening programmes, appointing a named director responsible for screening, so that it is clear to all stakeholders who is in charge.

“This should include both the implementation of ministerial decisions on screening and ‘business as usual’ matters, including commissioning, performance management, monitoring and audit.”

The national proactive screening programmes include programmes for abdominal aortic aneurysm, bowel cancer, breast cancer, cervical cancer, and diabetic eye screening. It costs an estimated £600m a year.

NHS England chief executive Simon Stevens said: “I’m grateful to Sir Mike for taking on this important assignment. His sensible recommendations keep all that is good about NHS screening services, while rightly setting out a blueprint for more convenient access, upgraded technology, and progressively more tailored approaches to early diagnosis.

“He is also right to point to the need to align the expert advice offered to the NHS, and streamline and simplify accountabilities for operational delivery.”

Sir Mike’s report said there would “inevitably” be “finance and resourcing implications and will need to be assessed in light of available funding resources”.

It added: “Screening programmes are constrained by the size and nature of their workforce, and the equipment and facilities available to them.”

Earlier this year, Macmillan Cancer Support published an assessment putting the UK at the bottom of the table for cancer outcomes in rich nations, saying a failure to recruit enough staff meant it would miss its 2028 target to catch 75 per cent of all cancers in stages one or two.

The screening quality assurance service, part of PHE, should also move to NHSE, the review said, but it should be ring-fenced and made to share its reports with the Care Quality Commission.

Sir Mike added NHSX should take responsibility for overhauling the IT for cervical and breast cancer screening programmes, plus “a roadmap for the delivery of new targeted and population screening IT systems as soon as possible”.

He also urged Health Education England to make the training of colonoscopists a “very high priority”.

PHE chief executive Duncan Selbie said: “We are delighted that the government has confirmed that PHE’s role in NHS screening services will be enhanced playing to our core strengths as expert, scientific advisers.”