There has been media coverage today on the BBC (both on radio and on their website) about delays in the reporting of cervical cytology screening samples.
http://www.bbc.co.uk/news/uk-england-40686393. This highlights that an increasing number of women are not receiving their result letter within the target time of 14 days from sample being taken for 98% of samples. The reports seem to be based on the 2015-16 English statistical returns, and hence relate to the English cervical screening service up to 31st March 2016. As such, the data is not up to date, and many of us are aware that the situation has got worse and for many seems to show no likelihood of improving in the near future. The article on the BBC website, with quotes from several sources, highlights that the main issue is one of low staff numbers and laboratory capacity. This has been brought into sharp focus with the intended switch to Primary HPV cervical screening in 2019. Many of us are acutely aware of the issue of limited laboratory capacity. PHE has published a mitigation plan to try and assist those laboratories with significant backlogs, but the capacity for this is currently very limited, and is highly unlikely to be able to address the needs for extra capacity across the whole of England. In the absence of any other current strategy to help reduce demand or increase laboratory capacity, it is difficult to see this situation improving until Primary HPV screening is rolled out across England. Plans for Wales and Scotland are well advanced. The plan for England is still in development, and the latest news on this is shown below, in a communication from Alison Cowie, Programme Lead, NHS England - Public Health Commissioning Central Team in response to an email from the BAC and which has been sent to others in the programme:
Thank you for your email on the 12th July 2017, regarding the implementation of HPV as the primary screen within the Cervical Screening Programme I wanted to provide you with a further update on the programme plan following the latest HPV Primary Screening Receiver Board, which was held on Thursday 13th July 2017.
The board considered and agreed a revised project plan which covers the key milestones and decision making required in respect of commissioning the cervical screening services. Following discussion of the options appraisal internally within NHS England, we have been challenged to ensure that wider pathology reforms are considered within our deliberations. As you will see from the table below, there is a significant refocus on engagement with local commissioning teams in relation to the development of the commissioning and procurement strategies, as it was felt that further work was required to identify and understand the current position regarding laboratory configuration and networks, local pathology strategies, the existing contractual frameworks and to begin the discussions around pricing and tariffs. The local knowledge and intelligence gathered via this engagement with local teams will allow for recommendations and decisions to be based on what will operationally work on a local and regional level; it will also inform any future commissioning and procurement arrangements. Therefore, we have had to revised our plans.
The following table details the various work streams and timescales which are required to deliver the changes in line with the recommendation made within the Cancer Strategy for England 2015-20, that there should be national coverage of HPV as a primary screen across the cervical screening programme by 2020.
|Development and approval of a commissioning strategy||June – September 2017|
|Development and approval of a procurement strategy||June – September 2017|
|Pricing/tariff development||June 2017 - TBD|
|If commissioning strategy determines, procurement processes and/or contracting processes undertaken.||
September 2017 – December 2019
(contract commencement taking place between April and December 2019)
|Full national implementation and coverage of HPV Primary Screening by December 2019|
We completely acknowledge and appreciate that the revised plan does not necessarily correlate with previously agreed timescales for key decisions and that this may cause further frustration amongst your members, however we’re confident that the revised plans will ensure that the commissioning and procurement strategies are reflective of local arrangements and will support the safe and effective implementation of HPV Primary Screening into the Cervical Screening Programme. I appreciate how this is a difficult time for both commissioners and providers locally. As you are aware, work is ongoing nationally around mitigation in order to reduce TAT backlogs. A Risk Summit during the summer is planned between NHS England and PHE to firm up other options to aide mitigation. We will inform our local Heads of Public Health Commissioning of the outcome and ask that they cascade to local providers.
If you do have any questions or queries on anything contained within this email, please do not hesitate to contact me.
We will continue to share what news we have, and get more answers to legitimate questions and concerns from us as professionals, many working in the cervical screening programme.