Cancer Reform Strategy - First Annual Report - Merseyside ...

16 CANCER REFoRM STRATEgy3.3 To tackle problems around uptake ofscreening, six Primary Care Trusts (PCTs) havebeen selected to work with the NHS CervicalScreening Programme and the ImprovementFoundation (IF) to develop and test initiativeswhich aim to improve the uptake of cervicalscreening in women aged 25-35 in these localcommunities. They are using social marketingtechniques and, once the different possibleinitiatives have been evaluated, the resultswill be disseminated.3.4 To incentivise services to encourage highercoverage, the decision has been taken to havea tariff for cervical screening (along with breastand bowel screening).3.5 To help reduce the time taken to getresults back to women, guidance to the NHSon achieving the 14-day turnaround timewas issued in April 2008, in preparation fordelivering the required turnaround by 2010. NHSImprovement is now working with ten areason how best to streamline the pathway frominitial test to getting the results. This is part of athree-year programme of work which will involveimprovements across the whole of the cervicalscreening pathway to enable women to get theirresults sooner.3.6 As the CRS reported, prior to theintroduction of new technology (liquid basedcytology – lBC), rates of inadequate sampleswere over 9% resulting in about 300,000women a year being screened again. In october2008, rollout of lBC across the country wascompleted. As lBC was rolled out, the rateof inadequate samples has fallen every yearand is now at a record low of just under 3%or fewer than 100,000 women (last year’sfigure was 4.7%). This means that in 2007/08,200,000 women did not have to have a repeattest because their original sample could notbe read, with all the anxiety that entails.3.7 In terms of making the best use of newtechnologies, we have now moved forwardinto the implementation phase of HumanPapillomavirus (HPV) triage for women withborderline and low-grade abnormalities usingHPV testing. Work has begun in six screeningservices. We will be able to deliver healthservices targeted more appropriately, reducingthe need for significant numbers of repeat tests.Improving breast screening3.8 The CRS set out plans to maintain andextend this country’s excellent record on breastscreening.3.9 In terms of the age extension of breastscreening to women aged 47-73 years,arrangements have been made with six breastscreening centres to pilot the rollout. Activitywill commence in these sites from January2009. These areas will meet strict quality andperformance criteria and will also act as alearning platform to enable remaining servicesto model their rollout plans.3.10 The NHS is committed to conversion todirect digital mammography for use throughoutthe NHS Breast Screening Programme. Thisequipment is now available in a number of sitesand a national framework agreement has beennegotiated to enable easier acquisition of thisequipment by the remaining services. Advice tothe service on digital mammography and all theCRS breast screening initiatives will be issuedshortly. The CRS Advisory Board has expressed itsconcern to ensure that the funding provided fordigital mammography is used for that purpose,and the Board will be considering progress withits introduction in the Spring of 2009.3.11 The following are being taken forwardto improve surveillance of women identified asbeing at high risk:• guidance on quality assurance for magneticresonance imaging (MRI) is in developmentby the Royal College of Radiologists Breastgroup and the NHS Breast ScreeningProgramme Quality Assurance Radiologistsgroup: this will include good practicestandards to be achieved and workloadcriteria• a functional specification is being preparedfor a new module on the National BreastScreening System in order to managethese women