NHS Bowel Cancer Screening Programme in Merseyside: Till Receipt Awareness Campaign in 2014 Screening & Imms Team\Cancer Screening\2-Year Plan for Uptake Rates\BCSP Till Receipt Campaign Mar-Jun14.docx 1
NHS Bowel Cancer Screening Programme in Merseyside: Till Receipt Awareness Campaign in 2014 Version number: 3 First published: February 2015 Prepared by: Marie Coughlin, Screening & Immunisation Manager Merseyside Screening & Imms Team\Cancer Screening\2-Year Plan for Uptake Rates\BCSP Till Receipt Campaign Mar-Jun14.docx 2
1.0 Introduction This paper is written for the Cheshire & Merseyside Sub-Regional Head of Public Health and Director of Commissioning, Merseyside Directors of Public Health and members of the Merseyside Task Group for 2-year Plan to Increase Participation in Cancer Screening. Till receipt awareness campaigns have previously been used in Sefton Primary Care Trust (PCT) and other PCTs pre-april 2013 and are a method of delivering awareness messages directly to the public. It is a marketing channel that is used by a range of customers such as NHS, police and fire services. As part of the 2-year plan to increase participation in cancer screening 2014-16, and one of various work-streams within the plan, it was agreed to utilise this method of awareness raising. Although not previously evaluated when used in Sefton, (or indeed any of the other NHS organisations we contacted), anecdotally it was believed a useful approach. The campaign in Merseyside ran from March 2014 through June 2014. 2.0 NHS Bowel Cancer Screening Programme About one in 20 people in the UK will develop bowel cancer during their lifetime. It is the third most common cancer in the UK and the second leading cause of cancer deaths, with over 16,000 people dying from it each year (www.cancerscreening.nhs.uk). Regular bowel cancer screening has been shown to reduce the risk of dying from bowel cancer by 16 percent and in 2006 the NHS Bowel Cancer Screening Programme (BCSP) was introduced in England. Both men and women aged 60 up to 75 years are eligible for bowel cancer screening and people over 75 can self-refer. An extension of the programme, NHS Bowel Scope Screening, which offers a one-off test to men and women aged 55 years, is currently being rolled out across England. In Merseyside in 2013/14 almost 93,000 men and women were invited for bowel cancer screening with around half of those taking part. Fifty-eight bowel cancers were detected through screening in Merseyside during this time. 3.0 Till Receipt Awareness Campaign in Merseyside Based on evidence that advertising NHS messages is a useful way of raising awareness (www.nhs.uk/change4life), for example Be Clear on Cancer national campaign, it was agreed to repeat the approach in Merseyside and this time, to undertake evaluation. As per the previous arrangement in Sefton, Access Point UK Advertising Company co-ordinated the campaign between the Merseyside Area Team and the retail company, 99p Stores. Four 99p Stores were chosen for the campaign, based on their central locations. It was also agreed to utilise 99p Stores due to their diverse customer group, more so than for instance Morrison s supermarket, where a campaign had previously been held in Merseyside. With a customer profile ranging from mid-20 years to 70 years plus, an exclusive campaign with full colour awareness messages printed on the reverse side of till receipts, was organised for use at the main till banks within 99p Stores in Liverpool Bellevale, Liverpool St Johns, Southport and St Helens. Access Point UK liaised with 99p Stores head office and directly emailed campaign information to store managers. Information included campaign start and end dates and key messages about bowel cancer screening, purely to aid the knowledge base of their staff: About 1 in 20 people in UK will develop bowel cancer It is the second leading cause of cancer death with over 16,000 people dying from it each year Screening & Imms Team\Cancer Screening\2-Year Plan for Uptake Rates\BCSP Till Receipt Campaign Mar-Jun14.docx 3
Regular bowel cancer screening has been shown to reduce the risk of dying from bowel cancer by 16 percent Bowel cancer screening is offered every 2 years to all men and women aged 60 up to 75. Those aged over 75 can self-refer Till staff were briefed on the information and asked wherever possible to ensure the receipt was given to the customer, showing the side of the screening advert facing upwards. Image 1: Till receipt advert Image 2: Campaign costs Description Full art and design service including printing and distribution of receipts to 99p Stores Total Cost Produced by Access Point UK 3,385 + VAT Image 3: Campaign timescales and receipts issued 99p Store Duration of Campaign Number of Receipts Issued Liverpool 14 weeks 70,680 Bellevale Liverpool St 6 weeks 72,966 Johns Southport 14 weeks 68,950 St Helens 11 weeks 70,455 Total Receipts Issued 283,051 Screening & Imms Team\Cancer Screening\2-Year Plan for Uptake Rates\BCSP Till Receipt Campaign Mar-Jun14.docx 4
4.0 Results The till receipt campaign ran from March 2014 through June 2014, with 99p Stores active for different lengths of time, based on the number of receipts produced, thus campaigns in the busier stores ran for a shorter time. The national benchmark of 60 percent uptake has rarely been achieved in Merseyside, be it on a screening centre, CCG or GP practice footprint. For the purpose of comparing uptake rates pre and post the campaign, and taking into account national calculations for measuring uptake, the time periods for comparison were January to September 2013 and January to September 2014. Image 4 below shows uptake rates in the year 2013. Generally to note and throughout the year, uptake had fallen in the majority of CCG areas in Merseyside. This decline is reflected in North West and England figures. Image 4: Bowel cancer screening uptake rates for 2013 by CCG/North West/England CCG Jan-Mar Apr-Jun Jul-Sep Oct-Dec Trend Halton 53.5 51.3 44.3 45.3 Knowsley 47.4 48.1 40.8 43.0 Liverpool 53.0 53.2 37.9 37.4 Southport & Formby 56.2 58.4 52.9 52.5 South Sefton 49.7 52.4 46.4 45.9 St Helens 55.1 54.1 48.1 50.3 North West 55.0 54.4 50.2 48.6 England 58.7 58.1 52.8 51.6 Data provided by: NW BCSP QARC Image 5 below shows uptake data available so far for 2014. In Halton CCG there was an increase of almost 10 percent in the first 3 months of 2014, however this decreases towards July-September. The pattern is the same for Knowsley CCG. In Liverpool CCG again there was an increase at the start of the year, which grew further but dipped in July-September. There are similar patterns for Southport & Formby and South Sefton CCGs. Uptake for North West and England increased at the start of 2014 with a lesser drop, appearing steadier. Image 5: Bowel cancer screening uptake rates for 2014 by CCG/North West/England CCG Jan-Mar Apr-Jun Jul-Sep Oct-Dec Trend Halton 54.9 51.5 48.6 Knowsley 52.3 47.4 46.9 Liverpool 48.4 51.3 46.2 Southport & Formby 59.7 62.1 55.7 South Sefton 51.9 55.4 50.1 St Helens 58.5 57.5 53.2 North West 54.6 56.4 56.1 England 57.9 57.1 58.0 Data provided by: NW BCSP QARC Screening & Imms Team\Cancer Screening\2-Year Plan for Uptake Rates\BCSP Till Receipt Campaign Mar-Jun14.docx 5
5.0 Limitations of the Campaign Because there was no direct association between the campaign and the BCSP (for example, a code to quote from the receipt should a person decide to take part in the programme), it was always going to be difficult to link increases in participation directly with the campaign, thus making the evaluation itself also difficult. 6.0 Problems Encountered During the Campaign Although we had been advised of exclusive rights to the till receipt during the campaign, there was actually another advertisement used at the same time. The advert as shown in image 1 did take up most of the space on the receipt, however it was accompanied by a small strapline advert (www.offer.genie.co.uk a website similar to My Voucher Codes and Groupon). As part of the arrangement, 99p Stores also agreed to provide some basic staff training at the start of the campaign, mostly to increase the knowledge base of their staff. Unfortunately this did not happen due to time constraints within the stores. A final issue was when our mystery shopper visited one of the stores. When they were at the till making their purchase, they were asked by the cashier as to whether or not they wanted the receipt! When challenged over these matters, the advertising company reported that the additional strapline advert would not dilute our message; in fact they advised it could only strengthen the campaign. When asked about staff training, they advised they had no control over staff training. They had no comment to make regarding the mystery shopper. 7.0 Conclusion Even though participation rates in the majority of CCG areas did show increases when comparing the same timeframes between 2013 and 2014, we cannot conclude that this is as a direct result of the till receipt campaign. Equally we also cannot say that the campaign didn t have a positive impact. Till receipt campaigns can be a low cost intervention. The annual contract costs for BCSP screening centres in Merseyside are approximately 1.5m, with the campaign costing just 3,385 + VAT. Should healthcare partners wish to undertake till receipt campaigns in future, it is recommended they pay closer attention to contracting, ensuring all parties are clear on their commitments. A tangible way of linking the receipt to participation rates, wherever possible, is also recommended. 8.0 Further Information For further information please contact Marie Coughlin, Screening and Immunisation Manager: marie.coughlin@nhs.net Screening & Imms Team\Cancer Screening\2-Year Plan for Uptake Rates\BCSP Till Receipt Campaign Mar-Jun14.docx 6