NHS Bowel Cancer Screening Programme

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NHS Bowel Cancer Screening Programme Wolverhampton Bowel Cancer Screening Centre Annual Report April 2016 to March 2017 @RWT_NHS

Introduction Bowel cancer is the fourth most common cancer in the UK after breast, prostate and lung cancers. Over 41,200 people are diagnosed with bowel cancer every year in the UK. There are more than nine out of ten new cases (94%) diagnosed in people aged over 50, and almost six out of ten cases (59%) are diagnosed in people aged 70 or over. However, bowel cancer can affect any age. Bowel cancer is not gender specific with 1 in 14 men (7%) and 1 in 19 women (5%) being diagnosed with bowel cancer during their lifetime. Around 268,000 people living in the UK today have been diagnosed with bowel cancer, but it is treatable and curable, especially if it s diagnosed early. More than nine out of ten people diagnosed with stage 1 bowel cancer survive five years or more after diagnosis. However this drops significantly as the disease develops. There is only a small chance that bowel cancer will come back after five years. Almost 16,000 people die from bowel cancer in the UK every year. It is the second most common cause of cancer death in the UK, behind lung cancer. Nevertheless, the number of people dying of bowel cancer has been falling since the 1970s. This may be due to earlier diagnosis and better treatment. 1 Bowel Cancer Screening Service 2016/17 The Wolverhampton Bowel Cancer Screening Centre is based at New Cross Hospital, Wolverhampton and covers the eligible population of Wolverhampton, Dudley, Walsall, and the Seisdon peninsula of South Staffordshire. This takes in a total population in excess of 900,000. The colonoscopy screening and bowel scope procedures are completed at New Cross Hospital, Wolverhampton and Russells Hall Hospital, Dudley. The team is led by Bowel Cancer Screening Clinical Director, Dr Andrew Veitch, who is supported by accredited screening Endoscopists, Endoscopy Nurses and Specialist Screening Practitioners (SSPs). The service is run in 1 https://www.bowelcanceruk.org.uk/about-bowel-cancer/bowel-cancer/ [accessed 19 September 2017]

accordance with the National Bowel Cancer Screening QA, maintaining timescales and contact time within National Cancer Pathways. In addition to this, SSPs participate in health promotion activities. Extension of Service The Royal Wolverhampton NHS Trust is proud to announce that the NHS Bowel Cancer Screening Programme for the population of Cannock is being transferred from University Hospitals of North Midlands from April 2017. The transition is almost complete and will enhance access to the service for Cannock residents. Bowel Cancer Screening, using the Faecal Occult Blood Test (FOBT), will continue to be offered to men and women between the ages of 60-75, and we are now delighted to be able to offer the Bowel Scope service from April 2017. This will truly be a local service for local people. Quality Assurance Visit During April 2016, the quality assurance (QA) review of the Wolverhampton and Dudley Bowel Cancer Screening Programme (BCSP) was carried out. The aim of quality assurance in NHS screening programmes is to maintain minimum standards and promote continuous improvement in bowel screening. This is to ensure that all eligible people have access to a consistent high quality service wherever they live. QA visits are carried out by the Public Health England screening quality assurance service (SQAS). We are pleased to report that the visit was successful and there were no immediate recommendations, ensuring that our patients receive the highest quality of care. The Screening Centre Team The colonoscopy screening and bowel scope procedures are completed at New Cross Hospital, Wolverhampton and Russells Hall Hospital, Dudley. The team is led by Bowel Cancer Screening Clinical Director, Dr Andrew Veitch, who is supported by

accredited screening Endoscopists, Endoscopy Nurses and Specialist Screening Practitioners (SSPs). Meet the Bowel Cancer Screening Team at New Cross Hospital: Dr A Veitch Dr B McKaig Dr A Murugananthan Dr M Brookes And the Bowel Cancer Screening Team at Russells Hall Hospital: Dr S Shetty Dr S Ishaq

Organisation Chart New Cross Hospital

Organisation Chart Russells Hall Hospital

Bowel Cancer Screening Service The NHS Bowel Cancer Screening Programme offers screening every two years to all men and women aged 60 to 74 who are registered with a GP. It aims to detect bowel cancer at an early stage in people with no symptoms when treatment is likely to be more effective. Residents in this age group will automatically be sent an invitation through the post, followed by their screening kit, so they can complete the test in the privacy of their own home. The GP records provide the contact details, so it is important that they are kept up to date with any changes. The Faecal Occult Blood test or FOB (occult blood means hidden blood) does not diagnose bowel cancer, but the results will tell whether an examination of the bowel is needed. The procedure is called a colonoscopy and can detect bowel cancer in people that have no symptoms. When diagnosis is made early, before it has had a chance to spread, bowel cancer can be cured in over 90% of cases. The later a diagnosis is made, the more difficult bowel cancer is to treat. Screening can also detect polyps, which are not cancers, but may develop into cancers over time. They can be easily removed at a screening colonoscopy, reducing the risk of bowel cancer developing. In June 2016, Wolverhampton Bowel Cancer Screening service celebrated its 10 th anniversary of bowel cancer screening. One of our first screening patients attended the unit to help celebrate the occasion. Since inception, we have invited 633,699 to participate. A total of 334,407 have completed the FOBt kit and over 500 cancers have been identified. Whilst uptake of Bowel Cancer Screening is starting to increase there is still room for improvement. We could save even more lives from bowel cancer if more people used the home test kit when invited.

Bowel Cancer Screening Activity Indicators Targets 2015/16 (previous full year) 2016/17 BCSP Uptake (Age 60-74 years) 52% Invited Attended % Uptake Invited Attended % Uptake Percentage of people adequately screened out of those invited for FOBt screening. Wolverhampton CCG 17921 8723 48.67% 18713 9819 54.47% Dudley CCG 24490 13352 54.52% 26678 15660 58.70% Walsall CCG 20203 10123 50.11% 19594 10657 54.39% South Staffs CCG 5678 3444 60.66% 6634 4286 64.61%

Patient Experience Thirty days following the colonoscopy, a patient questionnaire is produced and sent out. The overall response rate across both sites between April 2015 and March 2016 was 74%. Encouraging results for the FOBt kit were: 97% of patients found the test kit instruction was helpful Test Kit Instruction Leaflet was helpful 2% 0% 1% Strongly disagree 45% 52% Neither agree nor disagree Agree Strongly agree 94% of patients found the FOBt kit easy to use 1% 2% 45% I found the test kit easy to use 1% 2% Strongly disagree Disagree 49% Neither agree nor disagree Agree Strongly agree Left blank A selection of comments on questionnaires from patients scoped at New Cross Hospital and Russells Hall Hospital are below:

The care I had was excellent and wouldn t be scared to the procedure again. I would like to thank you so much. Well done and thank you. I cannot fault the screening programme from start to finish. Staff were excellent and very professional. I was so relaxed. I don t remember anything that happened to me! Thank you very much, well done. The car parking at New Cross was awful! If you would like a copy of the audit, please contact us on 01902 695193, and we will be happy to post or email to you. Bowel Scope Service NHS Bowel Scope Screening is a test offered to all men and women aged 55, which looks inside the lower bowel. The aim is to find and remove any small growths, called polyps, in the bowel that could eventually turn into cancer. The Wolverhampton Screening Centre is the first site in the country to offer this new preventative service to the whole of its local population, of which we are very proud. The screening centre at Wolverhampton has managed to maintain this unique position since full roll out in June 2015. The service is now in its 4 th year and more than 14,000 patients have been screened across the catchment area. As with the Bowel Cancer Screening service, uptake remains low.

Bowel Scope Screening Activity CCG Table 1: Breakdown by CCG 2015-2016 Subjects Invited Number Attended Number Responded Initial Response Rate % Actual Uptake % Cannock Chase CCG 41 19 23 56.10% 46.34% Dudley CCG 4183 1725 2057 49.18% 41.24% South East Staffs & Seisdon 801 352 422 52.68% 43.95% Stafford & Surrounds 143 75 87 60.84% 52.45% Walsall 3223 1204 1449 44.96% 37.36% Wolverhampton 3043 1230 1448 47.58% 40.42% Total 11434 4605 5486 47.98% 40.27% CCG Table 1: Breakdown by CCG 2016-17 Subjects Invited Number Attended Number Responded Initial Response Rate % Actual Uptake % Cannock Chase CCG 178 86 101 56.74% 48.31% Dudley CCG 4064 1701 2060 50.69% 41.86% South East Staffs & Seisdon 863 426 495 57.36% 49.36% Stafford & Surrounds 167 92 103 61.68% 55.09% Walsall 3607 1354 1656 45.91% 37.54% Wolverhampton 3299 1408 1660 50.32% 42.68% Total 12178 5067 6075 49.89% 41.61%

Patient Experience Bowel Scope This year, the service undertook a survey to establish why patients choose to attend or not to attend their screening and to identify where they would like to receive more information regarding the programme The services handed out 160 questionnaires following the bowel scope procedure, 102 (64%) were returned. Results revealed: The top three reasons why people choose to attend: 100 90 80 70 60 50 40 30 20 10 0 For peace of mind To detect & treat any changes early Concerned for own health Series1 When asked where would you like to find out more about NHS Bowel Cancer Screening, the responses were: 160 140 120 100 80 60 40 20 0 Series1

Health Promotion The Screening Programme has continued to actively promote the bowel cancer screening programme throughout the year. This included regular posts on social media, press articles, attendance at GP patient forums and education sessions, attendance at Practice Manager Meetings and promotional events across both sites. Additionally we have been working closely with Walsall CCG Pilot Group to support those practices with the lowest uptake. The service celebrated 10 years of the Screening Programme in June 2016. We invited the first patient to be screened to a celebratory event held at the Endoscopy Unit, photographs and the patient story was then published in the Express and Star and local Chronicle. Future service development As of April 2017, The Royal Wolverhampton NHS Trust is proud to announce that it will be extending its Bowel Cancer Screening Programme of FOBt and Bowel Scope to the population of Cannock. Conclusion Bowel Cancer Screening continues to expand to capture and encourage participation within the catchment area. It continually meets the challenges of capacity to maintain parameters set by QA standards. Increase in promotional activities and education continues to help raise awareness of the service and also of prevention. We continue to build good relations with our CCG partners and GP surgeries to promote the benefits of screening which should increase the number of people who take part.