BOARD MEETING 25 JUNE 2014 AGENDA ITEM 3.4 UPDATE REPORT: POPULATION SCREENING PROGRAMMES IN POWYS Report of Director of Public Health and Strategic Planning Paper prepared by Purpose of Paper Principal Public Health Practitioner Director of Public Health and Strategic Planning This is a briefing report on the delivery of population screening in Action/Decision required The Board is asked to note the content of this report Link to Doing Well, Doing Better: Standards for Health Services in Wales : Link to Health Board s Annual Plan Acronyms and abbreviations This paper supports Standards 1, 2, 3, 6, 7, 8, 11, 12, 13, 14, 18, 19, 21 Improving Health and Wellbeing Breast Test Wales (BTW) Newborn Hearing Screening Wales (NBHSW) Abdominal Aortic Aneurysm (AAA) Page 1 of 5
1 Purpose POPULATION SCREENING PROGRAMMES IN POWYS Population screening programmes in Wales are led and managed by the Screening Division of Public Health Wales. This briefing report is based on the most recent screening performance update report provided for by Public Health Wales (, Public Health Wales, April 2014). The data used in this Board report was provided by the Screening Division of Public Health Wales (unless otherwise stated). 2 Background The Board last received an update on screening programmes in in June 2013. The Board also received a briefing report on revisions to the national screening programme for Down s Syndrome in October 2013. Under the national leadership and direction of the Director of the Screening Division of Public Health Wales, the five population-based national screening programmes reported in this briefing are: Breast Test Wales Cervical Screening Wales Bowel Screening Wales Newborn Hearing Screening Wales The Wales Abdominal Aortic Aneurysm Screening Programme The Public Health Wales Screening Engagement Team works across these national programmes to engage with the public on screening and to facilitate informed choice by the population of Wales. The Team also works in partnership with the local public health teams to ensure that messages are locally tailored and coordinated. 3 Breast Cancer Screening The aim of the breast cancer screening programme is to reduce the mortality from breast cancer through earlier detection. Currently, eligible women aged 50-70 years are invited for breast screening every three years (the round length of the programme); women over the age of 70 years can self refer to the programme. Breast Test Wales (BTW) has now become the first fully digital breast screening programme in the United Kingdom. The national uptake target for the breast screening programme is 80%. The uptake of breast screening in in 2012/13 was 74.1%, an improvement on 2011/12 (68.3%) and higher than the Wales average (71.5%). Page 2 of 5
Public Health Wales has not identified any -specific issues in its most recent report. Table 1: Breast Screening (1 April 2012-31 March 2013) 4 Cervical Cancer Screening The aim of cervical screening is to reduce the incidence of and morbidity and mortality from invasive cervical cancer. Changes have been made to programme delivery following an announcement by the Health Minister in February 2013, which was based on recommendation from the UK National Screening Committee and the Wales Screening Committee. Prior to September 2013, women aged 20-64 years were invited for screening every three years. From September 2013, women aged 25-50 years are invited every three years; women aged 50-64 years are invited for cervical screening every five years. The national target (for the period of this report) was that 80% of eligible women should be screened. Local uptake in 2012/13 was 79.9%, higher than the rate achieved across Wales (76.2%) and the same as the rate in the previous year. Table 2: Cervical Screening (1 April 2012-31 March 2013) There are a number of current national issues. A cervical screening Wales modernisation project was established in April 2013 to manage future changes to the programme, including implementation of human papilloma virus (HPV) testing, replacement of the programme s information management system and implementation of an improved colposcopy imaging system. With reference to HPV testing, there is significant evidence that HPV testing within an organised screening programme is more effective (in the prevention of cervical cancer) than cervical cytology screening alone; this is now being taken forward across Wales. No local issues were highlighted in the most recent report from Public Health Wales. There have been some recent improvements in local colposcopy services, including Page 3 of 5
development of the colposcopy service in Newtown (which was reported as work in progress in the last Board briefing). 5 Bowel Cancer Screening The aim of the bowel screening programme is to reduce mortality from bowel cancer amongst men and women through earlier diagnosis. The uptake target is for 60% of the eligible population (adults aged 60-74 years) to have a validated test result in the screening round. In 2012/13, the uptake in was 50.9%, a small deterioration from the previous year (51.1%) but better than the rate across Wales (48.2%). Table 3: Bowel Screening (1 April 2012-31 March 2013) There are a range of national issues, including a programme of work to improve uptake (which will encompass ), a national service improvement plan for screening colonoscopy services (which is also a local issue) and establishment of a multidisciplinary team and national referral centre for the management of complex colorectal polyps. 6 Newborn Hearing Screening The aim of the Newborn Hearing Screening Wales (NBHSW) programme is to identify babies with significant hearing loss, which is of sufficient severity to cause or potentially cause a disability. Following screening, babies requiring further assessment receive specialist audiological review in local services. Babies who are confirmed to have significant hearing loss should receive support from local multidisciplinary teams, including paediatric and audiological input. The minimum standard is that 95% of eligible babies are screened. Table 4 summarises performance in 2012/13. Table 4: Newborn Hearing Screening (1 April 2012-31 March 2013) Current national issues and developments include succession planning for the programme s professional leads and improvements in quality assurance Page 4 of 5
arrangements. The most recent report did not highlight any specific local issues in. 7 Wales Abdominal Aortic Aneurysm (AAA) Screening Programme The aim of the AAA screening programme is to reduce AAA related mortality - by up to 50% by 2025. The screening programme is based on a single ultrasound measurement of the aortic diameter in 65 year old men. The test is delivered in a variety of community venues, including community hospitals, health clinics and GP practices. Men are either discharged from the programme, remain under clinical review or receive surgical intervention. The AAA screening programme was launched in Wales April 2013, with a target uptake of 80% of invited men to attend for screening. Annual performance and outcome data are not yet available. However, the most recent report did not highlight any specific local issues with the programme. 8 Recommendations The Board is asked to note the content of this report. Report prepared by: Nicola Gordon Principal Public Health Practitioner Dr Catherine Woodward Director of Public Health and Strategic Planning Presented By: Dr Catherine Woodward Director of Public Health and Strategic Planning Background Papers Financial Consequences As summarised in the report None specific to the report Other Resource Implications None specific to the report Consultees None specific to the report Page 5 of 5