Dr Wilkinson gave an overview of Breast Screening for women aged 50-70 years. She reported that there are ten screening sites in South West London as women should not be more than thirty minutes away from a screening centre. Uptake of breast screening tends to be lower in inner London and higher in the suburban areas. The South West London uptake rate is 65% which is higher than the average for an outer London area.  There is a link between low uptake and people who live in deprived areas. In South West London a higher level of cancer is detected than in London generally and around 5% of people are called back for further tests.

Dr Ruwende  said Bowel and Cervical Cancer is screened  in General Practice. The national target is 80% In South West London screening rates have increased from 67% -73% which is above the London average of 70%. There are significant variations between practices. There has been a 5% increase in bowel cancer screening, again with significant Practice variation.

There is lower uptake amongst younger people and those in deprived wards.

In terms of improving uptake it was reported that NHS England support providers such as St George’s hospital, who  text people offering scheduled appointments and send reminder letters. They also work with Age UK and other voluntary organisations to try and improve take up.

Action by individual practices can also have a significant impact. Therefore they are developing a good practice guide for all practices called an ‘Uptake and Coverage Strategy’.

A panel member said she tried unsuccessfully to book a test on line and then was not able to re-schedule the appointment. Dr Louise apologised to the councillor for their experience and said the service has now been improved and should be more robust. 

A panel member asked if screening  within the wider age range  results in higher cancer detection rates. Dr Wilkinson said there is an on-going debate in the media about whether screening is effective. A pilot is being run on the effects of screening the wider age range and results will be available from 2020.

 A panel member asked the length of time a patient would have to wait between the detection of an abnormality and being seen by a consultant. Dr Ruwende said it would depend on the severity but is likely to be three weeks for breast screening and six weeks for bowel and cervical.

A panel member asked why cervical cancer is on the increase and if this is due to higher levels of screening. Dr Ruwende said this is a trend across the country particularly within the younger ages groups, we are not sure why this is but is likely to decline because the HPV vaccine.

A panel member asked what we are doing to address the link between low uptake of immunisations and deprivation. Dr Wilkinson said  Pan London commissioning was having an impact , as well as letters from GP’s, texting women,  second  appointment. In South West London nursing staff go into the practice to help with uptake, they hold health open days, give out information at supermarkets. Incentivising GP’s may also help to improve take up.

The Chair said all the information in the report is open interpretation, we need to look at why we are falling short of the target, what are we doing in the East of the borough, are you providing information in different languages? are you using social media to contact young people.? He further stated that he is deeply saddened that we are so far from the national targets. We could reach younger people at the school gates we need to be creative in our thinking. We need to provide the right material in the right languages.

The Director of Public Health said the public health team try to fill in some of the gaps locally by using community health champions and the health guide, which provides basic information to communities. The team  go to locality meetings and challenge GPs with comparative data on take up rates. The Public health team have also developed a set of top tips on the basic things they should be doing to improve uptake of immunisations.

Dr Wilkinson said there is an Early Indications and Management Group and are working with the CCG on a cancer action plan.  There is also a pilot with NHS England on providing more support for people who have received the kit but not completed the test.

Dr Ruwende agreed that it s important to meet the national  targets although there are many determinants which are outside the scope of their team so they are working with providers to implement good practice which will help in reaching the  national targets. A leaflet is provided in a common non English language, although this cannot cover all languages, and will not support those who have low levels of literacy.

A panel member said she found the bowel screening test unpleasant. The Chair said we need to talk to people about the consequences of not doing it. Dr Ruwende said the unpleasantness of the test can put people off, the pilot is looking at ways to support people such as offering gloves.

Resolved

Officers were thanked for their work and for attending the Panel meeting.