Committee finds that DHSC is ‘losing its grip’ on screening programmes

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The Department of Health and Social Care is “losing its grip” on health-screening programmes designed to identify some of the biggest killer diseases at the earliest – and most treatable – stages, a new report has warned.

Parliament’s Public Accounts Committee said their study of four of the 11 health screening programmes operating in England – bowel, breast and cervical cancers, along with abdominal aortic aneurism – found none met targets for checking eligible members of the public.

The committee singled out as a key shortcoming the continued use of an IT system that had been “unfit for purpose for screening programmes since 2011”, but which had not been replaced. This meant health bodies had to carry the “constant risk” that target candidates for checks were being missed, MPs found, adding that the “woeful inadequacy” of the IT supporting breast screening has played a fundamental role in the failure of the screening programme. 

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It said DHSC accepted that the pan-service suite of software – known as NHAIS, short for National Health Application and Infrastructure Services – was “not fit for purpose” as far back as eight years ago but was not due for replacement until 2020, three years later than planned.

The report said NHS England had decided that it could no longer work with Capita, its original partner, on the project and that NHS Digital would take on responsibility for replacing NHAIS.

It warned that until the system was replaced a risk remained that that more people would not be invited for screening when they should be. 

The report, which looked at 2017-18 screening results for the four programmes, identified that the period had marked a 21-year low for numbers of women screened for cervical cancer. The number of screenings for the year was 3.2m, which represented 71.7% of the eligible population – meaning that 1.2m women had missed out. The screening target is 80%.

MPs also found disparity across the nation in terms of the reach of screening programmes, with areas in the north east “consistently” outperforming parts of London.

PAC chair Meg Hillier said the committee was calling on the department and NHS England to set out a plan of action to better hold local screening providers to account, overhaul governance arrangements and develop an IT system that worked properly. 

“Millions of people are not being screened for serious illnesses like bowel, breast and cervical cancer,” she said. “Our inquiry has exposed a health service that is losing its grip on health screening programmes. Many individuals waiting for delayed results will suffer avoidable anxiety, stress and uncertainty. Those delays also stretch far beyond the department’s target waiting periods.”

Hillier added: “The government’s understanding of variation across the country and the barriers facing different demographics of the population is patchy at best, which constrains their capacity to act. Ultimately, this is a question of health equality. The government has a duty to ensure that everyone has access to health screening.”

A DHSC spokesperson said 11m people a year benefited from the NHS’s world-class screening programmes and record numbers of people were receiving life-saving NHS treatment.

“Although we await further recommendations from the Sir Mike Richards Review of national screening programmes, we are pushing ahead with important changes to help detect as many cancers as early as possible,” they said. “Under the Long Term Plan for the NHS – backed by an extra £33.9bn a year by 2023-24 – patients with suspected cancer are beginning to receive a diagnosis or the all clear within 28 days, and the NHS in England is investing £200m to fund new ways to rapidly detect and treat cancer.”

DHSC said it expected results Richards’ review to be available this summer.