NHSX reports progress in screening transformation

The National Health Service’s digital unit, NHSX, has provided an update of how it is transforming screening in England with digital technology following a major review that found a number of issues with the programmes.

Geraint Lewis, the senior responsible officer for the digital transformation of screening at NHSX, said the organisation has begun work to address the recommendations about screening IT systems outlined in the independent report of adult screening programmes by Mike Richards, published in October 2019.

Recent work has focused on bringing efficiency to the IT systems that underpin screening, which have been unfit for purpose since 2011 and are unconnected, resulting in reductions in the uptake of screening and incidents such as nearly 500,000 women missing their breast cancer screenings, some of whom say they have “had their lives shortened”.

To address the issues, the team at NHSX aims to create systems that identify people who are eligible for screening, then manage the screening journey effectively, from testing through to diagnosis, treatment, results and follow-up, then collect and collate data on results on outcomes of screening, for use by individuals as well as the health system.

Lewis said in a blog post: “[The IT systems underpinning screening] are a cause of duplication of effort and expenditure, and they lead to frustration among screening participants and staff. Over the next few years, the digital transformation of screening programmes will upgrade this technology to modern standards.”

As part of the work carried out so far, Lewis noted that NHSX used agile methods to consolidate the discovery work that has been completed on breast screening and cervical screening.

NHSX is setting out a roadmap to deliver new screening IT systems and improve access to screening, including through using text messages. It is also developing a new call/recall system for cervical screening.

Recent progress around screening achieved by NHSX includes a discovery on the data and technology requirements that will be needed to support targeted screening. This is where screening is offered to people at higher-than-average risk of developing the disease or condition for which they are being screened.

The approach being used to revamp screening is based on the technology vision set out by the Department of Health and Social Care, which has open standards, secure identity and interoperability as core principles.

For example, the team will focus on using existing digital components already developed elsewhere in government, such as Gov.UK Notify and the NHS eReferrals Service. Lewis said the team will also seek to reuse any components developed for one screening programme in other screening initiatives.