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Tackling screening inequalities in Merseyside

My name is Marie Coughlin and I work for Public Health England (PHE) as a screening and immunisation manager covering Cheshire and Merseyside.

Between 2014 and 2017 I was the lead officer for the Merseyside Cancer Screening Plan, which was  a period of my career I'm very proud of.

We've been told how our plan has helped to raise awareness of screening, particularly within vulnerable and hard to reach groups.

We are planning a number of blogs about the Merseyside work over the next few months but for this first one I want to give you a bit of background about the project and share some of the insights we gained.

The situation in Merseyside

Merseyside has a population of 1.25 million people with large pockets of deprivation with health inequalities between local areas.

Incidence rates for bowel, breast and cervical cancers are higher than the national average and cancer screening takeup is lower.

The aim of the cancer plan was to reduce screening inequalities in the 3 cancer screening programmes (bowel, breast, cervical) across Merseyside. Our work was in line with principles of informed choice - providing support to people or groups who are not able to access screening as readily as others.

NHS England North, Cheshire and Merseyside funded the plan with an investment of £150,000 and health partners from across Merseyside were involved, including:

  • NHS England
  • local authorities
  • Clinical Commissioning Groups (CCGs)
  • Cancer Research UK


As part of the plan, we:

  • developed a communications strategy to underpin and run alongside our plan
  • offered education sessions to general practice staff and learning disabilities teams
  • ran awareness raising sessions across Merseyside

The awareness sessions were delivered in pharmacies, with pharmacy staff using their everyday interactions to champion screening.


Overall the plan was successful and positively impacted on cancer screening rates:

  • bowel cancer screening coverage rates increased in 3 of the 6 CCGs
  • breast screening coverage rates increased in 4 of the 6 CCGs
  • cervical screening coverage rates increased in 3 of the 6 CCGs
  • screening rate increases were seen in many GP practices where projects were targeted

Of course, not everything went smoothly and we faced a number of challenges. These included funding and changing priorities of partner organisations and colleagues. Some colleagues also moved to new roles.

But there were a few things we felt were important to our success. These included:

  • having a clear plan of work
  • developing a memorandum of understanding signed by all health care partners so everyone had a clear commitment to the plan
  • establishing a task group to keep momentum going

Many stakeholders felt that our multi-targeted approach was effective in raising awareness of screening, particularly within vulnerable and hard to reach groups.


The response to the strategy was great. Here are just 3 of the positive comments we received:

I thought it was great and there is now a real opportunity to share this work in other areas.

Membership on the task group was really good - there was good buy-in from all the agencies.

You achieve results when everyone is working together.

It was also nice to get some recognition in the form of awards! These included:

  • a certificate of outstanding contribution as part of PHE’s fire and rescue safe and well visits
  • a healthcare transformation award for improving cancer outcomes as part of the safe and well project
  • a certificate of outstanding contribution for our cancer screening cards and leaflets

All stakeholders agreed that the cancer screening plan should be continued, focusing on those initiatives which demonstrated the strongest evidence base.

If you're interested in finding out more you can find our engagement and impact report online. Please also keep an eye out for future blogs about our work in Merseyside.

Screening inequalities

As many of you will know, earlier this year (2018) PHE published its screening inequalities strategy.

Screening and immunisation teams (SITs) lead this work to tackle inequalities locally – working with screening providers.

Part of PHE's approach is to share local learning and experience and put you in touch with people undertaking similar projects.

PHE Screening blogs

PHE Screening blogs provide up to date news from all NHS screening programmes. You can register to receive updates direct to your inbox, so there’s no need to keep checking for new blogs.

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