We know inequalities exist in screening and take our responsibility to address them very seriously.
In May 2018, we launched the PHE screening inequalities strategy to:
- reduce inequalities
- ensure equitable access to screening
- support our partners involved in providing screening
Last month, we asked you to complete a short survey to evaluate the strategy and tell us how we can develop and improve it.
Many thanks to the 104 of you who completed the survey. You highlighted some excellent initiatives that are taking place across the country and made some very constructive suggestions. Perhaps most importantly, many of you told us the strategy had helped raise awareness of inequalities generally and encouraged a greater focus on the issue.
What you told us
Most of you told us the strategy has:
- been a positive force for change
- helped to raise the profile and understanding of inequalities
- encouraged the sharing of good practice
However, a significant minority felt there had been little or no change and many of you highlighted issues that make it difficult to address inequalities.
How much has the inequalities strategy been a positive force for change in your work area?
- ‘No change’ – 25% (26 out of 104)
- ‘Little change’ – 27% (28)
- ‘Some change’ – 37% (38)
- ‘A lot of positive change’ – 12% (12)
How helpful has the strategy been in raising the profile and understanding of inequalities?
- ‘Unhelpful’ – 3% (3 out of 104)
- ‘Neither helpful nor unhelpful’ – 35% (36)
- ‘Somewhat helpful’ – 44% (46)
- ‘Very helpful’ – 18% (19)
Your examples of local positive initiatives included:
- working with asylum seeker health care teams
- using social media to raise awareness of screening for trans and non-binary people
- community-focused health awareness events for LGBT and BAME populations
- staff and prisoner healthcare champions in prisons
- health equity audits
- reviewing why people have been excluded from screening
- working closely with learning disability specialist nurses in trusts
Room for improvement
You cited issues that make it difficult to tackle inequalities, which included:
- operational pressures
- lack of resources
- lack of easily accessible data on protected characteristics
- information governance issues
Your suggestions for what you’d like us to do included:
- disseminating strategy and good practice more effectively to local area teams
- better data analysis
- more tangible national tools and resources for local service providers to use to implement change
- creating a shared learning forum
- greater collaboration
Next steps and work in progress
We are keen to keep up the momentum on the inequalities strategy so that all eligible people can access screening if they choose to do so.
We will study your feedback carefully and then aim to focus our efforts on the most effective interventions that will make a real difference.
Ongoing workstreams include rolling out new screening tests that are more acceptable to the public, particularly more vulnerable, underserved populations where uptake is lower. These new tests include the faecal immunochemical test (FIT) being rolled out in the bowel cancer programme and human papillomavirus (HPV) primary screening in the cervical programme.
We will continue to add to our:
- suite of easy read information materials for people with learning disabilities and those who struggle with written English
- national best practice guidance for health professionals
PHE Screening has commissioned an evidence review of strategies to increase screening participation, particularly in underserved populations.
This will build on a rapid review of interventions to improve participation in cancer screening services. Where we have good evidence, we will use this information to refine changes to screening service specifications, standard setting and quality assurance.
We are also piloting programme-specific tools to support important lines of inquiry about inequalities during screening quality assurance service (SQAS) visits.
Later this year we will be holding a national inequalities conference for experts and those responsible for providing screening.
PHE Screening resources
Easy guide information materials:
- AAA screening easy guide
- Bowel cancer screening easy guide
- Bowel scope screening easy guide
- Breast screening easy read
- Cervical screening easy read guide
- Diabetic eye screening easy read
- Screening tests for you and your baby: easy guides
National guidance for health professionals:
- Population screening: access for people with severe mental illness
- Cancer screening and people with learning disabilities
- Breast screening programme: supporting women with learning disabilities
- Cervical screening: supporting women with learning disabilities
- Cervical screening coverage and data tool
- AAAA screening: reducing inequalities
Information for trans and non-binary people:
- Information for trans people leaflet
Share your learning with us
As always, we want to continue to highlight inequality issues and circulate examples of shared learning and innovation through the screening blog.
Please get in touch with us by email if you have an example that you would like to share.
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. If you have any questions about this blog article, or about population screening in England, please contact the PHE screening helpdesk.