https://phescreening.blog.gov.uk/2019/06/21/what-you-told-us-about-our-inequalities-strategy/

What you told us about our inequalities strategy

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The national inequalities strategy sets out how we aim to ensure equality of access to screening

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.

We asked:

How much has the inequalities strategy been a positive force for change in your work area?

You answered:

  • ‘No change’ – 25% (26 out of 104)
  • ‘Little change’ – 27% (28)
  • ‘Some change’ – 37% (38)
  • ‘A lot of positive change’ – 12% (12)

We asked:

How helpful has the strategy been in raising the profile and understanding of inequalities?

You answered:

  • ‘Unhelpful’ – 3% (3 out of 104)
  • ‘Neither helpful nor unhelpful’ – 35% (36)
  • ‘Somewhat helpful’ – 44% (46)
  • ‘Very helpful’ – 18% (19)

Positive changes

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:

National guidance for health professionals:

Information for trans and non-binary people:

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 email iepp@phe.gov.uk 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.

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