Each day we hear reports of the extraordinary efforts the NHS is going to to get people vaccinated against coronavirus (COVID-19). Hundreds of thousands of people are having their vaccines every day. It is an incredible achievement.
There are a number of other mass NHS programmes that take place more quietly, but in terms of sheer numbers are just as impressive. Each day millions of people are screened for health issues – to see if they are at higher risk of a condition and so information or early treatment can be offered.
Safety in screening
NHS screening is complex. A local screening service involves a multitude of teams, tests, procedures, and sometimes different organisations. Safety has to be built into every aspect of the screening pathway. Local services work hard to make sure people are screened safely. They take the ethical responsibility to do as little harm as possible to healthy people who are invited for a screening test very seriously.
Occasionally incidents do occur. If something goes wrong in one service, it’s possible it may also be going wrong in another service for another person. Although the level of risk to an individual or an individual service may be low, because of the large numbers of people offered screening, this may equate to a high population risk.
For this reason there is national guidance on managing safety incidents in the NHS screening programmes, covering how patient safety incidents in the screening pathway should be notified and managed. It’s important to take prompt action and share learning from incidents as quickly as possible to prevent further issues.
What needs to change
We know some of the processes for screening incidents work very well. Feedback tells us we have good systems for notifying screening incidents locally. Screening services value the specialist advice screening quality assurance service (SQAS) teams provide for managing an incident, and work hard to put things right when incidents do arise.
However, we also know some things could be improved. In particular, how responses to screening incidents link to wider quality improvements and the move to roll out the NHS Patient Safety Incident Response Framework by 2022, as well as processes such as the Screening Incident Assessment Form (SIAF), which we think could be made easier and quicker to complete.
We would also like to feedback more information collected through the screening incident process to providers and the wider system. This will enable them to better learn from incidents and act on service improvements.
Working closely with NHS England and screening services through the PHE screening incident task and finish group, we plan to update the guidance by June 2021. The review aims to:
- prepare for the new patient safety incident response framework which will be rolled out to the whole of the NHS in 2022, particularly focusing on how the response to screening incidents can lead to real change
- cover gaps in the existing guidance, such as how we escalate and manage incidents where a national response is needed, and who is responsible for incidents that occur outside the screening pathway but impact on screening patients
- simplify the screening incident assessment form (SIAF) and develop a web-based portal for reporting incidents
- provide new education programmes to upskill staff working in SQAS, screening and immunisation teams (SITs) and screening providers in the best way to manage and learn from incidents
Over the coming weeks we’ll be publishing a series of blogs letting you know how you can get involved and the things we plan to change. Consultation and engagement with services is critical for the success of this project and there will be plenty of opportunities to put forward your views. Watch this space!
PHE Screening blog
The PHE Screening blog provides 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.