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England’s health screening programmes: experts warn of safety risks if national oversight is lost

BMJ 2024; 385 doi: https://doi.org/10.1136/bmj.q1117 (Published 22 May 2024) Cite this as: BMJ 2024;385:q1117
  1. Gareth Iacobucci
  1. The BMJ

Quality assurance checks of screening programmes could be delegated to local integrated care boards. Gareth Iacobucci looks at the implications

Plans to devolve responsibility for quality assurance of England’s 11 national screening services could result in major risks to patient safety, experts have said. The BMJ understands that NHS England is discussing proposals to delegate some of the functions of the national screening quality assurance service (SQAS) from NHS England to local integrated care boards, though the proposals have not yet been agreed.

Concerned experts have warned that cutting national oversight of screening programmes, used by millions of people in England each year, will increase the risk of errors not being picked up and acted on quickly enough. SQAS is currently informed of thousands of screening incidents across England each year. Devolving responsibility to local organisations will spread resources more thinly, lead to a loss of expertise and independence, and compromise national oversight, making it harder to identify problems early and help improve screening pathways, the experts said.

England has 11 national screening programmes. Three are for cancers (breast, cervical, and bowel), six cover antenatal and newborn screening, and two are for abdominal aortic aneurysm and diabetic eye disease. In visits to local screening services around England, SQAS staff can pick up urgent matters, such as understaffed pathology teams,1 problems in access to appointments,2 and failure to correctly follow national clinical guidelines.3

Talking to The BMJ under condition of anonymity, an individual who works on quality assurance visits warned that NHS England was cutting corners to save money. They said that cuts in recent years had already meant SQAS had to drastically reduce the number of site inspections, meaning problems were not being picked up as early as they would have been previously. The latest move would …

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