Scottish Screening Committee minutes: 10 September 2020

Attendees and apologies

Attendees:

• Lorna Ramsay, Medical Director, NHS National Services Scotland (Chair)
• Jane Burns, Medical Director, NHS Lanarkshire
• Tasmin Sommerfield, Consultant in Public Health Medicine for National Screening Programmes, NHS National Services Scotland
• Bob Steele, UK National Screening Committee Representative
• Fraser Tweedie, Public Partner
• Graham Foster, Director of Public Health, NHS Forth Valley
• Marion O’Neill, Cancer Research UK
• Susan Siegel, Public Partner
• Sean Neill, Deputy Director, DG Health and Social Care, Scottish Government

In attendance:

• David Proud, Head of Service Project and Service Management, NHS NSS
• Bryan Davies, Programme Associate Director, Cancer Screening Services, NHS National Services Scotland
• David Steel, Programme Associate Director, non-cancer screening services, NHS National Services Scotland
• Sarah Adams, Project Management Services, NHS NSS
• Joanna Swanson, Interim Deputy Director, Health Protection Division, Scottish Government
• Laura McGlynn, Interim Head of Health Protection and Screening, Health Protection Division, Scottish Government
• Caspian Richards, Committee Secretariat, Health Protection Division, Scottish Government
• Martyn Lindsay, Committee Secretariat, Health Protection Division, Scottish Government
• Agnes Munyoro, Committee Secretariat, Health Protection Division, Scottish Government

Apologies:

• Jann Gardner, Chief Executive, Golden Jubilee Hospital
• Scott Urquhart, Directors of Finance
• Liz Sadler, Interim Director of Population Health, Scottish Government
• Colin Briggs, Director of Planning, NHS Lothian

Items and actions

Welcome and apologies

LR welcomed attendees and explained that she would be chairing today’s session in Jann Gardner’s absence.

Following the last SSC meeting the Directors of Finance were asked to provide a representative – one has now been identified and will attend from the following meeting.

Revised SSC terms of reference

Revised terms of reference were discussed at the last meeting. One of the main changes discussed was the overall structure with the National Screening Oversight Board (NSOB) now in place.

Changes have been made following that discussion, including to roles and responsibilities in the membership section for individual members’ consideration.

LR asked for any further feedback to be provided to CR to move the Terms of Reference closer to a final position.

NSOF implementation update

LR informed the meeting that Gareth Brown will take up post as Scottish Director of Screening from 28 September and work is underway to complete filling roles in the rest of the team.

The NSOF work plan was shared and the service design approach, co-production and roles of existing groups were discussed. 

DP provided an update on the Screening Digital Portfolio.

Screening recovery update

LR provided an update on the recovery process across each of the screening programmes. The majority of programmes have now restarted routine screening appointments, following the initial focus on higher risk screening programme participants.

For the Bowel Screening Programme, discussions are progressing with individual boards on their readiness to progress to stage 3 of the recovery plan.  

SSC members discussed the importance of the full screening pathway being operational before resuming routine screening, and of continuing to monitor pressures on capacity as services resume in order to take appropriate action.

Inequalities update

BD provided an update on the work that has taken place recently to address health inequalities in screening.

A Screening and Inequalities Workshop took place in August 2020 to gather input from stakeholders on the impact of Covid-19 on different groups. A summary of the themes and recommendations that emerged from this process will be prepared for consideration by the NSOB.

UK National Screening Committee update – AI task group

DP updated on consideration of potential uses of AI within the screening programmes. A UK National Screening Committee task group has been established to review AI capabilities and the process to develop AI capabilities in order to help the UK NSC prepare for the consideration of proposals for specific uses of AI within the screening programmes. DP will provide Scottish input to this task group along with SG.

Horizon scanning

The response to subsequent increases in Covid-19 cases, tightening of restrictions and potential lockdowns was discussed with the members invited to discuss and identify the key issues to consider when facing local or large scale tightening of restrictions.

TS gave an overview of experience in other UK nations on restarting their screening programmes and responding to the latest developments in Covid rates across the country. All are at broadly similar stages to Scotland in the restart of individual programmes and are dealing with comparable challenges.

The committee discussion identified key principles when considering how to manage ongoing and future Covid-19 impacts on screening services:

• the need for clear communications is essential (both for users and providers) 
• the full pathway must be operating/have sufficient capacity before inviting new people for screening
• the aim should be to avoid full pause in responding to future outbreaks/second wave – agree the minimum for each programme to operate at
• higher risk participants should continue to be identified (maintaining screening for this cohort may be the minimum)
• understand the service capacity and use data to predict trends so can vary demand accordingly
• aim for a National consistent service, but recognise local conditions will lead to differences
• service design work will potentially help with this blend of stage 3 and stage 4 running in parallel as well as looking ahead beyond recovery (flexible, risk focused, personalised etc.)
• ueful to prepare a short document for each programme of lessons learned from experience so far, to inform forthcoming decisions

AOB

Next meeting will be 17 November 9:30-11:30.