Scottish Screening Committee minutes: 21 January 2021

Attendees and apologies

Attendees:

• Jann Gardner - Executive, NHS Golden Jubilee (Chair)
• Bob Steele - UK National Screening Committee Representative
• Colin Briggs - Director of Planning, NHS Lothian
• Gareth Brown - Scottish Director of Screening, National Screening Oversight Board
• Graham Foster - Director of Public Health, NHS Forth Valley
• Lorna Ramsay - Medical Director, NHS National Services Scotland
• Susan Siegel – Public Partner
• Fraser Tweedie - Public Partner
• Marion O’Neill - Cancer Research UK 
• Julie Anderson - Senior Programme Manager, NHS NSS 
• Michael Kellet - Director of Population Health, Scottish Government
• Jacqueline Sneddon – Deputising for Safia Quereshi
• Simon Dryburgh – Deputising for Scott Urquhart
• Tasmin Sommerfield - Consultant in Public Health Medicine for National Screening Programmes, NHS National Services Scotland
• Claire Winstanley – Secretariat, National Screening Oversight Board
• Corrie Drumm – Cancer Research UK
• David Proud - Head of Service Project and Service Management, NHS NSS
• Laura McGlynn - Interim Head of Health Protection and Screening, Health Protection Division, Scottish Government
• Martyn Lindsay - Committee Secretariat, Health Protection Division, Scottish Government
• Agnes Munyoro – Committee Secretariat, Health Protection Division, Scottish Government
• Susan Thompson - Committee Secretariat, Health Protection Division, Scottish Government
• Stacey Berwick - Committee Secretariat, Health Protection Division, Scottish Government

Apologies:

• Scott Urquhart – Director of Finance, NHS Forth Valley Simon Dryburgh deputising
• Safia Quereshi – Director of Evidence, Health Improvement Scotland Jacqueline Sneddon deputising  
• Jane Burns - Medical Director, NHS Lanarkshire

Items and actions

Welcome and apologies

JG welcomed attendees and noted deputies for those who had given their apologies.

There were no urgent points raised on the minutes of the previous meeting.

Bowel screening and colonoscopy update

GB provided an update on the Bowel Screening Programme and Colonoscopy pressures. A paper was shared with SSC attendees on different options to deal with these pressures; this was also shared with Health Board Chief Executives.

It was noted that a number of boards are reporting challenges or forecasting challenges in colonoscopy capacity. 

An emergency Bowel Screening Programme Board meeting was held to consider options to deal with the pressures. The Board concluded that there were two viable options to manage the issue. The first option was to continue running the programme but make clear to those who received a positive result that they would have a longer wait for a colonoscopy; the second option was to pause the programme.

The Bowel Screening Programme Board agreed that the best option was to continue. However, pressures should continue to be monitored and the Bowel Screening Programme Board agreed that the NSOB could escalate issues to Scottish Ministers if the situation worsened without having to convene the Bowel Screening Programme Board again.  

The SSC was asked to agree that the NSOB could follow this approach without returning to the SSC. 

During discussion of the options issues were raised regarding the ethics of the two options – whether it is ethical to screen if someone might not have timely access to treatment/next steps. At the same time the benefits of continuing screening to get early diagnosis were considered.

The UK Government’s intentions were discussed, and it was understood that the plan is to continue with screening at the moment.

JG concluded by summarising that the SSC acknowledges the pressures, particularly from some boards and see that this is having ripple effects. However in line with the UK we would endorse the continuation of the programme. 

It was stressed by members of the Committee that it was important to be transparent and that any messaging provided to participants about possible delays must allow them to make an informed choice. 

Screening review update

GB provided an update on the Screening Review. 

The National Screening Oversight Function exists as a result of a review of screening completed in 2018. There were a number of other recommendations in that review and the NSOF has taken responsibility for progressing these. 

The NSOF have reviewed these recommendations and are implementing them into the NSOF work plan. 

The NSOF sought SSC agreement that the NSOF can therefore close down reporting on the review. There were no objections to this approach.

Delivery of population screening in early 2021

Given the pressures the NHS is currently facing, a number of questions on the future of screening were presented in a paper shared with the committee for discussion.

There was discussion about possible contingencies or different ways of working that could alleviate pressure or improve the delivery of screening.

It was suggested that the SSC could consider asking individual programme boards to come up with suggestions to alleviate pressures.

There was discussion about the drivers for change in the screening programme in the current landscape. There is a responsibility on the SSC to give a cross-Scotland view when providing advice to ministers.

Whilst there was some helpful discussion at this meeting, it was agreed that a workshop discussion was needed. NSOF will take this away and undertake discussions with the Programme Boards before coming  back to the SSC. 

AOB and date of next meeting

No other business raised