Scottish Screening Committee minutes: 25 June 2020

Attendees and apologies

Attendees

• Jann Gardner, Chief Executive, NHS Golden Jubilee (Chair)
• Lorna Ramsay, Medical Director, NHS National Services Scotland
• Colin Briggs, Director of Planning, NHS Lothian 
• Jane Burns, Medical Director, NHS Lanarkshire
• Belinda Henshaw, Senior Inspector/Reviewer, NHS Healthcare Improvement Scotland
• Elizabeth Sadler, Deputy Director, Health Improvement Division and Interim Deputy Director, Health Protection Division, Scottish Government
• Susan Siegel, public partner
• Fraser Tweedie, public partner 
• Marion O’Neill, Cancer Research UK
• Bob Steele, UK National Screening Committee Representative 

In attendance

• David Steel, Programme Associate Director, Non-cancer Screening Services, NHS National Services Scotland
• Tasmin Sommerfield, Consultant in Public Health Medicine for National Screening Programmes, NHS National Services Scotland
• Tracey Syme, Programme Board Co-ordinator, NHS National Services Scotland
• Joanna Swanson, Health Protection Division, Scottish Government (Secretariat)
• Agnes Munyoro, Health Protection Division, Scottish Government (Secretariat)

Apologies

• Colin Briggs advised of his late arrival to the meeting, and was therefore not present at the beginning of the meeting

Items and actions

Welcome, introductions and apologies 

JG welcomed the group and apologies were noted as above. 

Minutes and action update of previous meeting 

The Chair asked for comments or changes to the minute for the previous meeting. There was agreement that the minute was an accurate account of the meeting.

Chairs update

The chair announced plans to review SSC membership and terms of reference at the next meeting.

Scottish Government update 

ES advised that Ministers had approved the overarching recovery plan for the screening programmes, which will take a staged and measured approach to recommencement in line with the wider mobilisation of the NHS.   

National Screening Oversight Board (NSOB) monitoring and assurance

LR presented the overarching screening recovery route map and set out the National Screening Oversight Function’s (NSOF) role in monitoring and providing assurance as the screening programmes move through the stages within the route map. In particular, the NSOF will focus on the following areas: 

• ensuring that programmes meet the safe and patient-centred elements of the screening standards 
• national communications 
• impact on health inequalities

There was a discussion on how to rebuild the public’s confidence to re-engage with screening services and ensure that this process is consistent across all health boards. Key messages have been developed for inclusion in the communication materials for each programme and these will be distributed across NHS boards and stakeholders. Updated information will be available to the public on NHS Inform. In addition, higher risk AAA and DRS screening participants will be able to call ahead of their screening appointments to receive further guidance and reassurance from clinicians on how to attend screening safely. Throughout the planning process, screening programme boards have referred to Health Protection Scotland (HPS) guidance on PPE and infection prevention and incorporated this into their plans. There is ongoing engagement between PHS and SG to ensure that communications are consistent and aligned. 

Programmes’ readiness moving from stage 1 to stage 2 of the screening recovery route map

The progression of each of the screening programmes through the route map stages will undergo the  same governance processes that were outlined at the previous meeting. The SSC was invited to consider endorsing the National Screening Oversight Board’s  (NSOB’s) recommendation that each of the screening programmes progress from stage 1 to stage 2. 

Cervical 

TS presented the NSOB’s recommendations for recovery of the national cervical screening programme.  At the national and local level, the cervical screening programme was ready to restart and it was noted that there will be ongoing work to address capacity challenges at the local level. Screening participants whose appointment was affected by the pause will be able to make an appointment from 29 June and, in line with the recovery route map timelines, non-routine participants and individuals who had reached the upper-age range during the pause will be invited for screening in July and August. The recommendations were endorsed by the SSC. 

Bowel 

TS presented the NSOB’s recommendations for recovery of the national bowel screening programme.

For Bowel Screening stage 2 readiness, health boards will use numerical FIT values to prioritise high risk participants alongside symptomatic patients on the colonoscopy waiting list. Bowel screening colonoscopy is restarting at local level, however it was noted that there remains  a possibility that a ‘second wave’ of the COVID-19 outbreak could exacerbate current challenges surrounding capacity. The SSC endorsed the recommendations and noted the need to remain pragmatic and thoughtful going forward. 

Breast 

TS took the group through the NSOB’s recommendations on the recovery of the breast screening programme. 

The screening service will prioritise high risk and post treatment surveillance screening before resuming the national programme. There is local and national readiness to restart the programme.  There was discussion on the location of mobile units in relation to health  inequalities. It was confirmed that the location of mobile units had been considered during planning to ensure that the relocation would take into account barriers to attendance. The Health Inequality Impact Assessment for the breast screening programme will consider the location of mobile units. The SSC endorsed the recommendations.

AAA

DS outlined the NSOB’s recommendations on restarting the national AAA screening programme. 

It was noted that AAA participants are generally a higher risk group and this had been taken into account during planning. There is national and local readiness to progress to stage 2 and invitations for the higher-risk cohort of screening participants and individuals whose appointment was cancelled during the pause can be sent from 6 July. The SSC endorsed the recommendations.

DRS

DS presented the NSOB’s recommendations on restarting the DRS screening decision on screening recovery. 

It was noted that DRS participants are generally a higher risk group and this had been taken into account during planning. There was national readiness status to restart the programme, and a plan to invite higher risk participants and pregnant women with diabetes from 6 July in line with the recovery timeline. To reassure participants that the restart is safe, participants will be able to contact clinicians if concerned about attending screening safely. There will be ongoing engagement with boards to address capacity challenges.  

The SSC endorsed the decision to progress to stage 2 of the screening recovery route map.

Next steps 

The NSOF plans to develop a screening intelligence platform, incorporating lessons learnt and best practices into stage 4, and plans to pick up discussion on the programme that wasn’t paused, Pregnancy and Newborn Screening.

Cancer Research UK welcomed the work that had gone into remobilising screening services as part of wider NHS remobilisation and agreed to endorse a joint statement with the Scottish Government on screening programmes restarting.

Close/AOB

MO made the group aware that there is ongoing exploratory work on lung cancer screening and that an event may be convened on this topic in the near future.