Annette Brooke – 2014 Parliamentary Question to the Department of Health

The below Parliamentary question was asked by Annette Brooke on 2014-06-09.

To ask the Secretary of State for Health, what assessment he has made of the conclusions of the Demos report, Behind the Screen on (a) the decline in screening rates for all age groups and (b) the costs to both the NHS and individual women of screening uptake levels.

Jane Ellison

We welcome the Demos report Behind the screen: “Revealing the true cost of cervical cancer…”, which we have discussed in detail with Public Health England (PHE). On the specific recommendations in the report:

– it is NHS Cervical Screening Programme policy that general practitioners should offer ‘on the spot’ cervical screening tests to women during other appointments, as long as they are overdue. In 2012-13, more than 500,000 were taken without an immediate invitation;

– on awareness campaigns, PHE is looking at a number of other cancers for potential local pilot tests within the Be Clear on Cancer programme, and a decision will be made later in the summer;

– a strategy on using celebrities or religious leaders to improve coverage would need to be tied in with any overall marketing campaign, but previous experience shows that this only has a short term effect and needs frequent repetition. The publicity around Jade Goody, diagnosis, illness and subsequent death, brought in many under-screened women, but this dissipated within months following Jade’s death at the end of March 2009; and

– PHE has funded research on the effects of mother/daughter relationships on uptake of screening and vaccination, including in lower socio-economic groups. PHE would be very happy to discuss this with Demos and Jo’s Cervical Cancer Trust.

We know that for a number of reasons coverage rates amongst women have fallen slightly over the last decade, as highlighted further in the report, and a considerable amount of work is underway to tackle this decline. The third annual report of our Cancer Outcomes Strategy said that a priority for 2014-15 will be to improve screening uptake amongst disadvantaged groups. PHE is undertaking analysis on local screening programmes with poor coverage, and will work with them to develop action plans to increase coverage in their local areas.

Specifically on younger women, the National Institute for Health Research Health Technology Assessment programme has commissioned a £1 million study to determine which interventions are effective at increasing screening uptake amongst women who are receiving their first invitation from the programme. We also know that coverage rates are lower in certain communities. NHS Cancer Screening Programmes have worked with Jo’s Cervical Cancer Trust to host two events looking at challenges to screening uptake among black and minority ethnic communities, and a third event is due to be held in Birmingham in July 2014. NHS Cancer Screening Programmes has also funded an award winning Lesbian and Gay Foundation’s Are You Ready for Your Screen Test? campaign targeting lesbian and bisexual women to raise awareness about the need to attend for regular cervical screening tests.

Regarding costs discussed in the report, we will ensure that the report is sent to colleagues in NHS England who are responsible for commissioning the cervical screening service. The report will also be discussed at the next meeting of the Advisory Committee on Cervical Screening in the autumn.

Acceptable and achievable standards for cervical screening coverage rates are being discussed as part of the update of the cervical screening service specification attached to the NHS public health functions agreement: Public health functions to be exercised by NHS England (Section 7a agreement) for 2015-16.

We are fully supportive of Cervical Screening Awareness Week (CSA Week) and the work Jo’s Cervical Cancer Trust does, who I met recently.

I wrote to all Members of Parliament on 11 June to draw their attention to CSA Week, update them on national and local screening statistics and ask for their support in promoting take-up of screening. In addition, the Department and PHE promoted CSA Week on social media.