Agenda item

To consider a report of the Deputy Director of Public Health.

A review was commissioned from the Cheshire and Mersey Public Health Commissioning and Greater Manchester Health and Social Care Partnership in response to the change in arrangements for screening women registered at Heald Green practices in spring of 2017. The report details the key issues arising from that work.

The Board is invited to note the report.

Officer contact: Eleanor Banister/ Dr Vicci Owen-Smith, 0161 474 2447/ 07810045578, eleanor.banister@stockport.gov.uk / vicci@nhs.net

The Deputy Director for Public Health submitted a report (copies of which had been circulated) providing the Board with a summary of a review commissioned from the Cheshire and Mersey Public Health Commissioning and Greater Manchester Health and Social Care Partnership in response to the change in arrangements for breast screening women registered at Heald Green practices in spring of 2017. The report detailed the key issues arising from that work.

Carol Bailey, (Screening and Immunisations Manager, Greater Manchester Health and Social Care Partnership) and Marie Coughlin (Screening & Immunisation Manager, Cheshire and Merseyside Public Health Network) also attended the meeting to respond to questions from the Board.

The following comments were made/ issues raised:-

Drop off rates a concern in Cheadle. Have suggested Massey Street as a possible location, but despite supportive local businesses this not happened. Still offer of ward funds to help with that.

·           Concerns were expressed about a reduction in screening rates in the Cheadle area. The removal of the screen facility in Heald Green was acknowledged and the possible impact of patients being called for screening in Macclesfield identified as a possible contributing factor in the reduction given the difficulties of accessing the site.

·           Concerns were expressed that the performance against the 3 year round target was just above 50%, meaning that levels of uptake in Heald Green were below the England average. In response it was clarified that there was a difference between uptake and round length, with the reduce performance due to mergers of practices leading to higher than expected invitations. Current levels of round length were now back to within the 90% target. The statistics may also be misleading as the round length may people 3 years and 1 week but the performance indicator gave a worse impression of the situation. It was commented that the decline in uptake was part of a national trend, with reductions higher in more affluent communities. This may be in part due to the increased awareness and information provided by the NHS when communicating with people being called.

·           It was queried whether the public felt better able to access information and thereby make informed choices, meaning they may perceive their risk to be lower. In response it was stated that there was insufficient evidence available to say for certain, but that the Stockport Together model was designed to ensure that conversations were had with service users whenever possible to highlight where there were outstanding tests or screenings. As part of a GM wide review of cancer screening the reasons the public had for taking up, or not, screenings would be explored.

·           Concerns were expressed that despite falling uptake rates there was no indication of the steps being taken to address whether changes in delivery of screenings were needed, such as changing the sites where screening was offered. The John Lewis Department Store and Massey Street Car Park in Cheadle were suggested as possible alternatives. In response it was stated that these alternatives and others were being explored but that there were often significant practical challenges to overcome. It was also commented that there was not one simple answer to improving uptake and a range of options needed to be considered, including time of appointments as well as location.

·           Surprise was expressed that there was not higher rates of uptake for free screening services. In response it was stated that there was evidence that people’s perception of screening, such as potential painfulness, had an impact, but that it was also noticed that uptake reduction when the NHS information leaflet changed to give patients a more informed choice.

·           It was commented that the particular challenges being experienced in Heald Green highlighted the need to ensure that the whole screening system was able to adapt to changing arrangements on the ground, in particular the move to larger GP practices.

RESOLVED – That in relation to the review of Breast Screening Services:-

·           the outcome of the Review be noted;

·           the proposal to mitigate the impact of future practice mergers and reductions by the Stockport public health team informing the screening service of any forthcoming mergers be noted;

·           the proposal for Stockport Together consider the requirements for siting the mobile unit as part of its Estates strategy, to provide more suitable sites across Stockport, be welcomed.