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Key Issues
- Inequality in Screening Uptake - Breast screening uptake is not equal across the eligible population, in North Tyneside uptake ranges from 38.3% to 81.7% where the national target is 70% (Tables 1 and 2). This variation in uptake is associated with deprivation, with lower uptake in communities experiencing more deprivation. As screening aims to diagnose breast cancer at an early stage when prognosis is best, not accessing screening exacerbates inequalities in morbidity and mortality in communities with high deprivation. Screening uptake is also significantly lower amongst people with a learning disability compared to the rest of the North Tyneside population, with prepandemic uptake of approximately 57% and 2020-2021 uptake of approximately 38%.
- Adapting the National Screening Programme for Local Implementation - All national screening programmes are overseen by the National Screening Committee, and commissioned through NHS England to ensure a universal offer to those eligible. This consistency ensures quality however it can present challenges where a tailored offer for certain cohorts may be beneficial.
- Impact of Pandemic Programme Process Changes - In response to the pandemic, the breast screening process was altered to recover screening rates as quickly as possible (Figure 1). Consequently, the programme changed the invitation and appointment system from issuing a timed appointment, to an open invitation to book an appointment. It required individuals to make the appointment which may have reduced its perceived importance as well as requiring the necessary skills, resources, and impetus to do this. In North Tyneside, this may have contributed to the low uptake that was initially seen in early 2021. Subsequently other parts of North Tyneside have been offered timed appointment. Consequently, the borough has not had a universal offer of screening which may lead to further unmet need.
