Supporting screening
Challenges
Effective screening can help save lives and improve the quality of life through the early diagnosis and treatment of serious conditions. Screening presents different challenges to clinical practice as it is about targeting apparently healthy people from a large population in order to detect a small number of people who are affected.
How SPH can help
Developing evidence-based screening policy and guidance
At a national level SPH plays a key role in assessing the evidence for a number of possible new screening programmes for the National Screening Committee (NSC).
Since 2008 the NSC has been commissioning SPH to assess the viability, effectiveness and appropriateness of introducing new population based screening programmes for a variety of conditions. In each case a literature search is carried out by the NSC and we review the evidence against a set of criteria. These expert reviews summarise what is known about the condition, potential screening tests, the benefits and harms and costs associated with the screening programme, taking into account the outcomes of screening programmes for the same condition elsewhere. Recommendations about whether screening should be introduced and if not, what further research would be helpful, are given to aid the NSC in making a final decision. All reports and recommendations undergo an extensive process of peer review and consultation before they go out for formal consultation and the NSC makes a final policy decision.
To date, SPH has produced expert reviews on the following topics: alcohol misuse, Alzheimer's disease, autism, bladder cancer, Canavans disease, depression, familial dysautonomia, fetomateranal alloimmune thrombocytopaenia, haemochromatosis (an inherited disorder or iron metabolism), hepatitis B and C among ethnic minorities born outside the UK, glomerulonephritis, Tay Sachs disease, osteoporosis, thyroid disease, thelassaemia in newborns, hospitalisation of the elderly and preconception screening for sickle cell and thalassaemia. Find examples of the expert reviews that SPH has produced for the NSC here
SPH also produced the national public health and commissioning guidance for bowel cancer and abdominal aortic aneurysm sceening programmes.
Providing support and advice to screening commissioners
Between 2002 and 2013, SPH provided commissioning and public health support and advice to the commissioners of all cancer and non-cancer screening programmes across the Thames Valley area, including nine cancer screening programmes, two Diabetic Eye screening programmes and one AAA screening programme. SPH also supported all antenatal and newborn screening programmes carried out in up to four NHS hospital trusts over an 11-year period. The types of activity that SPH have undertaken include:
- Supporting commissioners to meet the requirements and standards of national and local service specifications.
- Ensuring that all screening programme contracts are monitored regularly and action plans implemented where necessary to recover performance.
- Providing public health advice and expertise to commissioners and screening programmes about national and local policies, standards and pathways.
- Communicating regularly with all relevant service providers along the screening pathway to support performance management of programmes.
- Identifying differences in access to screening programmes and developing actions to address them.
- Responding to enquiries from the media, commissioners, GPs and members of the public.
- Participating in the investigation of serious untoward incidents and putting in systems to ensure they are not repeated.
- Identify and disseminate best practice.
