| 3 | The Director of Public Health conducted a presentation detailing the cancer screening programmes undertaken within the Borough. He provided a comparison of the cervical screening uptakes for all the West Midlands Public Care Trusts (PCTs). The Director also detailed the system of calling and re-calling patients the practices undertook, where patients were called back every five years in order to identify any abnormalities.
Cervical Screening
The Director explained that the cervical screening uptake rate for Solihull was relatively high amongst all the local PCTs, noting that it was between 80 to 85 percent. He emphasised this was a good response rate, explaining that it was above the Government target of 70 percent.
The Director also provided an age break-down of the proportion of women screened in the last five years, detailing that, for the majority of age groups the number exceeded 80 percent.
Members noted that when women were 65 years or over, the local health authority stopped producing screening call-in letters. The Director detailed that at this age group, the patients pursued the screening on a voluntary basis, or contacted their General Practitioners (GPs) when they identified abnormalities.
Members also highlighted that the volume of patients who responded to the call-in was lowest amongst the youngest age group (ages 25 to 29), and they queried whether this was an issue. The Director emphasised that this wasn't an issue, especially since this age group was less sexually active.
The Director also detailed the proportion of women screened by all Solihull practices, noting that the majority achieved a response rate of over 80 percent, whilst six practices across the Borough achieved less than this.
Members noted that once patients were diagnosed with cancer, there could be cases where they saw different doctors, and they queried whether this was an issue. The Director acknowledged this was an important issue, especially in serious cases, however he did emphasise that this did not occur often and only in emergency cases.
The Director also detailed the survival rates for invasive cervical cancer over the first five years, emphasising that the survival rate was high at 70 to 75 percent due to early diagnosis.
Breast Screening
The Panel expressed concern at some of the age ranges detailed within the presentation and queried why the some of the statistics did not include patients under 50. The Director explained that the cases of breast cancer amongst this age group were lower and he also noted the potential problems of having prolonged exposure to radiation.
Members also queried the provision in place for men with breast cancer. The Director explained that breast tumours were more obvious to detect in male cases. He also noted the low percentage of cases, emphasising that it constituted less than 0.01 percent amongst all males, whilst breast cancer was the most common cause of cancer amongst women.
Members stated that one of the aims of the Panel should be to ensure that all eligible women received a call-up. The Director explained that there were quality assurances within the programme to ensure that all eligible women were contacted.
Members queried whether some patients were not responding to screening call-ins due to the gender of the doctor. They noted the lower up-take of screenings by patients within a sole male practice, emphasising that this should not be an issue, especially since many nurses were now qualified to conduct screenings.
Members queried whether the group could focus upon whether the gender of the doctor was an issue in relation to the up-take rates. They also questioned whether they could visit the six underperforming practices within the Borough and establish whether they could change the letters they sent to patients, in order to note that their nurses could also conduct screenings. Members also queried whether the practices produced reminder letters and whether they also conducted telephone contacts with patients.
The Director emphasised the importance of identifying the barriers to patients responding the screening up-takes and addressing them, rather than focusing upon individual practices. The Director also noted the lack of locally available statistics, emphasising that qualitative research was very resource intensive. He explained that the panel could look nationally at the barriers causing lower cervical screening take-ups and identify what the Local Authority was doing locally to address these issues. |