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Problems persist with NHS screening databases

04/02/19

Parliamentary Correspondent

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The NHS “cannot reliably identify” patients for screening programmes for cancer and other diseases because information is held on a staggering 83 separate databases.

The system for inviting eligible people was declared “not fit for purpose” by the Government as long ago as 2011, but problems persist, the National Audit Office (NAO) has concluded.

NHS England intended to replace the system, known as National Health Application and Infrastructure Services (NHAIS), in 2017 but shelved the plan, “causing additional cost and greater risk,” a new report from the NAO in the management of health screening warns.

In the starkest example of its failings, 98,000 women have been left waiting for the results of cervical cancer checks. At one point last year, only one in three received results within the recommended 14 days.

Disparate systems

Each screening programme relies on its own IT systems to send invitations, and to process and send results – with those for the cervical programme being the oldest at more than 30 years.

Meg Hillier (pictured), chair of the Commons Public Accounts Committee, said: “It is worrying that not everyone who is eligible to take part in screening programmes is doing so.

“Those responsible for screening programmes are not always capable of picking up when people are not invited for a screening appointment, or ensuring that people receive their test results on time.

“It is unacceptable that these important screening programmes are being let down by complex and ageing IT.”

Robert Music, chief executive of Jo's Cervical Cancer Trust, said: “It is simply not fair that women should be put under undue stress as a result of failings in the programme management.”

As well as breast, bowel and cervical cancer, screening is also offered for diseases in pregnant women, newborn babies and those at risk of eye disease and aneurysms.

Complexity

But the NAO’s report says: “All the screening programmes rely on a complex and ageing IT system to identify who to invite for screening.

“The department believes that NHAIS is not fit for purpose for screening programmes because, for example, information is held in 83 separate databases, making it hard to track screening histories when people move across geographical boundaries.

“NHS England intended to replace NHAIS in 2017 but this has now been delayed, causing additional cost and greater risk that screening services cannot reliably identify and invite eligible populations for screening.”

A spokeswoman for the Department of Health and Social Care said: “Our screening programmes are recognised as among the best in the world and we are committed to making any improvements needed.

“We are working closely with NHS England and Public Health England to address the issues this report highlights.”

Image from GOV.UK, Open Government Licence v3.0

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