Health watchdog finds shortcomings in breast cancer screening

A health watchdog’s report on how BreastCheck manages the patient information it gathers earlier this year found shortcomings in governance structures that had “the potential to impact on the quality of the breast cancer screening service”.

The report by the Health Information and Quality Authority (Hiqa) found that the governance structures at BreastCheck were not clearly defined in respect of information management, which relates to how the programme collects, stores, uses and shares the patient data it gathered.

For example, Hiqa could not determine who was responsible for identifying and managing various information-related risks or issues.

“Clear lines of reporting are essential for information management as, if an information-related risk is identified by an employee, it should be obvious who has responsibility for managing the risk and escalating the risk if necessary,” the report said.

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Traditional structures

At the time of the Hiqa review, new leadership arrangements were being put in place in BreastCheck as the traditional structures had been deemed as not fit for purpose. The previous structure had led to the creation of a “a silo effect” as the programme’s lead clinical directors did not have a forum to discuss cross-programme information management issues.

The Hiqa report made 11 key recommendations and said that its findings had relevance to the other three national screening programmes – CervicalCheck, BowelScreen and Diabetic RetinaScreen. While the four programmes operate as distinct units, all are positioned within the National Screening Service governance model.

“For the National Screening Service to operate more effectively and efficiently there is a need for greater integration of the four programmes into the current governance arrangements in respect of information management,” Hiqa’s report said.

Best outcomes

Rachel Flynn, Hiqa’s director of health information and standards, said that to ensure the best outcomes for women undergoing breast screening, it was important that BreastCheck implemented the 11 recommendations made by the report.

“Hiqa recommends that the National Screening Service should implement an appropriate governance structure in order to effectively address information management within BreastCheck, as well as developing both a strategy and performance assurance framework for information management,” she said.

Hiqa noted that the process of screening generates large volumes of personal health information and relies on accurate documentation and communication of information.

“Information needs to be managed correctly so that women attending screening will receive timely, efficient and effective care if a cancer is detected,” the report said.