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people lives communitiespeople lives communities
Access to bowelscreening services
people lives communities
What the Confidential Inquiry said
Many people did not respond to the invitation to participate in bowel screening
Little support was provided to enable people to participate
No evidence that people had received accessible information
No evidence of reasonable adjustments to support participation
Carers confused about what their role should be
people lives communities
Case study
Following a positive result, a man with mild learning disabilities was invited for a colonoscopy. Three months later the GP was told the man had not turned up despite two appointments being arranged with hospital transport.
On investigation, it was found that the man had sent the hospital transport away each time as he was unwell.
He had not understood that the medication he had to take before the colonoscopy resulted in diarrhoea
people lives communities
Joint Health and Social Care SAF data – bowel screening
The median of the reported proportions of people with learning disabilities being screened for colorectal cancer was 25.8%
The highest reported median proportion, in the East of England (48.8%) represented only one partnership board; the highest from a region with a more substantial proportion reporting was in the East Midlands: 43.1%
The lowest reported median proportion was in the West Midlands: 23.4%
For comparison, colorectal cancer screening in eligible people in the total population had reported median coverage of 39.4%
people lives communities
Joint SAF
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
England All (91/154)England LD (91/154)
South West (5/16)South East (11/19)
London (17/33)East of England (1/11)West Midlands (7/14)
East Midlands (6/9)Yorkshire Humber (8/15)
North West (24/25)North East (12/12)
Coverage of colorectal screening programme
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The bowel screening pathway
Information in accessible formats is available
No way to identify people with learning disabilities on the national registers
A standard letter is sent to all
Failure to respond triggers a letter to the GP 13 weeks after initial invite
If services are well co-ordinated, support can be given now
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Consent / Best Interests and bowel screening
The initial bowel cancer screen in non-invasive
If the result is positive, a colonoscopy is required
This is invasive – and potentially life threatening
What has been happening / should be happening?
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Screening strategy and toolkit
Work with the SW peninsular
Suggests access to screening nurses employed by screening services
www.ndti.org.uk/publications/ndti-publications/screening-services-strategy-and-toolkit
people lives communities
Supporting better access to screening
Worked with social care providers
Charter includes support to access health appointments
Social care providers can sign up on VODG website: http://www.vodg.org.uk/
people lives communities
IHaL
Wrote a Reasonable Adjustments digest regarding access to cancer screening
Now updating this
Examples welcome!
Also working with PHE
people lives communities
National bowel screening hubs
Developing guidance
Wrote an article for their digest
people lives communities
Thank you!
www.ndti.org.uk
@Ndtisue
ndti.org.uk
