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Welcome, introductions and
overview of the day
Jo Harcombe, IEPPNational Stakeholder Education Lead,
Screening, Public Hea...
National Cervical Screening
Programme update
Ruth Stubbs, National Programme Manager, Cervical
Screening, Public Health En...
Cervical Screening Programme
update
Ruth Stubbs
National Programme Manager
Public Health England leads the NHS Screening P...
Cervical Screening Programme
update
Ruth Stubbs
National Programme Manager
Public Health England leads the NHS Screening P...
Cervical screening programme update
• HPV Primary Screening Implementation
• 14 Day Turnaround Times
• Clinical Profession...
Key benefits of primary HPV screening
• Primary HR-HPV testing has higher sensitivity for high
grade cervical intraepithel...
Primary HR-HPV testing pathway
Impacts upon all programme elements
• Call and recall and IT
• Information for women
• Samp...
Primary HPV Testing Implementation
Progress
https://phescreening.blog.gov.uk/2017/01/31/deciding-how-best-to-roll-out-
hpv...
OPTIONSAPPRAISAL
Objective Weight
Quality 18
Staffing Feasibility 15
Effective IT Connectivity 15
Cost of Safe Delivery 15...
Option4a.Aminimumnumberofcentralisedservices4to5laboratories
Option4b.Amaximumnumberofcentralisedservices10to15
12 Cervica...
13 Cervical screening coverage data project
14 dayTAT
performance
September2017
Source: Exeter
VSA15 report for
September ...
14 day turnaround times for samples
14 Cervical Screening Programme Update 12 10 2017 E-learning Launch
• Laboratories con...
Clinical Professional Groups
Key Role in: Reviewing and producing guidance
Advisory role to the programme
Developing stand...
Development of Programme Specific
Standards
16 Cervical Screening Programme Update 12 10 2017 E-learning Launch
• The stan...
ResearchAdvisory Committee
17
The Research Advisory Committee roles are to:
• support and advise the programmes
• ensure a...
For PHE Screening Programmes:
The research co-ordinator will be the first point of contact for screening
applications and ...
Updated Programme Guidance
• Guidance for the training of cervical sample
takers December 2016
• Approved HPV tests for HP...
Guidance soon to be published
In progress:
• Ceasing guidance
• Failsafe guidance
• HBPC role changed title CSPL
• Review ...
Primary Care Support England PCSE
supports the National Cervical Screening
Programme by:
• Providing Prior Notification Li...
What will be different?
• PCSE are not changing what they do, just improving the
service by using more modern technology.
...
Benefits:
• One screen to access all screening information & histories
(according to user access permissions)
• Ability to...
Benefits:
• Improved Colposcopy Discharge Report process - currently 100%
manual; transformed service will allow direct da...
When?
• The plan is to introduce these improvements in Summer 2018
What do you need to do?
PCSE will be sending out furthe...
Cervical Screening SpotlightActions
• Present Data in more accessible way
• Influences of activity via GP contract
• Agree...
Health Matters https://www.gov.uk/government/publications/health-matters-making-cervical-
screening-more-accessible/health...
Primary Care Data Pack
• Collaborative piece of work with PHE, Jo’s Trust, NHS
Digital
• Provide meaningful Coverage data ...
https://www.gov.uk/government/publication
s/cervical-screening-coverage-and-data
29 Cervical Screening Programme Update 12...
Blogs
30 Cervical Screening Programme Update 12 10 2017 E-learning Launch
To summarise
• The cervical screening programme continues to evolve
and adapt according to the evidence.
• The current cha...
Producing the cervical screening
e-learning
Jonathan Waldheim, Digital Project Manager, Screening, Public
Health England
Cervical Sample Taker Training
E-learning
Jonathan Waldheim (PHE)
Background
2008: Collaborative development between North East and Yorkshire and
Humber.
2012: Initial discussions to updat...
Making the resource national
2016: Agreed that this would become a national resource rather than just a
regional resource
...
e-Learning for Healthcare (e-LfH)
37 Cervical Sample Taker Training
• NHS approved platform for hosting e-
learning
• Reso...
Registering and navigating the e-LfH hub
38 Cervical Sample Taker Training
Questions
39 Cervical Sample Taker Training
Cervical screening e-learning
demonstration
Ruth Stubbs, National Programme Manager, Cervical
Screening, Public Health Eng...
Cervical Screening Update
e-Learning module
Public Health England leads the NHS Screening Programmes
Cervical Screening Update
e-Learning module
Public Health England leads the NHS Screening Programmes
Cervical Screening Update e-Learning module
cervcal screening e-Learning launch 12 10 1744
Resources
cervcal screening e-Learning launch 12 10 1745
Cervical Screening Update e-Learning
module
cervcal screening e-Learning launch 12 10 1746
Cervical Screening Update e-Learning module
cervcal screening e-Learning launch 12 10 1747
Cervical Screening Update e-Learning module
cervcal screening e-Learning launch 12 10 1748
Cervical Screening Update e-Learning module
cervcal screening e-Learning launch 12 10 1749
Cervical Screening Update e-Learning module
cervcal screening e-Learning launch 12 10 1750
Cervical Screening Update e-Learning module
cervcal screening e-Learning launch 12 10 1751
Cervical Screening Update e-Learning module
cervcal screening e-Learning launch 12 10 1752
Cervical Screening Update e-Learning module
cervcal screening e-Learning launch 12 10 1753
Cervical Screening Update e-Learning module
cervcal screening e-Learning launch 12 10 1754
Cervical Screening Update e-Learning module
cervcal screening e-Learning launch 12 10 1755
Cervical Screening Update e-Learning module
cervcal screening e-Learning launch 12 10 1756
Cervical Screening Update e-Learning module
cervcal screening e-Learning launch 12 10 1757
Any Requests?
cervcal screening e-Learning launch 12 10 1758
Discussion and panel Q&A
DeclanO’Brien, NationalEducationManager,Screening,PublicHealthEngland
RuthStubbs,NationalProgramm...
Future education programme
developments
Catherine Witney, National Education and Training Manager,
Screening, Public Healt...
Future cervical screening
programme education
developments
Ruth Stubbs Catherine Witney 12 October 2017
Education and training manager role
64 Future cervical screening programme education developments
Cervical Screening Sampl...
Cervical Screening Education and Training
Cervical Screening Education and Training CSET
What is the groups remit?
The edu...
Cervical Screening Education and Training
Who is involved?
Membership of the group is drawn from:
PHE screening
Education ...
Cervical Screening Education and Training
How does the group work
CSET group meets every 6 months
CSET has core working gr...
Sample taker training approval/endorsement
Cervical Sample Taker Initial Training (2-day theory course) RCN accredited
Del...
Sample taker training approval/endorsement
NHS Cervical Screening Programme Guidance for the training of cervical
sample t...
Sample taker training approval/endorsement
How the Cytology Training Centres met the requirement
The RCN endorsement and a...
HPV Primary screening implementation
Training to support HPV Primary screening implementation
Training packages are being ...
HPV Primary screening implementation
HPV primary screening: training for sample takers
The ELearning module will support s...
HPV Primary screening implementation
HPV primary screening: training for colposcopists
A national colposcopy e-learning mo...
HPV Primary screening implementation
HPV primary screening: training for laboratory staff
All staff involved in the screen...
HPV Primary screening implementation
HPV primary screening training: Cervical screening provider lead CSPL
Laboratory serv...
Trainee GP sample taker training provision
GP trainee sample taker training provision
Potential problems :
• courses histo...
RCGP Cervical screening e-learning
How can we better engage with Primary Care practitioners?
NHS Screening programmes have...
RCGP Cervical screening e-learning
PHE screening and RCGP will collaborate to create ELearning resources to
meet the needs...
Future cervical screening
programme education
developments
Ruth Stubbs Catherine Witney 12 October 2017
Cervical screening coverage
data project
RuthStubbs
NationalCervicalScreeningProgrammeManager
Public Health England leads ...
Cervical screening coverage
data project
RuthStubbs
NationalCervicalScreeningProgrammeManager
Public Health England leads ...
Background
• cervical screening coverage is falling – high profile to address this for NHS
England and PHE
• stakeholder f...
Projectobjectives
• to make available more timely coverage data to internal and external
stakeholders
• to develop a prima...
How we will buildon this?
• developing cervix data availability
• improved timeliness
• additional data planned
• evaluati...
https://www.gov.uk/government/publication
s/cervical-screening-coverage-and-data
85 Cervical Screening Programme Update 12...
Choose CCG from dropdown = =
>
NHS North Cumbria CCG
NHS England North
(Cumbria And North East)
Report
covers
period up
to...
87 Cervical screening coverage data project
Choose CCG from dropdown = = > NHS Rushcliffe CCG
NHS England Midlands And Eas...
88 Cervical screening coverage data project
Choose CCG from dropdown = = > NHS Coventry And Rugby CCG
NHS England Midlands...
Thanksand acknowledgments
• Core Group
• Philippa Pearmain (chair)
• Ruth Stubbs
• Rad Latinovic
• Simon Wrathall
• Projec...
Cervical screening coverage data project
NHS Digital Live Demonstration
Cervical Screening Coverage
Data resource
Pritpal Rayat,Analytical Section Head of Screening and
Immunisations, NHS Digita...
Cervical Screening eLearning event
Cervical Screening Coverage Data Resource
presented by Pritpal Rayat & Ben Pace,
Screen...
Overview
• NHS Digital – who we are?
• The role of NHS Digital
• Data and Information Strategy
• Cervical Screening Covera...
NHS Digital – who we are?
• Formerly known as ‘The Health and Social Care Information Centre’ (HSCIC)
• We are the nationa...
The role of NHS Digital
96Fig. 1. The health and care system that NHS Digital supports
Health and care professionals
Resea...
Data and Information Strategy
• It sets out the future role that NHS Digital will take in driving forward the use of data ...
Cervical Screening Coverage Data Project
• PHE led project working collaboratively with NHS Digital and Jo’s Cervical Canc...
Cervical Screening Interactive Data Dashboard
• Developed in a software called Microsoft Power BI and is accessible via th...
Live Demo
• http://bit.ly/cervical_screen_coverage_quarterly_GPdata
• http://bit.ly/cervical_screen_coverage_quarterly_CCG...
www.digital.nhs.uk
@nhsdigital
enquiries@nhsdigital.nhs.uk
0300 303 5678
Discussion and panel Q&A
Closing comments and lunch
Launch of updated Cervical Screening Programme sample taker e-learning module
Launch of updated Cervical Screening Programme sample taker e-learning module
Launch of updated Cervical Screening Programme sample taker e-learning module
Launch of updated Cervical Screening Programme sample taker e-learning module
Launch of updated Cervical Screening Programme sample taker e-learning module
Launch of updated Cervical Screening Programme sample taker e-learning module
Launch of updated Cervical Screening Programme sample taker e-learning module
Launch of updated Cervical Screening Programme sample taker e-learning module
Launch of updated Cervical Screening Programme sample taker e-learning module
Launch of updated Cervical Screening Programme sample taker e-learning module
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Launch of updated Cervical Screening Programme sample taker e-learning module

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Launch of updated Cervical Screening Programme sample taker e-learning module

  1. 1. Welcome, introductions and overview of the day Jo Harcombe, IEPPNational Stakeholder Education Lead, Screening, Public Health England
  2. 2. National Cervical Screening Programme update Ruth Stubbs, National Programme Manager, Cervical Screening, Public Health England
  3. 3. Cervical Screening Programme update Ruth Stubbs National Programme Manager Public Health England leads the NHS Screening Programmes
  4. 4. Cervical Screening Programme update Ruth Stubbs National Programme Manager Public Health England leads the NHS Screening Programmes
  5. 5. Cervical screening programme update • HPV Primary Screening Implementation • 14 Day Turnaround Times • Clinical Professional Groups • Research and Advisory Groups • Primary Care Support England PCSE • Updated Programme guidance • Coverage • Blogs and Communications 7 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  6. 6. Key benefits of primary HPV screening • Primary HR-HPV testing has higher sensitivity for high grade cervical intraepithelial neoplasia (CIN) than primary cytology. Using primary HR-HPV testing to screen women will identify more women at risk of developing cervical cancer. • HR-HPV testing has a lower false negative rate than cytology. Meaning we will have the potential to increase screening intervals in the future for HR-HPV negative women. • UKNSC recommendation 2016 • Implementation by 2019 Cervical Screening Programme Update 12 10 2017 E-learning Launch8 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  7. 7. Primary HR-HPV testing pathway Impacts upon all programme elements • Call and recall and IT • Information for women • Sample takers • Screening laboratories • Screening protocol algorithm • Colposcopy service and management of women • Histology Cervical Screening Programme Update 12 10 2017 E-learning Launch9 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  8. 8. Primary HPV Testing Implementation Progress https://phescreening.blog.gov.uk/2017/01/31/deciding-how-best-to-roll-out- hpv-testing-as-the-primary-cervical-screening-test/ 10 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  9. 9. OPTIONSAPPRAISAL Objective Weight Quality 18 Staffing Feasibility 15 Effective IT Connectivity 15 Cost of Safe Delivery 15 Linkage to Local Services 10 Delivery During Transition 6 Adequate Clinical Support 6 Service Sustainability 6 Specimen Transport Feasibility 5 Commissioning Feasibility 4 Total 100 11 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  10. 10. Option4a.Aminimumnumberofcentralisedservices4to5laboratories Option4b.Amaximumnumberofcentralisedservices10to15 12 Cervical Screening Programme Update 12 10 2017 E-learning Launch 0 200 400 600 800 1000 1200 1400 1600 1800 1 2 3 4a 4b 5 WeightedBenefitScores Option for HPV Primary Screening Implementation Weighted Benefit Scores For Each Option
  11. 11. 13 Cervical screening coverage data project 14 dayTAT performance September2017 Source: Exeter VSA15 report for September 2017 Showing proportion of women in each CCG receiving their cervical screening result within 14 days of date test taken.
  12. 12. 14 day turnaround times for samples 14 Cervical Screening Programme Update 12 10 2017 E-learning Launch • Laboratories continue with workforce capacity issues and unable to achieve national target of women receiving their results within 14 days. • Mitigations are in place to start to address to extend HPV primary screening in pilot sites • Further Quality Review meetings have been held to consider further options with NHS England and PHE
  13. 13. Clinical Professional Groups Key Role in: Reviewing and producing guidance Advisory role to the programme Developing standards • Colposcopy Clinical Professional Group Reviewing the NHS CSP Colposcopy programme management guidelines Working with the programme to develop standards • Laboratory Clinical Professional Group Reviewing the NHS CSP laboratory programme management guidelines Developing Histology , failsafe, HBPC guidance • Cervical Screening Education and Training Clinical Professional Group Developing guidance for Training and Education both in Cytology and Sample taking. 15 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  14. 14. Development of Programme Specific Standards 16 Cervical Screening Programme Update 12 10 2017 E-learning Launch • The standards provide a defined set of measures that providers have to meet to ensure local programmes are safe and effective. • Consolidated standards focus on standards for improving the quality of screening programmes. • Additional operational guidance is included our guidance documents • Service specifications contain detailed information about the screening pathway. • The clinical professional groups for colposcopy and laboratories have met and reviewed current standards in the programme and a draft will be submitted to the PHE Data group. • Anticipated completed by end 2017
  15. 15. ResearchAdvisory Committee 17 The Research Advisory Committee roles are to: • support and advise the programmes • ensure applications do not adversely affect the uptake, acceptability and delivery of the NHS Screening Programmes. • review the scientific merit and feasibility of applications, and requests for data, and their impact on the screening programme. • determine which applications will have access to persons invited as part of the NHS Screening Programme. • produce recommendations for action following consideration of applications • assess possible areas of duplication, and to provide liaison between research groups considering similar projects • receive regular updates and final project reports from all applications • maintain a database of all applications • ensure, when required PHE ODR approvals process is followed. Research – new groups to drive change
  16. 16. For PHE Screening Programmes: The research co-ordinator will be the first point of contact for screening applications and will assist investigators throughout the application process. Data managers may work with applicants, when required to agree proposed data specifications The relevant Research Advisory Committees (RAC) will need to approve the request to access data before the application can progress through the relevant approvals i.e. PHE ODR For applications that do require PHE ODR approval the RAC outcome letter will include feedback from the ODR validation exercise ODR will assign the research co-ordinator as the ‘account manager’ for the project. 18 Presentation title - edit in Header and Footer
  17. 17. Updated Programme Guidance • Guidance for the training of cervical sample takers December 2016 • Approved HPV tests for HPV triage and test of cure January 2017 • Laboratory quality control and assurance for human papillomavirus testing January 2017 • Sample Acceptance guidance for laboratories Published April 2017 • Call and recall guidance Published April 2017 • EQA Protocol changes April 2017 19 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  18. 18. Guidance soon to be published In progress: • Ceasing guidance • Failsafe guidance • HBPC role changed title CSPL • Review of Cervical Screening Invasive audit • Achievable Benchmarks in Cytopathology • Histology guidance • HPV Primary Screening Implementation guide • Colposcopy and programme management gudiance • Programme standards. 20 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  19. 19. Primary Care Support England PCSE supports the National Cervical Screening Programme by: • Providing Prior Notification Lists (PNLs) of patients due for screening to GP practices • Sending out call and recall letters to patients eligible for cervical screening tests • Notifying patients of test results once we receive these from laboratories • Receiving and updating discharge lists from colposcopy clinics • Updating patient records with results 21
  20. 20. What will be different? • PCSE are not changing what they do, just improving the service by using more modern technology. • Most noticeably, replacing NHAIS (Exeter system) with a single database accessed via PCSE Online • The information required for the different screening tasks you undertake won’t change but the look and feel of the new system will be easier to navigate and intuitive to use. 22
  21. 21. Benefits: • One screen to access all screening information & histories (according to user access permissions) • Ability to download a prepopulated HMR101 form • Opportunity to update screening records at any point during the screening cycle, not just at PNL & FNR time • Greater flexibility to manage ceasing, deferring and delaying notifications • The ability to save PNLs and amend them after submission to PCSE • Ability to upload ceasing and deferral forms online, reducing print & postage costs • A more timely, secure & traceable process to update screening records 23
  22. 22. Benefits: • Improved Colposcopy Discharge Report process - currently 100% manual; transformed service will allow direct data upload from Colposcopy to PCSE • More timely lab file receipt reports and exception reports for laboratories • More timely access to women’s screening histories if they relocate to a new practice within England • Improved result matching processes should reduce the number of mismatches so result letters can be issued more quickly • Integrated Sexual Health Services (CASH/GUM clinics) will have the facility to view screening records of women attending their clinics. 24
  23. 23. When? • The plan is to introduce these improvements in Summer 2018 What do you need to do? PCSE will be sending out further information over the coming months including: • The IT specification required to access PCSE Online • How to register to use the new service • Online user guidance Updates will be distributed via Hospital Based Programme Coordinators and Screening & Immunisation contacts in area teams. You can also access latest news and bulletins on the PCSE website www.pcse.england.nhs.uk If you have any queries about the cervical screening transformation programme please contact: karen.burgess@nhs.net 25
  24. 24. Cervical Screening SpotlightActions • Present Data in more accessible way • Influences of activity via GP contract • Agree national language of targets • Flag additional needs in call and recall services Action to Improve coverage • Increase range of providers who can provide screening • Increase community engagement, who is best to do what, how are messages communicated, evaluate and share best practice • Work with CASH and GUM services Commissioner, provider local action to improve coverage Cervical Screening Programme Update 12 10 2017 E-learning LaunchCervical Screening Programme Update 12 10 2017 E-learning Launch
  25. 25. Health Matters https://www.gov.uk/government/publications/health-matters-making-cervical- screening-more-accessible/health-matters-making-cervical-screening-more-accessible--2 27 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  26. 26. Primary Care Data Pack • Collaborative piece of work with PHE, Jo’s Trust, NHS Digital • Provide meaningful Coverage data at CCG, L.A and practice level • https://www.gov.uk/government/publications/cervical- screening-coverage-and-data 28 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  27. 27. https://www.gov.uk/government/publication s/cervical-screening-coverage-and-data 29 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  28. 28. Blogs 30 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  29. 29. To summarise • The cervical screening programme continues to evolve and adapt according to the evidence. • The current changes are significant however working together will support the programme in achieving the aim: 31 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  30. 30. Producing the cervical screening e-learning Jonathan Waldheim, Digital Project Manager, Screening, Public Health England
  31. 31. Cervical Sample Taker Training E-learning Jonathan Waldheim (PHE)
  32. 32. Background 2008: Collaborative development between North East and Yorkshire and Humber. 2012: Initial discussions to update using regional developers. 2014: Further updates and complete overhaul the content for the NEYH region using regional developers and talent. 35 Cervical Sample Taker Training
  33. 33. Making the resource national 2016: Agreed that this would become a national resource rather than just a regional resource 2017: extensive peer review and feedback on the resource. Technical testing with the e-LfH team where the resource will be accessed. 36 Cervical Sample Taker Training
  34. 34. e-Learning for Healthcare (e-LfH) 37 Cervical Sample Taker Training • NHS approved platform for hosting e- learning • Resources available for anyone working in or delivering services for the NHS • Content exists alongside all existing e- learning for the national screening programmes
  35. 35. Registering and navigating the e-LfH hub 38 Cervical Sample Taker Training
  36. 36. Questions 39 Cervical Sample Taker Training
  37. 37. Cervical screening e-learning demonstration Ruth Stubbs, National Programme Manager, Cervical Screening, Public Health England
  38. 38. Cervical Screening Update e-Learning module Public Health England leads the NHS Screening Programmes
  39. 39. Cervical Screening Update e-Learning module Public Health England leads the NHS Screening Programmes
  40. 40. Cervical Screening Update e-Learning module cervcal screening e-Learning launch 12 10 1744
  41. 41. Resources cervcal screening e-Learning launch 12 10 1745
  42. 42. Cervical Screening Update e-Learning module cervcal screening e-Learning launch 12 10 1746
  43. 43. Cervical Screening Update e-Learning module cervcal screening e-Learning launch 12 10 1747
  44. 44. Cervical Screening Update e-Learning module cervcal screening e-Learning launch 12 10 1748
  45. 45. Cervical Screening Update e-Learning module cervcal screening e-Learning launch 12 10 1749
  46. 46. Cervical Screening Update e-Learning module cervcal screening e-Learning launch 12 10 1750
  47. 47. Cervical Screening Update e-Learning module cervcal screening e-Learning launch 12 10 1751
  48. 48. Cervical Screening Update e-Learning module cervcal screening e-Learning launch 12 10 1752
  49. 49. Cervical Screening Update e-Learning module cervcal screening e-Learning launch 12 10 1753
  50. 50. Cervical Screening Update e-Learning module cervcal screening e-Learning launch 12 10 1754
  51. 51. Cervical Screening Update e-Learning module cervcal screening e-Learning launch 12 10 1755
  52. 52. Cervical Screening Update e-Learning module cervcal screening e-Learning launch 12 10 1756
  53. 53. Cervical Screening Update e-Learning module cervcal screening e-Learning launch 12 10 1757
  54. 54. Any Requests? cervcal screening e-Learning launch 12 10 1758
  55. 55. Discussion and panel Q&A DeclanO’Brien, NationalEducationManager,Screening,PublicHealthEngland RuthStubbs,NationalProgrammeManagerCervicalScreening,PublicHealthEngland CatherineWitney,NationalEducationandTrainingManager,Screening,PublicHealth England JonathanWaldheim,DigitalProjectManager,Screening,PublicHealthEngland LouiseGardham,TechnologyEnhancedLearningDeveloperHealthEducationEngland
  56. 56. Future education programme developments Catherine Witney, National Education and Training Manager, Screening, Public Health England Ruth Stubbs, National Programme Manager, Cervical Screening, Public Health England
  57. 57. Future cervical screening programme education developments Ruth Stubbs Catherine Witney 12 October 2017
  58. 58. Education and training manager role 64 Future cervical screening programme education developments Cervical Screening Sample taker Cervical screeners-practice nurses GP midwife colposcopy nurse Physician associate Biomedical scientist Consultant BMS Cytopathologist Histopathologist Bowel Screening Assistant Screening Practitioner Specialist Screening Practitioner Lead Specialist Screening Practitioner Specialist Screening Endoscopist Clinical endoscopist Endoscopist Histopathologist Breast Screening Assistant mammographer Mammographer Advanced practitioner mammographer Consultant Radiographer-Breast Imaging Consultant Radiologist Consultant Histopathologist RCN RC Path RCGP SOR BAC IBMS RC Physicians GMC RCR CTCs HEE PHE Cancer Screening Programme managers IEPP CPGs Clinicians SQAS SITs Universities Cancer charities
  59. 59. Cervical Screening Education and Training Cervical Screening Education and Training CSET What is the groups remit? The education and training pathway for : • staff taking cervical samples • staff signing out negative and inadequate cervical cytology reports The group can recommend training initiatives for staff who sign out abnormal cervical cytopathology reports Training for virology or colposcopy is not included 65 Future cervical screening programme education developments
  60. 60. Cervical Screening Education and Training Who is involved? Membership of the group is drawn from: PHE screening Education Manager Cancer Screening Programmes (Chair) National Lead for Stakeholder Information and Professional Education and Training National Cervical Screening Programme Manager (Deputy Chair) Screening QA Service (SQAS) Portfolio Lead Education & Training Cytology Education Manager / Secretariat Representatives from professional organisations British Association for Cytopathology (BAC) Institute of Biomedical Science (IBMS) Royal College of General Practitioners (RCGP) Royal College of Pathologists (RCPath) Royal College of Nursing (RCN) Director of UK Cytology Training Centres Cancer Screening & Learning Disabilities Network 66 Future cervical screening programme education developments
  61. 61. Cervical Screening Education and Training How does the group work CSET group meets every 6 months CSET has core working groups • Sample Taker sub-committee cervical sampling • Examination sub-committee cervical cytology screening • Assessments sub-committee training provision and delivery Task & finish groups Examples of work undertaken • review group for the sample taker update eLearning resource • submission of CTC initial sample taker courses for RCN approval 67 Future cervical screening programme education developments
  62. 62. Sample taker training approval/endorsement Cervical Sample Taker Initial Training (2-day theory course) RCN accredited Delivered by 4 Cytology Training Centres in England: Birmingham Cytology Training Centre London Regional Cytology Training Centre North of England Pathology Screening Education Centre South West Regional Cytology Training Centre Course participants are awarded 12 CPD hours upon completion and receive a certificate from the RCN 68 Future cervical screening programme education developments
  63. 63. Sample taker training approval/endorsement NHS Cervical Screening Programme Guidance for the training of cervical sample takers Independent training providers should ensure their training provision is endorsed and regulated by an appropriate professional body. An appropriately regulated higher education provider (or similar professional body) should deliver training in screening theory. Training should be quality assured. The training institution should be able to demonstrate the ability to meet the competencies set out in this guidance. 69 Future cervical screening programme education developments
  64. 64. Sample taker training approval/endorsement How the Cytology Training Centres met the requirement The RCN endorsement and accreditation service includes a rigorous peer review process to validate the educational outcomes of the training programme Training being quality assured, applies to the framework in which training is delivered • CTC are quality assured through existing arrangements with their: • employing Trusts • local SQAS teams • commissioners for the provision of sample taker training 70 Future cervical screening programme education developments
  65. 65. HPV Primary screening implementation Training to support HPV Primary screening implementation Training packages are being developed to support the workforce as part of the national implementation of primary HR-HPV testing with cytology triage Staff groups include : • sample takers in primary care and colposcopy units • laboratory staff cervical screener ,BMS,Consultant BMS • colposcopists • cervical screening provider lead CSPL formerly HBPC 71 Future cervical screening programme education developments
  66. 66. HPV Primary screening implementation HPV primary screening: training for sample takers The ELearning module will support sample takers in primary care and colposcopy clinics to answer women’s questions about HPV primary screening The module will include: • HPV and cervical screening • transmission of HR-HPV • pilot of primary HR-HPV testing • Primary HR-HPV testing algorithms • possible results • sample taker training/monitoring • assessment and completion certificate Will be hosted on HEE eLearning for health website Sample takers are expected to complete the module prior to implementation and roll out 72 Future cervical screening programme education developments
  67. 67. HPV Primary screening implementation HPV primary screening: training for colposcopists A national colposcopy e-learning module is being developed by PHE and the British Society for Colposcopy and Cervical Pathology BSCCP It will provide colposcopists with confidence to follow the primary HPV testing pathway and discharge women appropriately To include: • why we are moving to primary HPV testing • effects of new pathways on referrals • colposcopy management algorithm • scenarios to support the colposcopist `s follow the pathway • future developments • certificate of completion Will be hosted on HEE eLearning for health website linked from BCSSP website Completing the resource is not compulsory, but considered good practice prior to implementation 73 Future cervical screening programme education developments
  68. 68. HPV Primary screening implementation HPV primary screening: training for laboratory staff All staff involved in the screening and reporting of cytology samples following primary HR-HPV testing need an up-to-date knowledge of the HPV screening pathway CSET will develop training content to include: • results of randomised controlled trials and pilots of primary HR-HPV testing • primary HR-HPV screening protocols and management algorithms • HR-HPV test and cytology workflow through the laboratory • quality assurance Training will be delivered by Cytology Training Centres 74 Future cervical screening programme education developments
  69. 69. HPV Primary screening implementation HPV primary screening training: Cervical screening provider lead CSPL Laboratory service reconfigurations resulting in large screening laboratories will require extra coordination with : • women being referred to multiple colposcopy units • audit of invasive cancers across separate trusts The role of the CSPL must ensure links are maintained between all elements of the local programme How will the CSPL role be supported? NHSCSP guidance for the role of the CSPL Training requirements will be developed based on NHSCSP guidance 75 Future cervical screening programme education developments
  70. 70. Trainee GP sample taker training provision GP trainee sample taker training provision Potential problems : • courses historically difficult to access • difficulty for trainees to obtain necessary supervised experience • difficulties for established GPs to keep up-to-date A regional training model which allowed ST2 trainees to access training in higher numbers is to be evaluated and if appropriate could be considered for adopted as national guidance 76 Future cervical screening programme education developments
  71. 71. RCGP Cervical screening e-learning How can we better engage with Primary Care practitioners? NHS Screening programmes have experienced challenges in accessing GPs, and primary care practitioners to provide programme information and updates. RCGPs recommends the most effective option is: • using short focussed e-learning • modules 15 minutes to complete for maximum impact NIPE e-learning feedback from Dirk Pilat, GP & RCGP medical director for e-learning: “This is an area of learning that would really appeal to GPs, an area where currently have very little content – I’d therefore imagine demand would be high’’ 77 Future cervical screening programme education developments
  72. 72. RCGP Cervical screening e-learning PHE screening and RCGP will collaborate to create ELearning resources to meet the needs of GP and primary care covering:  key information about the conditions screened for  screening pathways  primary care practitioner role in informing and supporting their patients Pilot phase Initially modules are being developed and piloted for: • Cervical screening • Diabetic Eye Screening • Sickle cell and Thalassaemia screening Development will start early 2018 with products available mid 2018 78 Future cervical screening programme education developments
  73. 73. Future cervical screening programme education developments Ruth Stubbs Catherine Witney 12 October 2017
  74. 74. Cervical screening coverage data project RuthStubbs NationalCervicalScreeningProgrammeManager Public Health England leads the NHS Screening Programmes
  75. 75. Cervical screening coverage data project RuthStubbs NationalCervicalScreeningProgrammeManager Public Health England leads the NHS Screening Programmes
  76. 76. Background • cervical screening coverage is falling – high profile to address this for NHS England and PHE • stakeholder feedback - data not easily available or timely • multiple definitions complicates the situation • agreement to set up small group to look at this 82 Cervical screening coverage data project
  77. 77. Projectobjectives • to make available more timely coverage data to internal and external stakeholders • to develop a primary care level data pack that supports and empowers GP practices and CCGs to improve cervical screening attendance and coverage rates • pragmatic decision on what to include – avoiding lengthy delays developing new things • “one-stop shop” for people to go to 83 Cervical screening coverage data project
  78. 78. How we will buildon this? • developing cervix data availability • improved timeliness • additional data planned • evaluation of use of tools • applying same methodology to breast and bowel data • breast project group just initiated • paper on project discussed at health inequalities strategic oversight board • aim to include use of data in new health inequalities standards • being included in new e-learning for sample takers being developed by the Programme (launch planned for the Autumn) 84 Cervical screening coverage data project
  79. 79. https://www.gov.uk/government/publication s/cervical-screening-coverage-and-data 85 Cervical Screening Programme Update 12 10 2017 E-learning Launch
  80. 80. Choose CCG from dropdown = = > NHS North Cumbria CCG NHS England North (Cumbria And North East) Report covers period up to 30th Septembe r 2016 For 25 to 49 age group - Standard: 80% of women to have adequate screening test within previous 3.5 years For 50 to 64 age group - Standard: 80% of women to have adequate screening test within previous 5.5 years NHS North Cumbria CCG No. of eligible women on last day of review period No. of women screene d in previou s 3.5 years 3.5-year coverage % NHS Cumbria CCG No. of eligible women on last day of review period No. of women screene d in previou s 5.5 years 5.5-year coverage % Screen s neede d to meet 80% RANK of 209 CCGs Screen s neede d to meet 80% RANK of 209 CCGs Performance of CCG 75,556 56,841 75.23 3,604 24 Performance of CCG 49,787 39,212 78.76 618 52 Performance for the practices that make up the CCG No. of eligible women on last day of review period No. of women screene d in previou s 3.5 years 3.5-year coverage % RANK Previous performa nce (August 2015) Performance for the practices that make up the CCG No. of eligible women on last day of review period No. of women screene d in previou s 5.5 years 5.5-year coverage % RANK Previous performa nce (August 2015) Screen s neede d to meet 80% of 76 practic es in CCG of practic es (nation al) Screen s neede d to meet 80% of 76 practic es in CCG of practic es (nation al) Surger y 1 ( A1234 5 ) 1,435 1,177 82.02 n/a 1 262 82.48 Surgery 8 ( H820 67 ) 369 331 89.70 n/a 1 85 89.37 Surger y 3 ( A1234 6 ) 776 633 81.57 n/a 2 324 79.17 Surgery 1 ( H820 70 ) 1,208 1,036 85.76 n/a 2 314 84.10 Surger y 6 ( A1234 7 ) 802 652 81.30 n/a 3 368 83.03 Surgery 3 ( H820 34 ) 1,890 1,564 82.75 n/a 3 1,072 84.57 Surger y 5 ( A1234 8 ) 1,587 1,285 80.97 n/a 4 417 81.11 Surgery 4 ( H820 31 ) 591 482 81.56 n/a 4 1,575 82.05 Surger y 8 ( A1234 9 ) <under 6> <under 6> -2.00 * * * * Surgery 6 ( H820 83 ) 947 771 81.41 n/a 5 1,641 81.68 Source for cervical coverage data: National Health Application and Infrastructure Services (NHAIS) systems accessed using Open Exeter. (https://nww.openexeter.nhs.uk/nhsia ) 86 Cervical screening coverage data project User selects one of the 209 CCGs The report has two tables. One for women aged 25 to 49, one for women aged 50 to 64 NB each table is ordered by descending performance for the particular age group. This column ranks the performance of the CCG and individual practices Performance for the practice from 12 months ago Small number (values 5 or below) suppression is used to mitigate potential identification of individuals. Where only one value has been suppressed within a region, the next smallest value is also suppressed. PHE Coveragetables– key for tables
  81. 81. 87 Cervical screening coverage data project Choose CCG from dropdown = = > NHS Rushcliffe CCG NHS England Midlands And East (North Midlands) Report covers period up to 31st December 2016 For 25 to 49 age group - Standard: 80% of women to have adequate screening test within previous 3.5 years For 50 to 64 age group - Standard: 80% of women to have adequate screening test within previous 5.5 years NHS Rushcliffe CCG No. of eligible women on last day of review period No. of women screene d in previou s 3.5 years 3.5- year cover age % NHS Rushcliffe CCG No. of eligible women on last day of review period No. of wome n screen ed in previo us 5.5 years 5.5- year cover age % Screen s neede d to meet 80% RANK of 209 CCGs Screen s neede d to meet 80% RANK of 209 CCGs Performance of CCG 19,993 16,223 81.14 n/a 1 Performance of CCG 11,454 9,686 84.56 n/a 1 Performance for the 13 practices that make up the CCG No. of eligible women on last day of review period No. of women screene d in previou s 3.5 years 3.5- year cover age % RANK Previou s perform ance (August 2015) Performance for the 13 practices that make up the CCG No. of eligible women on last day of review period No. of wome n screen ed in previo us 5.5 years 5.5- year cover age % RANK Previous performa nce (August 2015) Screen s neede d to meet 80% of 13 practic es in CCG of 7751 practic es (nation al) Screen s neede d to meet 80% of 13 practic es in CCG of 7751 practic es (natio nal) RADCLIFFE ON TRENT HEALTH CENTRE (C84084) 1,167 1,002 85.86 n/a 1 24 85.87 DR L H K KANDOLA ( C8470 3 ) 441 394 89.34 n/a 1 50 89.30 DR L H K KANDOLA (C84703) 1,019 863 84.69 n/a 2 43 85.14 DR SCAFFARDI & PTRS ( C8402 5 ) 742 659 88.81 n/a 2 65 87.76 DR KELLY PTRS (C84005) 1,979 1,666 84.18 n/a 3 53 84.44 MUSTERS MEDICAL PRACTICE ( C8409 0 ) 1,002 882 88.02 n/a 3 91 88.25 RUDDINGTON MEDICAL CENTRE (C84028) 1,170 978 83.59 n/a 4 71 81.77 DR KELLY PTRS ( C8400 5 ) 1,185 1,041 87.85 n/a 4 98 87.83 DR JELPKE & PTRS (C84086) 1,975 1,643 83.19 n/a 5 89 83.25 RADCLIFFE ON TRENT HEALTH CENTRE ( C8408 4 ) 767 670 87.35 n/a 5 117 87.58 MUSTERS MEDICAL PRACTICE (C84090) 1,547 1,259 81.38 n/a 6 245 80.53 DR JELPKE & PTRS ( C8408 6 ) 798 679 85.09 n/a 6 313 85.40 DR LANGRIDGE & PTRS (C84048) 1,413 1,131 80.04 n/a 7 468 81.66 RUDDINGTON MEDICAL CENTRE ( C8402 8 ) 583 491 84.22 n/a 7 482 81.80 BELVOIR HEALTH GROUP (C84017) 3,790 3,012 79.47 20 8 592 79.03 CASTLE HEALTHCARE PRACTICE ( C8460 5 ) 1,596 1,343 84.15 n/a 8 495 84.43 WEST BRIDGFORD MEDICAL CENTRE (C84621) 986 780 79.11 9 9 671 79.08 DR LANGRIDGE & PTRS ( C8404 8 ) 1,106 916 82.82 n/a 9 849 83.26 CASTLE HEALTHCARE PRACTICE (C84605) 2,880 2,242 77.85 62 10 1,051 77.53 DR FOSTER & PTRS ( C8204 0 ) 693 568 81.96 n/a 10 1,171 83.41 DR FOSTER & PTRS (C82040) 1,144 852 74.48 64 11 2,365 72.84 BELVOIR HEALTH GROUP ( C8401 7 ) 2,314 1,858 80.29 n/a 11 1,963 81.43 DR SCAFFARDI & PTRS (C84025) <Suppre ssed> <Suppres sed> -1.75 * * * 85.70 WEST BRIDGFORD MEDICAL CENTRE ( C8462 1 ) <Suppress ed> <Suppr essed> -1.75 * * * 81.90 This sheet lists all practices in the CCG area and ranks them by cervical coverage performance. PHE Coveragetables– Example
  82. 82. 88 Cervical screening coverage data project Choose CCG from dropdown = = > NHS Coventry And Rugby CCG NHS England Midlands And East (West Midlands) This CCG has 75 practices Report covers period up to 31st December 2016 Age Range 25 to 49 Standard: 80% with an adequate test in last 3.5 years CCG Performance 67.62 % Rank of 209 CCGs 160 Age Range 50 to 64 Standard: 80% with an adequate test in last 5.5 years CCG Performance 78.18 % Rank of 209 CCGs 78 0 200 400 600 800 1000 1200 1400 1600Age range: 50 to 64 95.69 93.10 87.83 87.24 86.20 86.19 85.06 84.95 84.68 84.30 82.67 82.55 82.29 82.25 81.65 81.59 80.90 80.89 80.65 80.60 80.51 79.96 79.90 79.72 79.69 79.10 78.99 78.98 78.65 78.57 78.55 78.49 78.45 78.42 78.24 77.90 77.80 77.51 77.33 77.17 76.69 76.38 76.28 76.11 75.67 75.54 75.45 75.43 75.20 75.10 74.92 74.53 74.11 73.96 73.91 73.61 73.52 73.38 73.00 72.57 72.17 72.14 72.12 71.68 71.43 71.37 70.31 69.28 67.75 65.08 65.05 63.08 37.50 0 20 40 60 80 100 Y04952 M86014 M86026 M84004 M86034 M84020 M86638 Y04947 Y00140 M86038 M84023 M86046 M86610 M86035 M86032 M86015 M86037 M86027 M86624 M86006 Y04949 M86607 M86020 M86617 M86045 M86008 M86048 M86002 M86613 M84065 M86004 M86013 M86012 M86041 Y04965 M86029 Y00060 Y02613 80% or higher 75% to 79.99% 70% to 74.99% below 70% 0 1000 2000 3000 4000 5000Age range: 25 to 4980.15 80.12 78.15 77.99 77.15 76.25 76.17 75.93 75.87 75.09 74.73 74.69 74.36 73.34 72.95 72.87 72.78 72.65 71.68 71.68 70.93 70.88 70.82 70.80 70.68 70.46 70.22 69.85 69.60 69.50 69.36 69.17 68.88 68.85 68.67 68.67 68.64 67.29 67.21 67.10 66.70 66.12 65.70 65.35 65.21 64.66 64.60 64.60 64.48 63.42 63.19 62.71 62.46 62.14 61.70 60.60 60.00 59.91 59.76 59.33 59.21 58.98 58.20 57.94 57.72 57.63 57.23 57.14 55.57 53.71 52.84 50.65 48.75 0 20 40 60 80 100 Y04952 M86014 M86026 M84004 M86034 M84020 M86638 Y04947 Y00140 M86038 M84023 M86046 M86610 M86035 M86032 M86015 M86037 M86027 M86624 M86006 Y04949 M86607 M86020 M86617 M86045 M86008 M86048 M86002 M86613 M84065 M86004 M86013 M86012 M86041 Y04965 M86029 Y00060 Y02613 80% or higher 75% to 79.99% 70% to 74.99% Below 70% This sheet shows CCG performance on two graphs. One for 25 to 49s, the lower for 50 to 64s Key Every practice from the selected CCG is shown . Symbol colour denotes whether performan ce meets 80% standard (dark green), is over 75% (light green), between 70% & 75% (blue), under 70% (orange) Grey bars show relative size of eligible population for each practice PHE Coveragegraphs - Example
  83. 83. Thanksand acknowledgments • Core Group • Philippa Pearmain (chair) • Ruth Stubbs • Rad Latinovic • Simon Wrathall • Project group stakeholders • Rob Music and Kate Sanger, Jo’s Cervical Cancer Trust • Nicola Benge and Dan Seddon, SILs • Anthony Cunliffe, Macmillan • Ginny Fieldsend, Kathie Binysh and Nikki Osborne, NHS England • John Wisset, Capita • Ben Pace, David Connolly, Pritpal Ryat, NHS Digital • IEPP • TJ Day, Jonny Waldheim, Mike Harris, IEPP 89 Cervical screening coverage data project
  84. 84. Cervical screening coverage data project NHS Digital Live Demonstration
  85. 85. Cervical Screening Coverage Data resource Pritpal Rayat,Analytical Section Head of Screening and Immunisations, NHS Digital Ben Pace, NHS Digital Senior InformationAnalyst, Screening and Immunisations, NHS Digita
  86. 86. Cervical Screening eLearning event Cervical Screening Coverage Data Resource presented by Pritpal Rayat & Ben Pace, Screening & Immunisations Team
  87. 87. Overview • NHS Digital – who we are? • The role of NHS Digital • Data and Information Strategy • Cervical Screening Coverage Data Project • Cervical Screening Interactive Data Dashboard • Live Demo • Q & A 94
  88. 88. NHS Digital – who we are? • Formerly known as ‘The Health and Social Care Information Centre’ (HSCIC) • We are the national information and technology partner for the health and care system • Our vision is to harness the power of information and technology to make health and care better • We aim to: – ensure that every citizen’s data is protected – establish shared architecture and standards so everyone benefits – implement national services to meet national and local needs – support care organisations to get the best out of technology, data and information – enable much better use of health and care information • We have a statutory duty to help the health and care system drive greater value from the data and information it generates 95
  89. 89. The role of NHS Digital 96Fig. 1. The health and care system that NHS Digital supports Health and care professionals Researchers ALBs Politicians Citizens Media rities Health and care providers Living healthy lives and making choices about health Providing health and care services Organising the delivery of health and care services Overseeing, influencing and regulating the delivery of health and care services Information and technology delivery partner for the health and care system DH Health and care professionals Health and care providers ALBs Regulators Commissioners Charities DH Media Politicians Researchers
  90. 90. Data and Information Strategy • It sets out the future role that NHS Digital will take in driving forward the use of data and information in delivering the Five Year Forward View and government priorities • It also aligns to the shared vision and plans for data and information across the health and care system that are owned by the National Information Board and the Paperless 2020 programme • Some of the key themes towards achieving this Strategy include: • Engaging with our customers proactively to understand their requirements • Being the single authoritative source of data across the health and social care system • Utilising data to add value in all that we do and making data accessible to our customers in a timely way • Presenting and publishing data and statistics in innovative ways that add value for our customers 97
  91. 91. Cervical Screening Coverage Data Project • PHE led project working collaboratively with NHS Digital and Jo’s Cervical Cancer Trust • Cervical Screening coverage has continued to fall year on year – key area for improvement and is a high level PHE objective • NHS Digital publish coverage data annually as part of the Cervical Screening Programme Statistics bulletin • Increased requirement for more timely coverage data to be made available in the public domain at more granular levels (i.e. GP Practice/CCG) • This has led to the development of a set of data resources that will help support and empower GP practices and CCGs to improve cervical screening attendance and coverage rates • NHS Digital have developed a web based interactive dashboard and first release went live in June 2016, with updates published on a quarterly basis • Data on attendance and coverage rates published as ‘management information’ down to GP Practice level 98
  92. 92. Cervical Screening Interactive Data Dashboard • Developed in a software called Microsoft Power BI and is accessible via the internet • Focus on making data available ‘interactively’ through many types of visualisation, including graphs, charts and maps, and other dynamic features The Dashboard: • Presents data for screening coverage at two groups – 25-49 years and 50-64 years at GP Practice, CCG and Local Authority levels which is released into the public domain every three months • Includes data for the number of women eligible and screened • Provides information on how GP Practices rank within the CCG and Nationally in relation to cervical screening coverage rates • Data are obtained monthly reports from the Open Exeter system, which is hosted by NHS Digital • Provides end users with a more immediate source for local oversight and commissioning of cervical screening services • Helps those involved in managing the screening programme make better informed decisions on the most up to date data available 99
  93. 93. Live Demo • http://bit.ly/cervical_screen_coverage_quarterly_GPdata • http://bit.ly/cervical_screen_coverage_quarterly_CCGdata • http://bit.ly/cervical_screen_coverage_quarterly_LAdata Relevant/Related Sources: NHS Digital - http://http//digital.nhs.uk/pubs/cervical_screen_coverage_quarterly PHE - https://www.gov.uk/government/publications/cervical-screening-coverage-and-data Jo’s Cervical Cancer Trust - https://www.jostrust.org.uk/information-healthcare- professionals/information-practice-nurses-and-gps 100
  94. 94. www.digital.nhs.uk @nhsdigital enquiries@nhsdigital.nhs.uk 0300 303 5678
  95. 95. Discussion and panel Q&A
  96. 96. Closing comments and lunch

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