Report of the Director of Public Health and the Chief Medical Officer, Manchester Local Care Organisation

This report provides the latest position in relation to cancer screening programmes for the population of Manchester.

The Committee considered the report of the Director of Public Health and the Chief Medical Officer, Manchester Local Care Organisation that provided the latest position in relation to cancer screening programmes for the population of Manchester.

Key points and themes in the report included:

·         The latest available screening uptake figures for Manchester in relation to the national cancer screening programmes, noting that there were currently three screening programmes for the prevention or early detection of cancer, namely Breast, Bowel and Cervical screening;

·         The role of the Manchester Population Health Management Board within the Manchester Local Care Organisation;

·         Information on the actions that were being taken across Manchester to address low uptake and coverage, with a greater focus on health inequalities; and

·         Describing the Greater Manchester targeted lung health check programme, and the plan for Manchester.

Some of the key points that arose from the Committee’s discussions were:

·         Stating that the key message was that screening saved lives;

·         What was the process for following up on bowel cancer testing kits that were not returned;

·         What was the current advice in relation to prostate cancer;

·         More information was requested in relation to the Equality Impact Assessments undertaken in relation to cancer screening;

·         What were the ages of people accessing screening services;

·         Welcoming the mobile mammogram unit at North Manchester General Hospital; and

·         Noting the reported issues and limitations to gynae services at Manchester University NHS Foundation Trust (MFT) as a result of staff shortages, recruitment processes and training for new staff.

The Chief Medical Officer, Manchester Local Care Organisation addressed the discussions in relation to the data presented in the report and stated that it was important to differentiate between the rates of screening rather and incidents of cancer diagnosis. He made reference to the Health Development Coordinators and the Manchester Population Health Management Board (PHM). He said that PHM plans were built on their work in communities, building positive relationships with local communities and local partners in the VCSE and, importantly, primary care. He commented that all this work was data led and evidence based. In terms of the age of cohorts and screening he commented that this was in accordance with national clinical guidance.  

The Chief Medical Officer, Manchester Local Care Organisation discussed the need to consider health literacy adding that this could be a barrier to people accessing screening services, making reference to his own experience when receiving a testing kit. He commented that consideration needed to be given to the language used to ensure it was appropriate. He commented on the issue of trust amongst some communities and health services and the need to work to tackle these barriers to screening and health services more generally, noting that it was recognised that a ‘one size fits all’ approach was not appropriate.

The Chief Medical Officer, Manchester Local Care Organisation said that the national advice in relation to prostate cancer was to contact your GP if you experienced any change when passing urine and/or noticed blood in your urine. The Cancer Reform Manager (Manchester), NHS Greater Manchester made reference to the 2023 ‘This Van Can’ prostate cancer awareness roadshow. The roadshow had visited sites across Greater Manchester between May and October 2023 as part of an NHS pilot. It was targeted at black men aged over 45 who were at greater risk of getting prostate cancer. 

The Chief Medical Officer, Manchester Local Care Organisation advised that the issues reported at MFT in relation to gynae services were being addressed, noting that the issue of staff recruitment and retention was a national issue. He added that the impact of the pandemic on NHS backlogs of work remained an issue. The Cancer Reform Manager (Manchester), NHS Greater Manchester informed the Committee that MFT had established a cervical screening facility for their staff in an attempt to increase the take up rates of screening.

The Cancer Reform Manager (Manchester), NHS Greater Manchester said that if a bowel testing kit was not returned, a second kit was issued. If this was not returned the patient was classed as a non-responder. She said that an individual could request a kit at any time if they had missed the initial invitation. With regard to the question asked in relation to the Equality Impact Assessments she advised that these were undertaken by commissioners and that Health Equality Audits were also undertaken.

The Executive Member for Healthy Manchester and Adult Social Care welcomed the report and paid tribute to the collaborative approach of the cancer alliance. He further recognised the important work of the Population Health Management Board, chaired by the Chief Medical Officer, Manchester Local Care Organisation, noting this was responsive to address the needs of residents. He further made reference to the good practice demonstrated by the exercise undertaken by the Miles Platting, Newton Heath and Moston Primary Care Network, who between June and early December 2023 had called more than 400 eligible patients who had not returned their screening kits to discuss the importance of screening and identify any barriers, noting that as a result, 220 screening kits were reissued.

Decisions

The Committee recommend;

1.    That the Director of Public Health, in consultation with relevant partners review the letters issued with bowel screening kits to ensure the language and terminology used is appropriate.

That the Director of Public Health, in consultation with relevant partners, give consideration to the use of videos as a visual medium to promote the importance of cancer screening.