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Screening activity

BreastCheck operated a reduced service in February 2021 due to unprecedented levels of COVID19 in the community. With levels of the virus now dropping, and the opening up of treatment pathways, routine screening is resuming nationwide on 08 March 2021.

Our clinics and mobile units are working hard to keep people safe when they go for their appointment.

Measures to ensure participant and staff safety include:

• Vaccination of frontline staff, with patient-facing staff vaccinated by 08 March
• Upgraded units to meet infection control and physical distancing requirements
• Staff use of PPE and social distancing observed in all units
• Reduced cross-county flow of staff and participants

We are prioritising those who have waited longest for routine screening. This means that:

• Invitation letters will be sent first to those who had appointments cancelled in January 2021
• Invitations for all other women due routine screening will follow
• Women in the assessment phase of breast screening will continue to be seen

Breast screening capacity is reduced due to social distancing due to COVID-19. A new text management system is in place to maximise appointment uptake. We are asking all participants to:

• check their telephone details on the register
• Let us know if they can’t make their appointment so that it can be reallocated
• Do not attend if they have symptoms of COVID-19, and visit HSE.ie for advice.

Screening capacity

Many women who were due their screening invitation in 2020 have had their invitation delayed during the global pandemic.

The NSS continues to investigate ways to increase capacity to address the longer screening times that are a factor of care in a COVID-19 environment. These include asking staff to work additional hours where possible. We note however that there is finite level of staffing resources available to healthcare worldwide, regardless of available budget.

The focus of the resumption of routine breast screening is therefore to achieve a maximum invitation rate that is compatible with a safe and controlled follow-up assessment and our treatment capacity within the health service. BreastCheck will operate at reduced capacity for the foreseeable future to ensure the safety of participants.

We continue to emphasise to our participants that BreastCheck is a screening service for well women within the population age range, and is not for people with symptoms. If a woman has any concerns or symptoms concerning their breasts, we strongly encourage them to contact or attend their GP to ensure that they are given the appropriate advice/referral regarding a symptomatic clinic for breast symptoms, which are in operation.

CervicalCheck

From the 01 to 26 February 2021, the following activity has taken place:

• c88,000 invitations and reminder letters have been received;
• c21,000* samples have been received from primary care, less than the 23,000 slides per month normal throughput in screening and in line with programme standards.
• Colposcopy clinics are continuing to work at capacity to see women referred for treatment.

We continue to advise women to:

• book their test when they are due
• take the next available appointment at their GP or clinic, even if it is some weeks away.
• check the list of registered screeners on our website, www.hse.ie/cervicalcheck , in the event their GP is temporarily unable to offer screening

Transfer of Quest laboratory facilities

Our US screening laboratory partner Quest Teterboro is moving to a new, state-of-the-art facility in Clifton, New Jersey. Any change to laboratory processes - including a move of premises - is subject to quality assurance review and this is in progress.

BowelScreen

BowelScreen continues to match invitations to participate to colonoscopy capacity.

We are working with host hospitals to maximise the volume of follow-up procedures they can accommodate safely during COVID-19.

In February 2021 the following activity has taken place:

• Over 3,800 invitations issued
• Over 248 colonoscopies (index and surveillance) completed.

BowelScreen will continue to respond appropriately to the impact of COVID-19 on the delivery of the programme in support of the endoscopy units in conjunction with the National Endoscopy Programme.

Diabetic RetinaScreen

Diabetic RetinaScreen continues to invite participants to attend screening. We are working with providers to ensure screening is delivered safely, in line with Public Health guidelines, for staff and participants.

From the 01 to 28 February 2021, the following activity has taken place:

• c15,000 invitations have been sent;
• c10,000 participants have been screened;

On 16 February 2021, DRS introduced a two-yearly screening pathway for screening participants who are deemed eligible. Until now, DRS invited programme participants for diabetic retinal screening once a year. This has changed to a two-yearly appointment for people who fulfil certain criteria. If a person has received a result of ‘no retinopathy’ from their previous two screenings, their next DRS screening invitation will be two years from the time of their last screen.

The new pathway will reduce the number of screening appointments and reduce unnecessary clinic visits and examinations. Other countries that offer two-yearly screening intervals include Canada, Denmark, Finland, Iceland and Scotland.

We are continuing to invite participants for screening, with regional variations in screening capacity at this time. We are working with the host hospitals as they make local decisions on their referral capacity. All urgent referrals are being seen in the treatment centres.

* provisional laboratory data.