Dr. Scally Final Report statement

Women can have confidence in Ireland’s cervical screening programme - according to final progress review of CervicalCheck from Dr Gabriel Scally

The HSE’s National Screening Service has today (Wednesday, 23 November 2022) welcomed the publication of Dr Gabriel Scally’s final progress review of the implementation of the recommendations from his Scoping Inquiry into the CervicalCheck screening programme.

The report states that: “women can have confidence in and should take full advantage of the cervical screening programme. It has saved many women's lives and will continue to do so.”

The final review was commenced in January 2022 at the request of Minister for Health, Stephen Donnelly TD. In it Dr Scally acknowledges the progress achieved to date and highlight areas for further improvement.

The HSE and NSS accepted in full, without exception, the recommendations from Dr Scally’s Scoping Inquiry into CervicalCheck, and embraced the changes required to improve screening services.

This work included developing an updated reporting structure for the NSS within the HSE; and was facilitated by significant investment to enable restructuring of the CervicalCheck programme. The HSE will take time to review the final progress report and continue to work to implement its findings.

NSS can confirm the following actions have been completed in relation to CervicalCheck:

• Patient Requested Reviews – this is a cancer review process for any individual with cervical cancer which incorporates full and open disclosure of all findings which is due to begin in January 2023
  
  • The Patient Requested Review process provides an alternative process for women to get answers. The process has placed feedback from members of 221+ at the centre of its design. We are committed to ensuring women who are informed about discordant results in the future will have a better experience of receiving this news than the women who received this information in the past.
• Enhanced oversight of laboratories 
• Commissioning of a new National Cervical Screening Laboratory 
• Additional investment in colposcopy to support rapid access to diagnostics and treatment after screening 
• Extended education and training programmes 
• Information governance and records management 
  
  • Improved access to records
  • Improvement in data analytics and reporting
  • Strengthened data sharing arrangements, including with the National Cancer register Ireland (NCRI), and the National Immunisation Office (NIO) consistent with best information governance practices

Changes implemented related to the four NSS screening programmes (BreastCheck, CervicalCheck, BowelScreen and Diabetic RetinaScreen) have included establishing:

• Governance structures to foster public trust, including the formation of the HSE Board which reports directly to the Minister of Health 
• Clear reporting structures – through the office of the Chief Clinical Officer, including to the HSE Board oversight committees related to internal audits; risk management; safety; quality; public procurement and financial reporting; and of performance related to key performance indicators (KPIs) 
• NSS Quality Assurance framework – a standardised cross-programme approach to quality assurance, read more here 
• A streamlined NSS organisational structure - with a new Chief Executive of the NSS responsible for the leadership, management, performance, quality, governance, and co-ordination of all four national screening programmes 
• New functions to support the work of the programmes:
  • Public Health
  • Quality, Safety and Risk
  • Communication, Engagement and Information Development
• Public, patient and partnership working and participation - The Patient and Public Partnership (PPP) Strategy 2019-2023 sets out NSS commitment to a partnership approach where decision making is shared between patient and public representatives. Also, see PPP Progress Report 2022
  
  • Systems to capture feedback and improve service user experience

Equity Strategy Development – read more here about our equity work

The work to build on these changes forms a major part of the NSS strategy for 2023 onwards, including those areas highlighted by Dr Scally that still need to be addressed.

NSS Chief Executive Fiona Murphy said: “Dr Scally’s final report marks a milestone for NSS staff who have shown huge commitment to embedding the recommendations into NSS to improve our screening services. We accepted and implemented all recommendations, cementing clear governance, meaningful patient and stakeholder involvement, and transparent reporting structures at the heart of the NSS.

“We have achieved a lot in the last four years. We will now take time to review the final report and ensure we implement its findings. Our work will continue to be informed by Dr Scally’s reports to ensure we offer a high-quality service with participants at its heart.”

CervicalCheck Clinical Director, Professor Nóirín Russell said: “This report details the progress CervicalCheck has made in improved governance, strengthened reporting lines, and what Dr Scally has recognised as ‘excellent system of Quality Assurance’ in the laboratories we use to process women’s screening tests. We are continuing to make good progress in putting patients and their experiences at the centre of how we do our work.

“In designing our new Patient Requested Review process we are working extensively in partnership with patients, including the 221 group, who have told us how we can improve on the previous audit process. We are listening to patients and embedding the patient voice in our processes ensuring women can have trust and confidence in our service now and in the future.”

To review Dr Scally’s report, please click here 

For a report on the National Screening Service’s Implementation of Dr Scally Reports, please click here.

To find out more about how NSS, and specifically CervicalCheck, is performing visit screeningservice.ie. Here you will find links to our year-end reports - where we measure performance against KPIs; research and project updates.

 

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