The year 2021-22 was a challenging one for screening. There were still some COVID restrictions in place, work on recovery following the pause was underway, and business as usual was also restarting with changes and developments taking place even on the background of recovery.
Although a lot of focus has been placed on tackling inequity and improving accessibility, this is not necessarily reflected in the figures showing uptake by deprivation quintile.
Table 6: Difference in uptake between most and least deprived quintile
|
Programme |
2021/22 |
2020/21 |
2018/19 |
|
Bowel |
15.9% |
14.5% |
16.5% |
|
Breast |
15.3% |
18.9% |
15.9% |
|
Cervical |
13.2% |
12.1% |
11.5% |
|
AAA |
12.4% |
8.7% |
12.8% |
One factor that will have affected this is the continued impact from COVID pandemic and the way that services were delivered throughout 2021/22. Although carrying out an Equality and Health Impact Assessment is part of our standard practice when making changes or developments, as is consideration of differential impact on different groups of service users, some changes were unavoidable during this time. One example was around venues, as we were still limited as to where we could screen for some programmes, which did affect travel times. Our Equity Strategy was developed during 2021/22 and we are hoping to see more positive impact in the figures for 2022/23.
However, the figures presented here are a crude measure and do not reflect the breadth of work discussed in the first part of the report and the ongoing engagement and collaborative work to better understand and address barriers and enablers to access.
This data in this report have focused on uptake, which is only the start of the screening pathway. The overarching aim of screening is to improve health outcomes for the people of Wales through reduced morbidity and mortality. As we work to improve health inequities across the screening pathway we will also develop how we can incorporate data at different stages of the clinical pathway including access and availability of diagnostic tests and treatment to inform the response needed to reduce health inequities.
Key findings from the data that will continue to inform action include the difference in uptake between people who have previously taken part in screening and those who have not. This, along with the findings that generally uptake is lower in people who are younger, reinforces the need to focus efforts around increasing uptake on people who are invited to screening for the first time.
Over the next year, the Screening Division will continue to progress the actions that came from our Equity Strategy. We will work through phase 2 actions as well as additional areas of focus that will continue to arise, structuring our actions around the key themes of Communication, Community and Engagement, Collaboration, Service Delivery and Data and Monitoring.
This will enable us to progress to achieve our vision that across the national screening programmes in Wales, everyone eligible for screening has equitable access and opportunity to take up their screening offer, using reliable information to make a personal informed choice.