Massive backlog of smear test samples piled up at NHS laboratories, says National Audit Office

More than 150,000 cervical screening samples have been piled up in laboratories across England waiting to be tested, according to a new report.
Screening programmes have been criticised.Screening programmes have been criticised.
Screening programmes have been criticised.

The National Audit Office (NAO) found that changes to testing arrangements led to a huge backlog that is still being tackled.

Its report also found that just one in three women undergoing a smear test received their result within the recommended 14 days at one point last year, suggesting thousands faced delays in finding out if they would need further tests or treatment.

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The NAO study found that not one NHS screening programme – including those for breast and bowel cancer – was meeting national targets for how many people should be screened.

The NAO also noted problems with dated IT systems, meaning concerns remain that people may miss out on cancer screening.

It follows serious incidents reported last year regarding the cervical and breast cancer screening programmes, when thousands of women were found to have not been sent invitations.

Referring to cervical screening, the report said: “In October 2018, there was a backlog of 98,000 cervical screening samples waiting to be tested by laboratories across England. NHS England told us that it is working to reduce the backlog, which has been reduced from 152,742 in March 2018 by moving the analysis of samples around the country, to reduce the burden on those laboratories under most pressure.”

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Some 98 per cent of women should receive their results within 14 days of their appointment, but the target has not been met since November 2015.

In March 2018, only 33 per cent of women were getting their results on time but by December, it had improved to 55 per cent.

The NAO also said none of the adult cancer screening programmes met their standard coverage target during 2017/18, although most met a new “lower threshold target” introduced to reflect the lowest level of performance expected.

A bowel scope test for people aged 55 to check for signs of bowel cancer has also not reached as many people as hoped.

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By September 2018, 166,043 people had been invited for bowel scope screening, against a target of 499,877.

In its report, the NAO noted: “All the screening programmes rely on a complex and ageing IT system to identify who to invite for screening.”

A legacy database of GP registrations has been described by the Department of Health and Social Care as “not fit for purpose for screening programmes”. NHS England intended to replace it in 2017 but that was delayed, leading to spiralling costs and greater risk to screening programmes.

Meg Hillier MP, chairwoman of the Public Accounts Committee, said: “It is worrying that not everyone who is eligible to take part in screening programmes is doing so, and the proportion of eligible people taking part varies across England. It is unacceptable that these important screening programmes are being let down by complex and ageing IT.”

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Responding to the study, a spokesman for the Department of Health and Social Care last night said: “Prevention and early diagnosis of cancer are key priorities for this Government, and we are already working closely with NHS England and Public Health England to address the issues this useful report highlights.

“An independent review announced by NHS England is looking at cancer screening services. We expect this to lead to an overhaul of the system so it meets the high standard NHS patients rightly expect.”