HSE Statement: Tuesday, 11th June 2019
The HSE welcomes the publication today by Minister Harris of the Supplementary Report of the Scoping Inquiry into the CervicalCheck Screening Programme by Dr Gabriel Scally.
This Supplementary Report provides further reassurance to Irish women about cervical screening quality, notwithstanding the issues raised in relation to the use of additional laboratories. Dr Scally finds that use of additional laboratories did not result in a reduction of the quality of the screening provided to Irish women and there is no evidence to suggest deficiencies in screening quality in any laboratory. In addition we welcome Dr Scally’s view on the accreditation schemes used by laboratories, that there are no overall differences that may impact significantly on the quality of the final reports on cytology.
Dr Scally has acknowledged in this report the substantial and important progress being made to date in implementing the recommendations of his First and Final Reports. Of Dr Scally’s 56 recommendations prior to today, including the 6 interim recommendations, the HSE has responsibility for implementing 32 and a further 8 recommendations which are jointly owned with the Department of Health. Of the 154 actions against all of the recommendations, the HSE has responsibility for implementing 105 of them.
Each set of actions has a detailed action plan inclusive of timelines for commencing and completing and fortnightly progress reporting is provided by action owners. This plan is iterative and therefore the actions will change as the plan progresses.
The HSE continues to be committed to keeping the voices of patients and service users at the centre of this process and has been communicating with patient representatives during the plans’ further development and also in overseeing implementation of recommendations to date.
In terms of the 105 actions assigned to the HSE, 42 have been completed, 52 are in progress and 7 due to start later in 2019. Most actions will be completely implemented by the end of 2019. Interim updates on status of actions within the HSE’s remit are published on www.hse.ie
Specifically in relation to quality assurance, the following improvements have been made;
- A National Laboratory Quality Assurance Lead has been appointed to Cervical Check – this is a new post that will provide significant expertise and assurance to monitoring quality of laboratory services in the programme. A Deputy Laboratory Coordinator has also been recruited to provide further support in the laboratory area.
- A new pre-Quality Assurance inspection visit questionnaire was introduced to strengthen recent Quality Assurance visits in relation to additional capacity.
- Quality assurance inspection visits to laboratory providers are in progress with a number already complete. All five of Quest Diagnostic’s laboratories have had an initial quality assurance visit, with a follow up planned in Q3.
- Progress is continuing in relation to developing improvements in programme standards, quality assurance and the implementation of a single agreed terminology for recording results at the next Clinical Advisory Group.
- The National Screening Service has developed, tested and validated the cervical screening report specifications in order to obtain comparable data excluding samples taken from colposcopy and will publish all performance statistics on samples taken in primary care or equivalent.
- Updated standards for laboratories will also be implemented in line with the introduction of HPV primary screening.
- National Screening Service has collated data for the next annual report (for 2018) on all categories broken down by providers. A review of the data is currently taking place prior to its publication.
- The newly appointed Director of Public Health in the National Screening Service is establishing a quality improvement project across all programmes in order to adopt a formal quality assurance risk management approach.
We are working to strengthen governance, quality assurance and management in the CervicalCheck programme and the wider National Screening Service.
We have established an interim management team with the reassignment of senior staff to key positions while we fill these key positions on a permanent basis. We have recently appointed a Director of Public Health for the National Screening Service, a Clinical Director and a Laboratory Quality Assurance Lead for CervicalCheck.
In addition, a Risk Committee for the National Screening Service, which is independently chaired, has been in place since Q3 2018. A Quality and Risk manager has also been appointed.
Dr Lorraine Doherty, Clinical Director CervicalCheck said; “We passionately believe in cervical screening and the positive impact it has on the health, and lives of women. As Dr Scally said in his report, the continuation of cervical screening is of ‘crucial importance’. Cervical screening can prevent 75% of cervical cancer cases. As a result of our national screening programme, one woman is diagnosed with cervical cancer every two days, while thousands of abnormalities are detected every year.
Like all screening tests, cervical screening is not perfect. Some women will still develop cervical cancer despite regular screening. While the risk of cervical cancer can be reduced, it can't be eliminated by screening.
We recognise the many challenges faced by CervicalCheck and we are fully committed to addressing these and working to rebuild confidence in our screening programme. We are committed to delivering the best possible cervical screening service for the people in our care and their families.”
Last updated on: 11 / 06 / 2019