1. CERVICAL CANCER SCREENING UPDATE Dr Keith Faulkner Quality Assurance Reference Centre NHS North East, Yorkshire and the Humber

2. Civil service code Restriction on what we can do or say New organisational culture QARC Staff Become Civil Servants

3. Public Health England Directorate Structure Public Health England Directorate Structure

4. Health Improvement And Population Health Directorate Structure

5. 5 ‘Day 1 vision’ - update Productive discussion on our ‘vision’ for day 1, at our event in March. We agreed that it is essential to ensure that, from day 1, the new system is in a position to deliver services effectively, with strong leadership and a clear direction for priorities for 2013-14. You advised on priorities for a safe and secure transition that maintains performance to at least the same level as the previous system. We have taken that thinking to develop proposals for the Secretary of State. the proposed success criteria are that, by Day 1, the new bodies should be: Fully operational capable of delivering all their functions with all assets, staff and liabilities transferred safely performing with no “dip” in delivery Credible Capable of managing effective relationships across the system New organisations are visibly in place Public confidence is maintained Positioned to achieve improved outcomes Leadership in place, setting direction and engaging with staff and partners plans include clearly identified projects to develop capability and performance

6. NHS Commissioning Board Ring fenced funding for: National immunisation programmes National routine screening programmes (non-cancer) National routine cancer screening programmes Children’s public health services from pregnancy to age 5 Child Health Information Systems Public health services for people in prison and other places of detention Sexual Assault Referral Centres The agreement provides the NHS CB with £1.8bn from the public health budget for these programmes, in addition to other funding provided for public health in primary care.

7. Achievements in NEYH since 2009 All laboratories implemented HPV Triage and Test of Cure Year 1 Laboratories are currently in the process of implementing ABC3 The time taken to send results to women has improved significantly The region has implemented the CSTD web-based system There is now a standard portfolio for Basic Sample Taker Training in the Yorkshire and the Humber

8. Coverage Data

9. Coverage Data by age – North East

10. Coverage Data by age – Yorkshire and Humber

11. QA Visits Since 2009 the NEYHQARC has undertaken QA visits to all areas The new system of visiting units by programme area has been implemented The process has been expanded to include MDTs, case note reviews, HPV processing and histopathology services Round 4 will commence in April 2013 and the timetable has been circulated

12. Good Practice identified at QA visits There are systems in place to facilitate discussions relating to the performance of the programmes at the Local Programme Board All result letters sent 1 st class five days per week Laboratories and Call/Recall services have worked together to ensure their systems are up to date with the new codes and letters Laboratories are/have implemented LEAN methodology The histopathology services within the region are in the process of implementing BMS cut-up Overall consensus of patient feedback through the patient satisfaction survey indicates that NEYH units provide a good or excellent service All HBPC have processes in place to ensure they are aware of women who develop cancer to enable them to be registered on the Invasive Audit Some areas have implemented electronic referrals The HPV Pathway Managers have led with the implementation of Triage and Test of Cure whilst balancing other demanding roles There are some examples of good processes for the administration of MDTs

13. Common issues at QA visits Not submitting the required documentation in advance Old terminology in protocols, leaflets and letters Professionals workloads not meeting the minimum requirements Trust Incident protocols not referencing to screening Not signing up to the NIGB Issues with attendance at MDTs and QA Groups Lack of job descriptions for HBPCs and Lead Colposcopists Lack of administration and/or nursing support Lack of routine audits relating to the programme Backlog in completion of the invasive cancer audit Lack of evidence submitted to allow the QARC to sign off recommendations

14. 14 day Turnaround times

15. HPV Vaccination reporting The uptake across the region is good The data is now available by cohort This shows that most PCTs do not have all HPV vaccination data uploaded onto the Open Exeter system A central project is taking place to establish the barriers to uploading data An e-learning package is being produced centrally to support professionals in uploading data This is currently being piloted and will be available in the near future

16. Types of Referral – North East

17. Types of Referral – Yorkshire and the Humber

18. Clinical Indication rates

19. Any questions?

20. A View From Julietta’s North American Cousin HPV Primary Test Unnecessary tests, anxiety of false positives. Things I can only dream of…