1. PREPARED BY National Bowel Screening Programme Meeting 19 August 2015

2. Why are you all here? Provide information and set scene for regional meetings: What might a national bowel screening programme look like? Equity Waitemata DHB Pilot learnings Workforce implications National screening framework

3. Where have we come from 1998 - Population Screening for Colorectal Screening, NHC 2005 - Report of the Colorectal Screening Advisory Group 2008 – Next Steps Towards a Feasibility Study for Colorectal Screening 2010 – Pilot approach announced October 2011 – Pilot commences May 2015 – 2 year extension to the Pilot July 2015 – Minister of Health announces that he will report to Cabinet by December 2015 on a potential national bowel screening programme

4. PREPARED BY Laying the foundation What it might look like Mhairi Porteous Manager, Bowel and Prostate Cancer Programmes August 2015

5. Work in progress NZ Familial Gastrointestinal Service Bowel Screening Pilot since October 2011 Colonoscopy wait time indicators for DHBs National Endoscopy Quality Improvement Programme

6. Waitemata Bowel Screening Pilot (BSP) Four year Pilot - 2012 to 2015 two screening rounds plus two year extension until end of 2017 Age range 50-74, men and women (approximately 136,000 eligible people) Screening test - Faecal immunochemical test for Haemoglobin (iFOBT) - Every two years Acknowledge the hard work, commitment and willingness of the Waitemata Team.

7. Equity is Essential

9. Participation in the BSP Round 1 and the first year of Round 2

10. Participation in the BSP by ethnicity Round 1 and the first year of Round 2

11. Participation in the BSP by deprivation group Round 1 and the first year of Round 2

12. NHI database extract BSP register Pre invitation letter Invitation letter, test kit, consent form Sample returned to laboratory Result to register and GP 10 days GP/Endo nurse refers to Colonoscopy 55 days Result letter to participant Recall to screening in 2 years Colonoscopy Recall to screening in 5 years Surveillance Opt off Treatment Opt off NegativePositive

13. Quality is Critical Across all elements of the programme National endoscopy quality improvement programme

14. Some questions to consider What do we need to do to ensure equity of service delivery and outcomes across New Zealand and between different groups? How can primary care best support a national bowel screening programme? How might we ensure district health boards are ready to begin providing a bowel screening programme in their area? How could colonoscopy services best be organised? What do we need to consider in planning for additional colonoscopy volumes?

15. Some questions to consider continued How can private providers best support a national bowel screening programme? What issues do we need to consider around: CTC polyp and cancer histology services surgical services oncology services? What do we need to consider in planning for additional volumes in these services?

16. Contact us Bowelcancerteam@moh.govt.nz