NHS South Yorkshire - Mobile Cervical Screening Pilot

Description

The aim of this project is to set up and trial a mobile cervical screening unit to explore the impact on uptake rates of the cervical cancer screening programme in Doncaster, and the user's experience of using the mobile unit.<br/><br/>Please note that, due to reasons beyond the control of South Yorkshire ICB, we are having to abandon this procurement process.<br/><br/>This is a Provider Selection Regime (PSR) notice that this provider selection process has been abandoned and a contract has not been awarded. This process has been abandoned under the Health Care Services (Provider Selection Regime) Regulations 2023. For the avoidance of doubt, the provisions of the Public Contracts Regulations 2015 do not apply. Lot 1: The procurement falls outside the scope of application of the Public Contract Regulations 2015.<br/>Explanation: This is a Provider Selection Regime (PSR) intention to award notice. The awarding of this contract is subject to the Health Care Services (Provider Selection Regime) Regulations 2023. For the avoidance of doubt, the provisions of the Public Contracts Regulations 2015 do not apply to this Competitive Process.<br/><br/>Key criteria<br/>Relevant authorities must consider five key criteria when applying direct award process C, the most suitable provider process or the competitive process. These are:<br/>• quality and innovation<br/><br/>Piloting a mobile cervical screening service model is key in identifying whether this method of access supports the increase of cervical screening uptake for women and people with a cervix in Doncaster. The implementation of a mobile cervical screening service may be one method of support for eligible women to overcome barriers (such as lack of time, having other commitments, difficulty accessing the primary care appointment system, travel to general practice), and support with the reduction in inequalities.<br/><br/>To meet the local requirements of a mobile cervical screening service, the provider will enable eligible women and people with a cervix with the option of attending cervical screening in an alternative location, either pre-bookable or on a drop-in basis where no appointment is needed.<br/><br/>• Value<br/><br/>Evidence suggests that mobile screening units are beneficial in supporting people to complete screening (5). Mobile screening units have been utilised within the breast cancer screening programme in the UK, which is also due to receive a £10 million investment to deliver 29 new units to increase screening capacity (6). Yet, no such mobile provision is in place for cervical screening, but this may be one method to increase screening uptake, and reduce the barriers identified consistently within literature/research.<br/><br/>Recent statistics highlights that approximately 4.6 million women aged 25 to 64 in England have never been screened for cervical cancer or are not up to date with their tests (1). Statistics further highlight that from 2020 until now, England uptake percentage has not exceeded 70% for those under 50 years old, where the acceptable uptake target is 80%, compared to those who are 50 years and above, where the uptake often reached 75% uptake (2). Those who live in deprived areas of England are approximately 40% less likely to attend their cervical screening (3).<br/><br/>There are multiple reasons why women and people with a cervix decide not to attend, or delay, their cervical cancer screening appointment or delay their attendance. Factors such as lack of time, having other commitments, and making an appointment is inconvenient (4). One method to overcome these barriers and to reduce inequalities may be achieved through the implementation of a mobile cervical screening unit, including drop-in facility.<br/><br/>Locally from 2021/22 to 2022/23 (Fingertips Public Health Data) we have seen a 1.7% decline in cervical screening coverage between in patients aged 25 to 49 years old. Investment in these services would support mitigation of risks around later stage diagnosis, failing to meet NHS England Cancer Screening targets, as well as other targets that have been locally agreed within contracts.<br/><br/>References:<br/>1. Bawden A. Proportion of women in England not screened for cervical cancer at 10-year high. The Guardian. 2023.<br/>2. NHS England. National statistics - Young person and adult screening KPI data: Q1 summary factsheets (1 April to 30 June 2022) HTML: NHS England; 2023 [Available from: https://www.gov.uk/government/statistics/q1-1-april-to-30-june-2022-annb-and-ypa-screening-kpi-data/young-person-and-adult-screening-kpi-data-q1-summary-factsheets-1-april-to-30-june-2022-html#cervical-screening.<br/>3. Wright H. Jos Trust. 2022. [cited 2023]. Available from: https://www.jostrust.org.uk/about-us/news-and-blog/blog/our_call_to_action_on_health_inequalities#:~:text=We%20know%20cervical%20cancer%20is,cervical%20screening%20(smear%20tests).&text=However%2C%20women%20living%20in%20deprived,in%20the%20least%20deprived%20areas.<br/>4. Wilding S, Wighton S, Halligan D, West R, Conner M, O’Connor DB. What factors are most influential in increasing cervical cancer screening attendance? An online study of UK-based women. Health psychology and behavioral medicine. 2020;8(1):314-28.<br/>5. Greenwald ZR, El-Zein M, Bouten S, Ensha H, Vazquez FL, Franco EL. Mobile screening units for the early detection of cancer: a systematic review. Cancer Epidemiology, Biomarkers & Prevention. 2017;26(12):1679-94.<br/>6. New breast cancer screening units to speed up diagnosis [press release]. Gov.UK2023.<br/><br/>• integration, collaboration and service sustainability<br/><br/>Piloting a mobile cervical screening service model is key in identifying whether this method of access supports the increase of cervical screening uptake for women and people with a cervix in Doncaster. This forms part of a wider programme of work within the South Yorkshire and Bassetlaw (SYB) Cancer Alliance that aims to improve screening uptake and the early diagnosis of cancer by meeting the needs of people across SYB and continuing to work in collaboration with key stakeholders including the ICB colleagues, PCNs, VCS organisations and Public Health Programme teams.<br/><br/>SYB Cancer Alliance developed and contributed to several projects and action plans throughout 2023/24 to improve local uptake and address inequalities in participation in NHS screening programmes. Partnership working across SYB Cancer Alliance and SY ICB including Place and Public Health England has enabled sharing of insights on health inequalities from projects and/or business intelligence which in turn has supported the development of initiatives and campaigns to reduce inequalities in uptake, in line with Core20PLUS5. Close partnership working will continue in 2024/25 to encourage uptake and reduce inequalities (particularly deprivation-related) within screening programmes and to continue to understand and analyse the impact of targeted work with communities who have the most missed cancer screening programme screening appointments and agree a continued programme of work with these identified communities to increase a focus on screening with other stakeholders.<br/><br/>• improving access, reducing health inequalities and facilitating choice<br/><br/>The cervical mobile screening service contributes towards meeting the national NHSE cervical screening targets ('Proportion of women in the resident population eligible for cervical screening aged 25 to 49 years who were screened adequately within the previous 3.5 years' and the 'Proportion of women in the resident population eligible for cervical screening aged 50 to 64 years who were screened adequately within the previous 5.5 years') and this model is key in identifying whether this method of access supports the increase of cervical screening uptake for women and people with a cervix in Doncaster.<br/><br/>The implementation of a mobile cervical screening service is one method to both facilitate choice and support eligible women to overcome barriers (where lack of time to attending a specific appointment time, having other commitments or trying to facilitate general practice appointments systems is challenging), and also support the reduction in inequalities. Venues chosen include good access links via public transport. <br/><br/>Via a thorough, far-reaching communications strategy, offering a choice of venues and drop-in times, the cervical mobile screening service will offer additional choice to eligible women and people in a different way to current NHS primary care cervical screening services.<br/><br/>• social value.<br/><br/>The cervical mobile screening service contributes towards meeting the national NHSE cervical screening targets ('Proportion of women in the resident population eligible for cervical screening aged 25 to 49 years who were screened adequately within the previous 3.5 years' and the 'Proportion of women in the resident population eligible for cervical screening aged 50 to 64 years who were screened adequately within the previous 5.5 years') and this model is key in identifying whether this method of access supports the increase of cervical screening uptake for women and people with a cervix in Doncaster.<br/><br/>The implementation of a mobile cervical screening service is one method to both facilitate choice and support eligible women to overcome barriers (where lack of time to attending a specific appointment time, having other commitments or trying to facilitate general practice appointments systems is challenging), and also support the reduction in inequalities. Venues chosen include good access links via public transport. <br/><br/>Via a thorough, far-reaching communications strategy, offering a choice of venues and drop-in times, the cervical mobile screening service will offer additional choice to eligible women and people in a different way to current NHS primary care cervical screening services.