FOI – 2023-000255 - Bowel Screening Query (HTML)

Date received – 18 July 2023 | Date responded – 14 August 2023

Request

I would under a freedom of information or subject access request whichever applies to a member of the public, also like to be given a copy of the minutes of the meeting where the decision to introduce a telephone screening appointments was introduced into the bowel screening programme. With details of why it was made also from the meeting along with the timescales on those telephone screening appointments.

More specifically the decision to interfere with the normal running of the bowel screening programme and the normal patient expectations following a positive test on the national screening.

Response

I can advise you that we have now completed the search of our records and can provide you with the following information:

Under Section 17 of the Freedom of information Scotland Act, 2002 (FOISA) an organisation does not have to provide that information if it does not hold that information. NHS National Services Scotland (NSS) does not hold this information. We are unable to locate any minutes of a meeting where the decision to introduce telephone screening appointments was introduced into the bowel screening programme. The telephone pre-colonoscopy assessment appointment has always been part of the Bowel Screening Programme process, dependent on the NHS Board of residence, and it does not interfere with the normal running of the bowel-screening programme.

The policy in place in July 2022 related to the Healthcare Improvement Scotland Bowel Screening Standards 2015, standard statement 7 ‘People with a positive screening test result are offered a timely pre-colonoscopy assessment and a colonoscopy, if appropriate.’ The time between NHS (National Health Service) boards being notified of the positive screening test result for a participant and the date offered for colonoscopy is within 31 days for 95% of cases.

From 2011, the cancer waiting time targets are as follows: 62-day target from receipt of referral to treatment for all cancers, including any screened positive patients who are referred through a national cancer-screening programme.

Please be advised that since the start of the bowel screening programme it has been the policy and practice of the programme that someone with a positive screening test should be referred onto the individual’s NHS Board of residence to be followed up for consideration for a colonoscopy. It has always been the case that the NHS Board of residence should manage this process. It has also always been the case that this should first include a pre-colonoscopy assessment for each individual participant of the Scottish Bowel Screening Programme. This is laid out in the NHS Scotland Bowel Screening Manual 2012/13 and further detailed by the Healthcare Improvement Scotland Bowel Screening Standards 2015.

Please find attached Appendix 1 - NHS Scotland Bowel Screening Manual Extract and FOI – 2023-000255 Appendix 2 - Healthcare Improvement Scotland Bowel Screening Standards.

Section 6.3 of the NHS Scotland Bowel Screening Manual states the following: “In order to reduce anxiety, encourage participation and compliance and minimise the risks of colonoscopy all individuals who have a positive screening test result should be offered a precolonoscopy assessment by a suitably qualified health care professional.”

It also states: “The pre-assessment is an essential step to assess health fitness for the procedure. Some individuals may be assessed as high risk for colonoscopy and certain precautions need to be taken to minimise risk during the procedure. Other individuals may be deemed high risk for a screening colonoscopy due to significant co-morbid disease.”

Within section 6.3, it also states: “There is evidence that the time interval between receiving a positive screening test result and assessment for colonoscopy can result in significant anxiety. HIS (Health Improvement Scotland) Standard 5, Pre-colonoscopy Assessment, states that this time should be within 14 days for at least 80% of individuals and that there are arrangements to identify all individuals who do not participate in pre-colonoscopy assessment and offer them a further opportunity to do so.”

It is also noted that the first pre-assessment can be either face to face or by telephone appointment, the manual continues to state: “Clinic appointment letter for pre-assessment (either face to face or telephone appointment dependant on NHS Board) and information about colonoscopy.”

If there are any risks to the participant identified during the telephone pre-assessment appointment, then a further face to face appointment should be offered. If you require information on the process within your own individual NHS Board for pre-colonoscopy assessment, then we would advise that you should seek this information from your NHS Board of residence.

I trust you will find the information of assistance and if you require any further information, please do not hesitate to contact us.

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Contact

Address

If after a review you are still unhappy, you also have the right to apply to the Scottish Information Commissioner, who can be contacted at Kinburn Castle, St Andrews, Fife, KY16 9DS, or via their application form.

National Services Scotland (NSS) is committed to publishing all information released in response to Freedom of Information requests. You can view all FOI responses within our FOI Publications repository.