Healthcare professionals’ views following implementation of risk stratification into a national breast cancer screening programme
Abstract Background It is crucial to determine feasibility of risk-stratified screening to facilitate successful implementation. We introduced risk-stratification (BC-Predict) into the NHS Breast Screening Programme (NHSBSP) at three screening sites in north-west England from 2019 to 2021. The prese...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-022-10134-0 |
| _version_ | 1811238878369021952 |
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| author | Rachel Hawkins Lorna McWilliams Fiona Ulph D Gareth Evans David P French |
| author_facet | Rachel Hawkins Lorna McWilliams Fiona Ulph D Gareth Evans David P French |
| author_sort | Rachel Hawkins |
| collection | DOAJ |
| description | Abstract Background It is crucial to determine feasibility of risk-stratified screening to facilitate successful implementation. We introduced risk-stratification (BC-Predict) into the NHS Breast Screening Programme (NHSBSP) at three screening sites in north-west England from 2019 to 2021. The present study investigated the views of healthcare professionals (HCPs) on acceptability, barriers, and facilitators of the BC-Predict intervention and on the wider implementation of risk-based screening after BC-Predict was implemented in their screening site. Methods Fourteen semi-structured interviews were conducted with HCPs working across the breast screening pathway at three NHSBSP sites that implemented BC-Predict. Thematic analysis interpreted the data. Results Three pre-decided themes were produced. (1) Acceptability of risk-based screening: risk-stratification was perceived as a beneficial step for both services and women. HCPs across the pathway reported low burden of running the BC-Predict trial on routine tasks, but with some residual concerns; (2) Barriers to implementation: comprised capacity constraints of services including the inadequacy of current IT systems to manage women with different risk profiles and, (3) Facilitators to implementation: included the continuation of stakeholder consultation across the pathway to inform implementation and need for dedicated risk screening admin staff, a push for mammography staff recruitment and guidance for screening services. Telephone helplines, integrating primary care, and supporting access for all language needs was emphasised. Conclusion Risk-stratified breast screening was viewed as a progressive step providing it does not worsen inequalities for women. Implementation of risk-stratified breast screening requires staff to be reassured that there will be systems in place to support implementation and that it will not further burden their workload. Next steps require a comprehensive assessment of the resource needed for risk-stratification versus current resource availability, upgrades to screening IT and building screening infrastructure. The role of primary care needs to be determined. Simplification and clarification of risk-based screening pathways is needed to support HCPs agency and facilitate implementation. Forthcoming evidence from ongoing randomised controlled trials assessing effectiveness of breast cancer risk-stratification will also determine implementation. |
| first_indexed | 2024-04-12T12:50:01Z |
| format | Article |
| id | doaj.art-fa909af03e9b4250986e180a778ccb16 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-12T12:50:01Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-fa909af03e9b4250986e180a778ccb162022-12-22T03:32:31ZengBMCBMC Cancer1471-24072022-10-0122111010.1186/s12885-022-10134-0Healthcare professionals’ views following implementation of risk stratification into a national breast cancer screening programmeRachel Hawkins0Lorna McWilliams1Fiona Ulph2D Gareth Evans3David P French4The Christie NHS Foundation TrustManchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of ManchesterManchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of ManchesterNIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University Hospitals NHS Foundation TrustManchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of ManchesterAbstract Background It is crucial to determine feasibility of risk-stratified screening to facilitate successful implementation. We introduced risk-stratification (BC-Predict) into the NHS Breast Screening Programme (NHSBSP) at three screening sites in north-west England from 2019 to 2021. The present study investigated the views of healthcare professionals (HCPs) on acceptability, barriers, and facilitators of the BC-Predict intervention and on the wider implementation of risk-based screening after BC-Predict was implemented in their screening site. Methods Fourteen semi-structured interviews were conducted with HCPs working across the breast screening pathway at three NHSBSP sites that implemented BC-Predict. Thematic analysis interpreted the data. Results Three pre-decided themes were produced. (1) Acceptability of risk-based screening: risk-stratification was perceived as a beneficial step for both services and women. HCPs across the pathway reported low burden of running the BC-Predict trial on routine tasks, but with some residual concerns; (2) Barriers to implementation: comprised capacity constraints of services including the inadequacy of current IT systems to manage women with different risk profiles and, (3) Facilitators to implementation: included the continuation of stakeholder consultation across the pathway to inform implementation and need for dedicated risk screening admin staff, a push for mammography staff recruitment and guidance for screening services. Telephone helplines, integrating primary care, and supporting access for all language needs was emphasised. Conclusion Risk-stratified breast screening was viewed as a progressive step providing it does not worsen inequalities for women. Implementation of risk-stratified breast screening requires staff to be reassured that there will be systems in place to support implementation and that it will not further burden their workload. Next steps require a comprehensive assessment of the resource needed for risk-stratification versus current resource availability, upgrades to screening IT and building screening infrastructure. The role of primary care needs to be determined. Simplification and clarification of risk-based screening pathways is needed to support HCPs agency and facilitate implementation. Forthcoming evidence from ongoing randomised controlled trials assessing effectiveness of breast cancer risk-stratification will also determine implementation.https://doi.org/10.1186/s12885-022-10134-0Risk-based screeningImplementationHealthcare professionalsQualitative researchRisk-stratificationBreast cancer |
| spellingShingle | Rachel Hawkins Lorna McWilliams Fiona Ulph D Gareth Evans David P French Healthcare professionals’ views following implementation of risk stratification into a national breast cancer screening programme BMC Cancer Risk-based screening Implementation Healthcare professionals Qualitative research Risk-stratification Breast cancer |
| title | Healthcare professionals’ views following implementation of risk stratification into a national breast cancer screening programme |
| title_full | Healthcare professionals’ views following implementation of risk stratification into a national breast cancer screening programme |
| title_fullStr | Healthcare professionals’ views following implementation of risk stratification into a national breast cancer screening programme |
| title_full_unstemmed | Healthcare professionals’ views following implementation of risk stratification into a national breast cancer screening programme |
| title_short | Healthcare professionals’ views following implementation of risk stratification into a national breast cancer screening programme |
| title_sort | healthcare professionals views following implementation of risk stratification into a national breast cancer screening programme |
| topic | Risk-based screening Implementation Healthcare professionals Qualitative research Risk-stratification Breast cancer |
| url | https://doi.org/10.1186/s12885-022-10134-0 |
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