Care Pathways

14.12.18

Hunt wrong to blame breast screening scandal on admin incompetence, panel concludes

An independent panel of reviewers has called for the NHS breast screening programme to be entirely reset after they concluded that former health secretary Jeremy Hunt called for a national investigation based on incorrect advice.

Back in May, Hunt quickly announced an independent review after it emerged that half a million women – a figure later corrected to just over 180,000 – had allegedly missed out on health checks as a result of what the secretary of state had labelled “administrative incompetence.”

He believed that women had not been invited to their final breast screenings between the ages of 70 and 71 due to an issue with a computer algorithm. The review today concluded, however, that this was an incorrect conclusion based on an “incomplete understanding” of what had happened.

While the IT systems in place were indeed “dated and unwieldy,” they have “broadly operated as they were designed to.” Instead, women weren’t invited because of the way the breast screening programme has been run since the late 1980s, which meant they had already received their final screening three years earlier.

Despite his misinformation, reviewers said Hunt is not to blame for the mistake and argued he made the right decision based on the advice he was given.

Nevertheless, while no one person is to blame for the scandal, it remains “unacceptable for there to be confusion about what women should expect.”

“For many years, from the beginning of the breast screening programme in the late 1980s, the specific age range of women to be invited was not set out in sufficient detail, and there was variability across breast screening units,” the final report said.

“In the hand-over of responsibilities to the newly-formed Public Health England and NHS England in 2013 we have found no evidence that there was a shared understanding of how the screening programme was being delivered.”

In short, there was no incident and ministers were incorrectly advised. And in the rush of announcing the mistake and correcting the issue, assumptions were made about policy and operations “which were not sufficiently challenged.”

“The breast screening programme now needs a re-set. The three organisations currently responsible for the programme – the Department of Health and Social Care, Public Health England and NHS England – should agree a clear and specific definition of the ages at which women will be invited for screening, based on the best available evidence and advice from experts in the field,” the investigation concluded.

Health minister Steve Brine agreed that there is an urgent need to clarify how the government defines the upper age limit for breast screening, and said it will be commissioning the UK National Screening Committee to provide advice as soon as possible.

“It is essential that we take all necessary actions to learn from the mistakes made. We will consider the review’s report and its recommendations in detail over the coming weeks and will provide a substantive response in the new year,” he added in a written statement.

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