The successful implementation of NHS England Screening Quality Assurance Service (SQAS) approved recommendations resulted in the establishment of a fully integrated service, streamlined governance, improved staffing levels, and the development of standardised procedures, ultimately enhancing the quality and consistency of breast screening services across Cheshire and Stockport.

Background

NHS England North West (NHSE NW) tasked NHS Midlands and Lancashire’s Improvement Unit with providing 12 months of project management and leadership support to complete the integration of the Cheshire and Stockport breast screening service. Following a quality assurance visit by SQAS in February 2023, 32 recommendations were identified for the service and the involved trusts to achieve full integration.

Action

Close collaboration with the Cheshire and Stockport Breast Screening Service was initiated to enhance communication and engagement across the pathway, facilitating progress towards full integration.

The current integration status of the service was assessed, and the SQAS recommendations were translated into a comprehensive quality assurance (QA) action plan. Roles, responsibilities, and leads were assigned for each of the 32 actions.

Ongoing project management office and leadership support were provided to drive significant progress against the QA action plan.

Regular meetings with leads from both trusts were facilitated to enable wider engagement and collaboration.

A monthly newsletter was developed to communicate with the entire team operating across two sites, sharing good news stories, workforce updates, incident learnings, and QA action plan progress.

Impact

The recommendations from the QA visit aimed to ensure that all eligible individuals invited for screening have access to a consistent, high-quality service across the different sites. SQAS approved closure for 22 actions in March 2024, evidencing:

– Achievement of a fully integrated service

– Establishment of clear oversight and governance arrangements

– Review of screening service staffing levels

– Development of estate plans to improve accommodation

– Creation of over 300 joint standard operating procedures

The Improvement Unit supported the trust in addressing issues arising from the screening service staffing review, collaborating closely with HR colleagues and breast screening programme management to develop a plan aligning staffing levels with national guidance. The revised workforce structure was approved by NHSE NW, and increased service funding was secured for implementation.

Improvements to processes along the pathway will better support individuals through their screening journey, enhancing their overall service experience. Streamlining standard operating procedures across all sites ensures consistent, high-quality service delivery in a timely and caring manner.

Feedback

The approach has been very structured, with significant engagement across multi-disciplinary services and teams and has been co-ordinated and planned in a methodical and effective way to ensure everyone’s time has been utilised most effectively. The Improvement Consultants have been a pleasure to work with and have become an integral part of the operational team in their support, understanding and drive for success. The overall improvement journey would not have been realised without them and this has been recognised through all the personal comments they received at project closure. Thank you so much for your help and commitment in delivering the plan.

Lisa Kirkup | Associate Director of Operations | East Cheshire NHS Trust

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