Plans to devolve responsibility for the quality of England's 11 national screening services could result in significant safety risks, experts tell The BMJ in an exclusive report. Assistant news editor Gareth Iacobucci explains that NHS England is currently discussing proposals to delegate some of the functions of the national Screening Quality Assurance Service (SQAS) from NHSE to regional Integrated Care Boards (ICBs). But concerned experts warn that devolving responsibility to local organizations will spread resources more thinly, lead to a loss of expertise and independence, and compromise national oversight, making it harder to identify problems early and help improve screening pathways.
There are 11 national screening programs in England. Three cover cancer screening (breast, cervical and bowel), six cover antenatal and newborn screening , and two cover abdominal aortic aneurysm and diabetic eye screening. Screening programs must report all safety incidents to the SQAS, and SQAS staff visit local sites to pick up urgent issues and make recommendations for improvements.
But talking to The BMJ under condition of anonymity, one individual involved in quality assurance visits warned that NHSE was cutting corners to save money. They said cuts in recent years had already caused SQAS to drastically reduce the number of site inspections, meaning problems were not being picked up as early as they would have in the past. The BMJ understands that the SQAS headcount has reduced subs.