GPs could be offered financial incentives to boost cancer screening uptake

GP practices and primary care networks could be incentivised for increasing uptake of cancer screening, following a major independent review of cancer screening in England.

FIT test for bowel cancer (Photo: James King-Holmes/Science Photo Library)

The review, which was led by former NHS cancer director Professor Sir Mike Richards, recommended that NHS England should 'urgently consider' how best to use financial incentives to increase uptake of screening, particularly for bowel cancer checks.

This could include payments via an enhanced service or 'enhancements to GP payment systems at either practice or primary care network level'.

Professor Richards' review said that there was 'some evidence' that financial incentives could boost screening. It suggested that GPs could be encouraged to promote uptake in patients who have not participated in bowel cancer screening within a set time of being sent a testing kit, but added that any such approach would need to 'minimise the administrative burden on general practice'.

The report highlighted an initiative in South West London, which found that phoning patients who had not completed their bowel screening test, along with sending a lettter from their GP, increased uptake by around 8%.

The report also said that NHS England should consider financial incentives for providers to promote out-of-hours and weekend appointments for cervical and breast cancer screening.

Cervical screening

Professor Richards' report said it was a 'major concern' that the proportion of women being screened for both cervical and breast cancer was in decline.

It highlighted that more could be done to boost uptake through social media and awareness campaigns and delivering appointments at more convenient times and locations. However, it said that IT improvements would be necessary to enable women to make appointments at alternative locations, such as near their place of work.

The bowel cancer screening programme in England is in the process of switching from using the Guaiac Faecal Occult Blood Test (gFOBT), which requires three stool samples, to the FIT test, which involves only one sample only.

The change began in June this year and so far over 900,000 FIT tests have been sent out, the report said. It added that switching to the new test was expected to increase uptake of bowel cancer screening by at least 7%.

Professor Richards said: 'Screening programmes are a vital way for the NHS to save more lives through prevention and earlier diagnosis and currently they save around 10,000 lives every year – that is something to be immensely proud of.

'Yet we know that they are far from realising their full potential – people live increasingly busy lives and we need to make it as easy and convenient as possible for people to attend these important appointments.

'The recommendations in this report are intended to help deliver the commitments set out in the NHS long-term plan and will hopefully save even more lives.'

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