Breast cancer screening: Why women in Hackney are being turned away for life-saving check-ups
- Credit: Nigel Sutton
Potentially life-saving breast cancer screening check-ups for women in Hackney have been delayed due to a shortage of specialist mammographers to carry out the service.
An investigation by the Gazette has found a lack of radiographers to fill NHS jobs is affecting breast screening provision in east and north London.
Health chiefs have refused to say how many women have been affected, but did confirm the problems have resulted in a “small number of appointments” having to be rescheduled.
The NHS trust that runs the breast screening service said it is working hard to fill long-standing vacancies and minimise delays.
But one woman affected by the backlog condemned a vacuum of information over the crisis.
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Julia Cameron, who has been trying to book her breast screening check-up since March, said: “This is appalling, especially on top of the the scandal of women a bit older than me who were never called for routine final breast screening checks. If it carries on it will cost lives.”
The 65-year-old was unable to attend a routine breast screening check-up in February.
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She cancelled, but when she rang her local clinic to reschedule was told there were no appointments available.
“They just said they didn’t have the staff to provide the service there,” she said.
Julia then contacted Barts Hospital and was told the same.
She has previously had benign breast disease and is worried the delay may impact on her health.
“It’s been very stressful,” she said. “I do examine my breasts regularly and I can’t feel anything untoward, but the whole point of mammography is it’s meant to pick up tumours before you can actually feel them.”
During routine breast screening women are x-rayed using a mammogram to check for early signs of tissue changes.
All women aged 50 to 70 are invited for the checks every three years.
In Hackney appointments are provided by the Central and East London Breast Screening Service, which is run by the Royal Free London NHS Foundation Trust.
The trust would not comment on Julia’s case, but admitted staffing problems in a statement to the Gazette.
“It has been recognised by Public Health England that there is a national shortage of qualified mammographers and this shortage is impacting multiple services both in London and nationwide,” it said.
The Royal Free took over the breast screening service from Barts Health in April this year and said “it had immediately identified recruitment of staff to fill long-standing vacant positions as a priority”.
Health chiefs are trying to ensure women can book appointments at two mobile screening units which visit Hackney and Newham, and at clinics at the Whittington Hospital, Kentish Town Health Centre, Whipps Cross Hospital and Mile End Hospital.
“In recent weeks we have managed to recruit to a number of vacant posts,” the Royal Free said.
“We are seeking to resolve any issues with the service as soon as possible and wish to reassure any patients who are finding it difficult to book a screening in their preferred location that we are working hard to minimise delays.”
The Gazette put detailed questions to the Royal Free and Barts Health about the scale of the appointment backlog and the number of vacant jobs, but neither trust provided answers.
Barts Health did confirm issues around working visas had not played a part in the staffing crisis and said budgets for the breast screening service had not been cut in recent years.
The crisis comes after the charity Breast Cancer Now warned the government in September that it needed to address shortages in the mammography workforce.
The charity published a report saying the jobs crisis was a “major barrier” to delivering breast screening programmes.
Sally Greenbrook, policy manager at Breast Cancer Now, said: “We need the government to heed these wake-up calls and deliver on its promise to expand the screening workforce as soon as possible.”
The scale of the jobs crisis was said to stretch to a 15 per cent vacancy rate in mammography in 2016, according to Public Health England.
The Society and College of Radiographers said it had made clear to government for many years that shortages of radiographers were inevitable unless more were trained.
Chief executive of the society Richard Evans told the Gazette: “The roots of the problem are in the funding available to train radiographers.
“Unfortunately the government did not make sufficient funds available to train enough radiographers to sustain the whole of the healthcare workforce, including breast screening.
“So now we’re in a situation of trying to catch up. The shortage is now biting.”
Changes in 2016 saw grant funding for radiography degree courses replaced by student loans, which is also said to have exacerbated the problems.
The Gazette contacted the Department of Health for comment but received no reply.
Meanwhile, four months after her breast screening check-up should have taken place, Julia Cameron is still without an appointment.
Should men be allowed to carry out breast screening checks?
Health unions have called for an “unnecessarily restrictive” ban on men carrying out breast screening checks to be lifted.
The Society and College of Radiographers tabled a motion to the Trades Union Congress last September calling for the rule to be abolished.
It argued the ban made no sense, particularly given the national shortage of mammographers.
Richard Evans, chief exec of the society, told the Gazette:
“We think it’s unnecessarily restrictive. Every women who’s attending for breast screening should have the choice. If they don’t want to be examined by a man they don’t have to be, in the same way as if you were attending a gynaecological examination. But the same example is relevant.
If it’s ok for other intimate examinations to be conducted by a man or a women, then we don’t see that mammography should be any different.”
Those in favour of the current rule say studies in other countries have shown 9 per cent of women would not attend breast screening if there was a possibility of being seen by a male practitioner.
Have you been affected by the backlog in breast screening appointments? Contact Emma Youle on firstname.lastname@example.org or 020 7433 0122.