BHR: Increasing Breast Screening uptake in patients with Severe Mental Illness
Introduction:
We are writing to inform the GP Practices in London Boroughs of Barking and Dagenham, Havering and Redbridge areas about a significant initiative in collaboration with the NEL ICB Data Service that involves the use of patient data for women diagnosed with a Severe Mental Illness (SMI), aged 50-70, who are eligible for routine breast screening.
Use Case-Purpose:
People with an SMI are less likely to seek medical advice for their physical health concerns and are also 25% less likely to attend screening programmes. At the same time, they are more likely to participate in harmful behaviours, such as, smoking and substance misuse, increasing their risk of cancer and other serious illnesses, making them 2.1 times more like to die of cancer by the age of 75.
In BHR, data from the Clinical Effectiveness Group (CEG) from 1 April 2024, shows that just 32.1% of the population with an SMI that is eligible for breast screening has been screened in the last three years. This equates to 910 unscreened women of an eligible cohort of 1,340.
To address this, the North East London Cancer Alliance aims to increase the uptake of breast screening in women with and SMI through collaboration across the ICB, increased identification and awareness of unscreened women of breast screening age with an SMI and proactive engagement and support of this cohort throughout the process, with the implementation of reasonable adjustments. The primary care services are utilising CEG templates to identify eligible patients and undertake an assessment of the reasonable adjustments required for InHealth to implement at the patient’s screening appointment.
How is the processing of information necessary to the work?
As outlined in the updated 2024 Service Specification for this project, the initiative involves the sharing of eligible patient data from NELFT’s SMI registers with the patient’s identified GP Practice, who will then cross-reference the data with their SMI registers to ensure eligible patients can be identified by the CEG search. The information generated from the CEG activity is then shared with InHealth to notify them of an eligible patient for screening and the reasonable adjustments required.
Outcome(s):
The initiative aims to offer support through individual assessments and implementation of personalised appointments through reasonable adjustments. Awareness training has been provided to NELFT and InHealth to increase the opportunities for support and engagement with the patient throughout their care journey. By fulfilling a more targeted approach for this cohort patients and through increased collaboration across NEL ICB primary care services, it is expected that there will be an increase in the uptake of breast screening, thereby reducing late-stage diagnoses of breast cancer.
A patient leaflet will be provided to support this work.
To conduct this activity in compliant with the data protection legislation and regulations such as UK General Data Protection Regulations, Data Protection Act 2018, all parties are required to sign the relevant agreements pertaining to their role within this process and confirming understanding of their obligations.
We have been working with the NEL Integrated Care Board IG Team and your Data Protection Officer to establish a Data Protection Impact Assessment (DPIA) and Data Sharing Agreement to facilitate this export and invitation. These were reviewed by the NHS North East London (NEL ICB) Data Access Group and approved by the NEL ICB) Information Governance Steering Group to provide you with reassurance.
As Controller(s). please could you take the following actions once you receive the alert from the Data Controller Console to confirm your acceptance of the Information Governance document.
1. Log on to the Data Controller Console
2. Review and accept the:
- Data Protection Impact Assessment (DPIA),
- Data Sharing Agreement (DSA), and
- Data Processing Agreement (DPA)
3. Update the Practice’s Privacy Notice to include this processing.
Please note that by accepting the DSA/DPA on the Data Controller Console, you are responsible for:
• putting in place effective procedures to manage data subject access requests (from your patients) about the processing; and
• managing your own data breach(es).
Please ensure that you review these documents thoroughly and sign promptly, to avoid delays in launching this important initiative. Please contact your relevant Data Protection Officer If you have any information governance concerns.
For any other queries, please contact Nikki Poland, NELCA Project manager on nikki.poland@nhs.net
On behalf of the North East London Cancer Alliance, we thank you for your participation in the ONEL SMI Breast Screening Project 2024/25 and we look forward to welcoming you to the programme.
Dr. Kanika Rai
Project Clinical Lead for ONEL SMI Breast Screening
General Practitioner,
The White House Surgery, Barking