NHS England is transforming the digital services that underpin NHS screening programmes.

In the next 5 years, our vision is that a third of interactions with the NHS will be delivered using the NHS App and other digital tools. These tools support people to take control of their health, while freeing up time for healthcare staff and providing valuable data and insight.

An integral part of this is current work to transform digital services to improve how patients interact with NHS screening programmes as well as automating and reducing staff time spent using outdated systems.

NHS screening programmes can save lives and reduce ill health by finding out if people have a higher chance of developing a health problem, so that early treatment can be offered, or information can be given to help them make informed decisions, and supporting the government’s shift from treatment to prevention.

The Digital Screening team are developing new digital products across the screening lifecycle, ensuring the right participants are invited to screening at the right time, communicating with participants about their screening via digital-first channels, conducting and managing appointments, and analysis of the entire lifecycle.

Moving to digital-first communications for breast screening

1 in 7 women will get breast cancer in their lifetime. The breast screening programme provides an opportunity to detect and treat breast cancers at an early stage when they are too small to see or feel.

A pilot with 3 breast screening offices (BSOs) – in Milton Keynes, Southwest London and Dorset – has recently launched, using the NHS App to invite participants to their breast screening appointments.

Appointment details were sent to 150 participants through the NHS app. If the participant did not have the app or did not open the message, they received a text message. A letter was sent via the post if neither of the first 2 messages were received.

NHS cancer screening programmes currently send over 25 million invitations, reminders and results letters to patients by post each year, costing £14.7 million annually. Using the NHS App in conjunction with the NHS Notify digital delivery system will reduce these costs.

While the pilots are still in progress, the NHS Notify monitoring capabilities indicate that participants are successfully receiving messages through at least 1 of the 3 delivery methods.

Better participant experiences

Alongside encouraging data, those who provided feedback on their experience with this delivery method have been overwhelmingly positive.

The common theme is people appreciating the convenience of having information sent to their phones, particularly in relation to details being easily available when they wanted to double-check on their appointment date and time. Text messages were an especially effective way of notifying people about the visit.

As one person said, recognising both convenience for her and benefit to the NHS: “I prefer to get a text, it’s easier and saves on paper and postage.”

Improvements for those with accessibility needs have been another benefit identified from speaking to participants. Digital messages can take advantage of features built into users’ devices including zooming and text-to-speech tools.

A clinic attendee who suffers from a severe sight impairment said: “My husband saw the notification on the phone and let me know to log into the NHS App. [Using it] was a good experience, even if a surprise as I usually got letters.”

While better digital services are important, it is clear that paper-based channels are still needed by some people and can impact them attending their appointment. There needs to be a commitment to delivering these to those who need a paper format.

Beyond the pilot

The results of this pilot will be used to inform further research and testing, with a specific focus on the accessibility, inclusion and equity aspects of digital channels.

A wider rollout to more BSOs is planned, with the lessons learned from delivering digital-first invitations helping to determine how to approach communications to breast screening participants around appointment reminders and test results.

Insights will also be shared across other programmes undergoing digital transformation including bowel cancer and cervical screening.

If you would like to ask any questions relating to Digital Screening or provide any feedback on the above, please contact england.digitalscreening@nhs.net.