A year delay in the roll-out of the National Bowel Screening Programme is being blamed on software issues and the need for more colonoscopists in some regions.
The delay has been described as “simply not good enough” by Bowel Cancer New Zealand and “disappointing” by the Cancer Society. The revised timetable means there is currently no screening programme start date for some of the country’s largest DHBs including Auckland, Waikato, Capital & Coast and Canterbury – which were all due to start in the 2018-2019 year.
Dr Susan Parry, the clinical director of the National Bowel Screening Programme, said in a statement yesterday that the revised roll-out timetable was to enable more time to develop the National Screening Solution (NSS) technology required to run it.
The long-awaited national roll-out began in July last year at Hutt Valley and Wairarapapa district health boards (DHBs) and follows on from the successful Waitemata District Health Board pilot that began back in 2012.
Parry said the revised timetable meant the six DHBs would start screening in 2018 – but the last five DHBs would now not start screening until the end of June 2021 – a year later than originally planned. The revised timetable also includes no roll-out start dates for 10 of the DHBs while the Ministry re-assesses their readiness – including DHBs serving some of the country’s largest populations like Auckland, Waikato, Capital & Coast and Canterbury.
She said the extra time for the national roll-out was needed to select and adapt a software system used to run and monitor the quality of the programme nationwide.
Parry added that the extended timeframe would provide extra time for some DHBs that “signalled concern” about their ability to meet earlier deadlines.
Ensuring DHBs had the colonoscopy workforce required to meet the increase demand arising from bowel screening was one of the major issues leading to the delay in starting the national roll-out. Parry said it had been working with DHBs since 2012 to increase colonoscopy capacity and had contributed $19 million “to support these endeavours”.
“Although DHBs had been advised in 2016 of anticipated requirements for bowel screening, in relation to both the number of colonoscopies and the number of cancers that would be diagnosed, we recognise we are asking a lot of them,” said Parry. “Bowel screening is only one of the many services they provide and some will welcome the extra time to make sure they have the required resources, including colonoscopists, to support the roll-out of a quality bowel screening programme in their DHB.”
The Press reported last week that Canterbury DHB – that was due to join the national roll-out in April – was now planning to start in April 2019 because of staffing concerns to meet the increased workload. But the official revised timetable does not include a start date for Canterbury DHB.
Dr Parry said while the revised timetable would mean a delay for some regions the National Bowel Screening Programme was “well underway” and much had been going on behind the scenes (see revised roll-out timetable below).
“We’ve also set up the four regional centres, to support the roll-out of bowel screening, and a National Coordination Centre.
“Those are pretty significant milestones for the programme and real progress is being made on providing bowel screening to an increasing number of New Zealanders.”
Parry said the first eight DHBs joining the national roll-out would implement the programme using the interim IT solution which was based on an enhanced version of the Waitemata Pilot IT system.
She said it had proposed to build its own screening software system for the national rollout but after wider advice had decided to purchase a commercial product and work with an IT partner to adapt it to the Ministry’s needs. “The Ministry is also seeking a system that’s capable of being extended for use by other health screening programmes, as well as bowel screening. This follows the approach of a number of other countries and provides better value for money.”
REVISED ROLL-OUT TIMETABLE
July 2017 Hutt Valley, Wairarapa
Jan 2018 Waitemata (transitioning from pilot programme)
June 2018 Southern, Counties-Manukau
Nov 2018 Nelson-Marlborough, Lakes, Hawke’s Bay
June 2019 Whanganui, Mid-Central (yet to be confirmed)
The remaining 10 DHBs will commence screening in the 2019-20 and 2020-21 year with the roll-out order being re-evaluated based on the Ministry’s assessment of their readiness:
- Capital & Coast
- South Canterbury
- Bay of Plenty
- West Coast