Routine cancer screening among last to return to non-Covid healthcare

Routine cancer screenings will be among the last of normal non-Covid-19 healthcare services to resume, senior Government sources have cautioned.

The HSE is working on a new plan setting out when it will be safe to resume routine screening appointments amid concerns about a growing backlog following a temporary pausing of Breastcheck, CervicalCheck and BowelScreen due to the coronavirus.

While a timeline is being worked on by the national screening service and by HSE chief clinical officer Dr Colm Henry, senior sources say it will not be safe to resume normal screening for “quite some time”.

It has also emerged that those who need a clinical exam may be asked to isolate for 14 days beforehand under new plans being developed by the health service as part of plans to resume non-Covid related healthcare.

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According to a document given to opposition parties about the roadmap to reintroducing non Covid-related healthcare, a “key enabler” of such healthcare returning “is the development of testing and screening criteria for non-Covid services”.

“Some lower risk patient interactions like clinical exams might in future be safely managed with 14 days isolation, screening/risk assessment for symptoms before the appointment and additional temperature checks on the day of presentation,” the document states.

It also says that a plan for the management of contact tracing in the event of an outbreak within a service will need to be developed.

The document also states that the reintroduction of non-Covid services should be “phased, clinically aligned and guided by clinical prioritisation”.

It states that “we have now reached a point where, as a result of public compliance with the mitigation measures, the anticipated surge in Covid patients has not happened and capacity within the health system is becoming available for non-Covid services”.

There is a need to “recommence the delivery of non- Covid services in a planned, appropriate and considered manner which addresses ongoing clinical demands while maintaining capacity for a future response to Covid-19.”

It also warns that the National Cancer Control Programme has reported a substantive decrease in the number of new referrals to all rapid access cancer and symptomatic disease clinics.

“This has led to an unmet need which may lead to delayed presentations, delayed access to diagnosis and treatment, poorer outcomes and increased mortality.”

A spokesman for the HSE said the four National Screening Service programmes, BreastCheck, BowelScreen, CervicalCheck and Diabetic RetinaScreen, are “preparing comprehensive plans for restarting their services in a safe and planned way, which will ensure that all who have missed out on screening can avail of a test in a phased basis over a period of months”.

“When restart dates are finalised, screening will be re-introduced on a phased basis, with invitations for screening issued according to clinical prioritisation and taking the screening and treatment pathways into account.

“As the reintroduction of services across the HSE is currently being rolled out, no start date for screening services is as yet available. However, please be assured that the restoration of important services is a priority for the HSE’s Screening Service.”