A major review of breast screening in Scotland has made 17 recommendations to strengthen and improve services.
Policy in NHS Scotland – and across the UK – is that all women aged 50 to 70 are invited for breast screening once every three years.
Women aged 71 and over can self-refer.
The report, published on Tuesday, recommends 17 ways to make the programme more accessible, resilient and sustainable.
They include a new approach to breast screening call-recall which is more person-centred and is based on calling individual women – rather than the GP practice they belong to – based on their next test date.
It also suggested greater flexibility of appointments to provide better access and uptake; better contact such as texts or phone calls to keep screening appointments on the radar for patients; an online appointment cancellation and rebooking system to provide a greater sense of individual control and convenience; and evening and weekend appointments for those who find it hard to adjust weekday commitments or rely on support from others.
Increased appointment availability in rural and semi-urban locations was also recommended.
The report said women in more deprived locations are less likely to attend for breast screening, with figures showing fewer than six in 10 (59.5%) are getting checked.
This compares with almost eight in 10 women (79.7%) in the least deprived areas of Scotland.
The report said: “In this review we geographically mapped uptake across Scotland, and whilst we can see that most areas meet or exceed the minimum uptake standard expected (70%), and small areas of under-target performance can be identified across Scotland, the central belt of Scotland has by far the greatest concentration of areas of lower levels of uptake.”
The review recommends exploring artificial intelligence (AI) further in breast screening mammography, and to develop a workforce plan to focus on areas such as training and leadership for any major developments in the programme.
The recommendations will be taken on by a new Breast Screening Modernisation Programme Board, chaired by Dr Marzi Davies.
She said: “The publication of this review and the establishment of the Breast Screening Modernisation Board represent an exciting opportunity to ensure resilience and deliver a sustainable, more person-centred breast screening programme in Scotland.
“I’m privileged to have been asked to lead this work, which will drive improvements in a number of areas and build upon an already high-quality and effective service.”
The Scottish Breast Screening Programme will allow women aged 71 and over to self-refer for appointments again from the autumn, after a “Covid pause”.
This will phased in and will not impact the main screening programme, the Scottish Government confirmed.
Public Health Minister Maree Todd welcomed the report.
“We accept all of the recommendations, many of which are already being progressed, such as reinstating self-referral services for those aged 71 years and over, and others that will require careful consideration and planning,” she said.
“It sets out a number of key learning points and opportunities for improving how we do things, and while it was commissioned pre-Covid-19, it’s important to note that the breast screening programme is still recovering from the impacts of the pandemic.
“Among our immediate priorities is ensuring that there is sufficient capacity for women aged between 50-70, the recommended screening population, to be invited for screening every three years.”