The UK National Screening Committee (UK NSC) evaluates the evidence for and against the introduction of population screening programmes. It then makes recommendations on whether screening programmes should be implemented.
If you’re reading this, you probably already know about the UK NSC to some degree.
Here are 5 important things you may not know, though.
We’re celebrating 25 years
The UK NSC was formed in 1996 with Sir Kenneth Calman as its first chair (his daughter is the comedienne – and Strictly star – Susan Calman). Since then, Dr Henrietta Campbell, Sir Harry Burns, Professor David Walker and Professor Bob Steele have been chairs.
When it started, the joint programme directors were Sir Muir Gray and Dr Pat Troop. Sir Muir remained in the role until 2007, when current Director of Programmes, Professor Anne Mackie, took on the role.
The concept of screening doing more good than harm and the importance of quality at every step of the screening journey have always been at the heart of the UK NSC. As Sir Kenneth said in his foreword to the first annual report (in 1998):
Early identification of a disease is important to the patient. As new technologies are discovered, so people's interest is raised in the possibilities for new [screening] programmes.
It is […] vital that before proceeding there is careful development and discussion with the service, the professions that would provide the screening service and the potential users of the service and consideration of whether this is the best use of resources.
We now have population screening recommendations published for 109 conditions.
We’re planning a series of blog articles over the summer to celebrate 25 years of evidence-based recommendations, so make sure you’ve subscribed to the blog so you don’t miss out!
We make recommendations – not decisions
We make recommendations to the 4 UK health departments and health ministers.
In England, the NHS Constitution ‘commits to provide screening programmes as recommended by the UK National Screening Committee’, though the policy decisions are made by ministers.
Ministers in Wales, Scotland and Northern Ireland use the UK NSC recommendations, plus the advice from their own screening expert groups, to inform their decisions on whether to implement a national health screening programme.
This means there can be some differences in screening programmes implemented across the 4 UK nations.
We have broad representation
The committee must include a balance of members from all 4 nations, as well as including experts from public life and academia and practising clinicians. They will have expertise in one or more relevant areas, including (among others):
- health economics
- social science
- patient and public voice
The UK NSC also has a number of reference groups that help inform its recommendations. These are the:
- fetal, maternal and child health group
- adult reference group
- artificial intelligence group
- ethics task group
You can read more about the way the UK NSC operates in our code of practice.
The UK NSC does not enjoy saying no
Screening has benefits and downsides. Our role is to advise ministers about whether the benefits outweigh the harms for any potential screening programme.
This means the committee often makes recommendations not to implement a new screening programme for a particular condition. If the evidence cannot support screening, for instance there is not a good screening test or there is no treatment for people found through screening, then it would obviously be wrong to use health care staff and public money on this when they could be used for other programmes that would help more people. But committee members hear about the difficult problems that people with the conditions have and want to help. Often, this encourages researchers to fill potential gaps in the evidence base so we might be able to recommend screening in the future.
For the UK NSC to recommend screening, the essential criteria need to be met for the:
- condition – it should be an important health problem (based on its frequency and/or severity)
- test – it must be simple, safe, effective and acceptable to the public (for example, it must not be so unpleasant that many people are put off having the test)
- intervention – there must be an effective intervention for when the condition is detected through the test and the benefits of this intervention must outweigh the harms
- screening programme – there must be good evidence that it is effective in reducing mortality (how many people die from the condition) and morbidity (how many people live with the condition and its effects)
You can read more about the criteria.
We have a world-leading reputation
The UK NSC’s recommendations are used to inform decisions all round the world. Anne Mackie, director of Screening at Public Health England, has provided screening advice on behalf of the UK NSC to many countries, including Canada, Germany, Ireland, Japan, Mexico, New Zealand, Qatar, Sweden and Ukraine.
An international comparison of screening policy making in 2014 found that the UK is viewed as having a ‘model’ approach, with the most integrated and evidence-based screening programmes in the world.
Watch this space
We hope you learned something new. Do look out for the publications and blogs to mark the UK NSC’s upcoming 25th anniversary.
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UK NSC blog
The UK NSC blog provides up to date news from the UK National Screening Committee. You can register to receive updates direct to your inbox, so there’s no need to keep checking for new articles. If you have any questions about this blog article, or about the work of the UK NSC, please contact the UK NSC helpdesk.