The UK National Screening Committee (UK NSC) uses in-service evaluation (ISE) to support its screening recommendation process and inform wider policy decisions about screening.
ISE is used to test proposed new screening programmes or changes to existing programmes. The process is used where a change in screening policy is justified by strong evidence, but important evidence gaps still remain that can only reasonably be filled by evaluation in a live NHS setting. It tests the new programme or programme change to collect data on ‘real world’ operational impact and effectiveness.
UK NSC has recommended the use of ISE a number of times in the past. We are currently consulting on the continuation of existing ISE of newborn screening for severe combined immunodeficiency (SCID). ISE of newborn screening for spinal muscular atrophy (SMA) is also being planned.
This approach to gathering robust evidence (that can be published in a peer-reviewed journal) in live NHS services has previously informed the:
- addition of 4 rare inherited metabolic diseases to the newborn blood spot screening programme
- introduction of human papillomavirus (HPV) primary screening in the cervical screening programme
Updated ISE information
The UK NSC evidence review process includes a recently updated definition of screening ISE.
The updated definition clarifies ISE’s purpose, structure, and governance. It makes clear that ISE uses robust research and evaluation methods, tailored to the specific project and the evidence gaps being addressed. It also emphasises that ISE is collaborative. Delivery, funding, and approvals are shared between the UK NSC, NHS, and academic partners.
The aim of the updated definition is to give stakeholders a clearer understanding of the ISE approach and clarifying the role of ISE within the evidence review process.
The definition may be refined further as the approach continues to develop and be applied.
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