Tuesday 24 May 2022

An independent quality improvement review of the national breast screening programme being announced today will ensure the nationwide service continues to deliver strong and equitable outcomes for New Zealand women.

The review, commissioned by interim Health NZ chief executive Fepulea’i Margie Apa, will assess whether current arrangements for quality and clinical safety around the BreastScreen Aotearoa (BSA) programme are fit for purpose.

This includes determining whether the arrangements are equitable and effective, and providing any recommendations for change or improvement.

“We know we have had a strong programme, which has been led for many years by a dedicated team at the National Screening Unit (NSU), alongside providers across the country,” says Margie Apa.

“Hundreds of thousands of women have been screened through the programme and continue to benefit from regular mammograms. “One impetus for this review is the identification that a number of people in the Wellington region had been waiting longer than the 60 working day target from enrolment to be offered appointment for mammography.

“Additionally, the establishment of interim Health New Zealand is a timely opportunity for a more detailed consideration of this vitally important service to ensure the quality and safety arrangements remain fit for purpose.

“I am very pleased to announce the review will be chaired by Dr Dale Bramley, the Chair of Health Quality and Safety Commission. He is also Chief Executive Officer of Waitemata District Health Board and brings both quality improvement and an experience in operational delivery of care. He will be joined by group members who are highly qualified, with backgrounds in consumer lived experience, clinical expertise specific to breast screening, health system leadership and management, and equity.

“Their focus will be on the provision of the breast screening service between 2017 and 2022.

“Key terms of reference include:

  • The systems (including monitoring, audit and clinical governance, clinical expertise and input) in place to manage equity, clinical quality and safety across the BSA programme, and whether these are being operationalised effectively.
  • Whether the needs of Māori and Pasifika people are being met.
  • Clarity about roles and responsibilities in relation to systems across the BSA programme.

“There will be consideration of how HNZ and the Māori Health Authority structures can work to maximise future improvement, and whether any changes are required to ensure appropriate BSA programme monitoring and quality, including equity, are included in the development of the future IT system.

“It will also consider whether a current review of mammography delays in the Wellington region has been sufficiently robust to give confidence in the process and outcomes, and to give assurance that all reasonable steps have been taken to identify all impacted people.

“This is a significant work programme but women should not be alarmed that the review signals any widespread clinical failing. Instead it is focused on continued improvement for what has been a highly successful programme over many years.

“From time to time, issues do arise in any health service. When that happens – as has been the case in the Wellington region, Health NZ expects any women impacted to be placed at the front and centre of any response.

“It’s appropriate that those incidents are already being investigated, and that Wellington region DHBs have apologised to the women concerned for any distress and anxiety.

“The review I am announcing today will take a broader view, including the role of the NSU in monitoring screening performance of breast screening services across the motu.

“The group will report back to me in September and I expect its findings to help drive continued system and quality improvement of the breast screening programme,” said Margie Apa.