Breast cancer services under threat

Friday, 21 February, 2020

Commodity watch by legislation and rural affairs policy officer Lorraine McKnight

The members of the Ulster Farmers’ Union (UFU) rural affairs committee recently considered and responded to the Department of Health’s public consultation on reshaping breast assessment services in Northern Ireland. Under the new proposals existing services which are provided across five hospital sites in Northern Ireland will be consolidated onto three sites. At present centres providing breast assessment services act as a “one stop” outpatient clinic for all patients. This includes referrals for breast symptoms suggestive of cancer better known as symptomatic referrals, and referrals from breast screening mammography tests which have indicated a need for further investigation and assessment.

The Department of Health are also carrying out a rapid review of breast surgery services and have cited challenges in relation to staffing, as one factor that has weakened the system which currently delivers breast cancer services in Northern Ireland. Other factors include increasing demands put upon the system by patients including urgent referrals for suspected cancer. By continuing with the existing system, waiting times are expected to continue to increase year on year. The new proposals have also recommended the use of a centralised appointment booking system and the establishment of a regional breast assessment network with its primary objective to shape and support service provision for the whole population of Northern Ireland.

Northern Ireland has some of the highest breast cancer survival rates in the United Kingdom and the UFU’s rural affairs committee have highlighted that by removing breast cancer assessment services from an existing site this could signify the commencement of plans to eventually close the whole centre. If the number of centres offering breast cancer assessment services are reduced from five to three, rural dwellers in particular could be most affected in terms of having longer distances to travel. The committee have recognised the need to ensure that a centre in the west of the province is maintained. Currently 100 percent of all women presenting suspected breast cancer symptoms should be seen within 14 days however in many cases, this target is not being met. Although the Department of Health believe that the answer to providing better quality care is to remove breast cancer services from two of the five existing sites, the committee would be keen for the Department of Health to explore other options available to each Health and Social Care Trust in order to increase capacity on each site. 

With the number of women attending screening and breast assessment clinics steadily increasing year on year, and with more women living longer this would suggest that the number of women using these services will continue to increase. Therefore, any proposals which the Department of Health recommend for implementation must allow equitable access to breast cancer services for all women right across Northern Ireland regardless of where they reside.  A strong cohesive approach to team working in order to combat shortages amongst staff and in particular consultant radiologists, and any future breast cancer care services must have the ability to adapt and provide patients with a service that is culturally appropriate.  Further information on the proposals that the Department of Health will be putting forward for approval by the Health Minister can be found on the Department of Health’s website at www.health-ni.gov.uk.