Quantitative analysis of 'virtual' SSP assessment clinics in the NHS bowel cancer screening programme in England.

Claire Nickerson, Suzanne Wright, Lucy Pickering, Lee Adams, Nagamani Mandli, Nick Hex, Cameron Collins, Anne Webb, Jeffery Rayment, Karen Emery-Downing, Rebecca Maclean
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Abstract

Background: Bowel cancer screening in England is initially carried out using a home testing kit, with those who require further testing first being referred to an assessment clinic. During COVID-19, these assessment clinics became 'virtual' (telephone or video-call) where previously they had only been held face-to-face.

Methodology: A before and after study design was constructed to examine the impact of this change in clinic type on key programme metrics.

Results and conclusions: The data showed fewer people changed their specialist screening practitioner appointments when the modality was virtual, with the virtual group also having higher clinic uptake and shorter times to first offered and first attended clinics.Despite clinical opinion that not being able to physically see a patient would negatively impact diagnostic test quality, suggesting that incomplete tests would rise, referrals to colonoscopy would fall, and bowel preparation quality would suffer, the data did not support any of these suppositions.Whilst the data indicated that diagnostic test uptake was lower in the virtual group, the presence of COVID-19 is likely to have skewed findings.The IT system is being developed to support virtual clinics, which will aid future data analysis/monitoring and assist staff with clinic management.

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