References and acknowledgements Appendices Appendix A – Action Plan
Appendix B – Map of Medicine – AAA Screening Pathway Appendix B – MOSAIC Groups
Section 1 Introduction:
Rationale This strategy and action plan have been developed in response to requests from local Commissioners in NCL and the National Abdominal Aortic Aneurysm Screening Programme (NAAASP), and in response to the challenges above the following strategic aims and objectives have been generated. It is an ambitious but achievable strategy with a clear vision of what success would look like
Overall indicators of success – by 2015 we aim to have in place:
Continual year on year uptake for the programme of over 70% with a marked reduction of initial and subsequent multiple DNAs (baseline to be established)
A Local and Sector Screening Champion with enhanced third sector co-operation and identification of the AAA “brand”
A Data Intelligence informed approach to DNAs, uptake and quality.
A well used learning network within London to share with other National and London specific AAA programmes with specific regard to cross border issues and uptake/promotion
A communications plan utilising national and local level resources/partnerships that is embraced and adopted in part by the NAAASP
Increased opportunities available service users to make healthy choices and take up the Triple A screening offer via a wider selection of screening venues and health interventions available via referral, promotional materials, direct interface
Systems in place to enable regular monitoring of screening uptake and the sources of self referrals and those invited via the NAAASP SOP
A rolling programme of awareness and where required training for primary care and allied health professional staff on the screening programme to encourage opportunistic raising of the AAA offer and signposting
An established and responsive network of venues and human assets to promote AAA screening across a number of settings within NCL.
THE NAAASP - The National Screening Programme
The National Screening Committee’s Abdominal Aortic Aneurysm Screening Programme is being introduced gradually across England.
Phased implementation commenced in March 2009 and it is anticipated that coverage across England will be achieved by March 2013.
Research has demonstrated that offering men ultrasound screening in their 65th year could reduce the rate of premature death from ruptured AAA by up to 50 per cent.
Ruptured abdominal aortic aneurysm deaths account for 2.1% of all deaths in men aged 65 and over.
This compares with 0.8% in women of the same age group. The mortality from rupture is high, with nearly a third dying in the community before reaching hospital.
Of those who undergo AAA emergency, the post-operative mortality rate is around 50%, making the case fatality after rupture 82%.
This compares with a post-operative mortality rate in high quality vascular services of 3-8% following planned surgery.
Treatment is available for these patients if their medical condition permits. In most hospitals the treatment is urgent surgery which requires the attention of a vascular surgeon, as well as the skilled attention from medical and nursing staff in the operating theatre, intensive care and on the surgical ward.
The AAA screening programme aims to reduce AAA related mortality by providing a systematic population-based screening programme for the male population during their 65th year and, on request, for men over 65.
An AAA is defined as a maximum aortic diameter of 3cm or greater in the maximum antero-posterior measurement. An aortic diameter of less than 3 cm is deemed to be within normal limits.
The NAAASP Programme Vision and Objectives The NAAASP has an established Programme Vision and Objectives which aims to reduce AAA-related mortality among men aged 65 to 74 by up to 50% through early detection, appropriate monitoring and treatment.
It does this by providing a systematic population-based screening programme for men during their 65th year and, on request, for men over 65 who have not previously been screened.
The national screening programme’s objectives are to:
• Identify and invite eligible men for screening during the year they turn 65
• Provide clear, high quality information that is accessible to all
• Carry out high quality abdominal ultrasound scans on those men attending screening according to national protocol
• Minimise the adverse effects of screening, including anxiety and unnecessary investigations
• Identify AAA accurately
• Ensure appropriate and effective management of cardiovascular risk factors identified through screening
• Ensure high quality diagnostic and treatment services
• Promote audit and research and learn from the results
The programme is underpinned by the guiding principle that screening should be effectively integrated across a pathway from invitation right through to the recording of treatment outcome. The programme aims to ensure all individuals are treated with respect and there is equitable access to screening.
All men eligible to participate in the screening programme should have access to adequate information about the potential benefits and risks of screening to enable them to make an informed decision before participating.
Vision and objectives NAAASP 2011
Challenges to Uptake, Promotion and Communication: The NAAASP is faced with significant challenges in terms of driving uptake and promoting the delivery of AAA Screening.
1 Low Uptake Levels – until recently Uptake in the NCL programme has been low and it is perceived by the RFH programme office and the NAAASP communications and uptake leads that a significant role in the recent upswing of take up (the NCL screening offer from 54%rising from to circa 62%) has been national level press lead story on the AAA programme (Daily Mail 2011) and linked announcement of the reiteration by the Secretary of State for Health the Rt Hon Andrew Lansley MP that AAA is a core screening programme with a national expectation for ubiquitous roll out by 2013.
2 Did Not Attends - As with many other screening programmes the NCL AAA screening programme is encountering significant DNA levels, the scale of which is difficult to assess given the relatively unsophisticated levels of reporting and scrutiny available through the programme ICT and Data solution Northgate. Currently NAAASP Standard Operation Procedures do not allow for a call recall system outside of the sending of DNA reminder letters. Whilst anecdotal evidence from other programmes exists for the efficacy of using DNA reminders repeatedly and over time whittling down and addressing DNAs, it is a time and resource expensive procedure ( both in terms of resource generation and
3 Overall System Change - The Nicholson Challenge and related organisation flux in Public Health, NHS and Local authority commissioning and provider structures resource bases and priorities have introduced a new level of complexity to uptake promotion and communication systems. Specifically with the rapid pace of change in existing delivery structures, shifts in responsibilities, overall national and local reductions in available uptake and communications resource and areas of responsibilities towards Liberated NHS structures post April 2013. Recent Department of Health Policy ( 2010 onwards) on what is appropriate spend (Circa £1000 ) and direction for communications have also acted as impediments to systems developed within health which have in the main relied on mass communications and campaigns to raise generic awareness at a national scale and lower level campaigns to generate local interest.
4 “Consumer awareness”- Low “consumer” ( i.e. patient and Health and social care economy ) awareness and identification of the AAA offer and NAAASP brand is overall low within the target demographic. Despite occasional coverage of AAA and related conditions the awareness of screening offer and specifics of conditions is certainly not at a level where public awareness can be readily mobilised.
5 Lack of Third Sector Champions - In comparison with other screening offers (both cancer and non cancer) the core issues and impacts of AAA are not significantly understood or recognised. In terms of third sector support the Circulation Foundation (an off shoot of the Vascular Society of Great Britain and Ireland) is a committed and innovative organisation, but cannot hope to have the same “footprint” ( overall awareness of the general public, brand recognition or embedding within cultural tropes, influence and so on) as other more established charities such as Asthma UK, Macmillan, Cancer Research, Breakthrough Breast Cancer, Diabetes UK, Alzheimer’s UK, RNIB etc and many more health sector charities or organisations. Accordingly status and understanding of the condition is low and the balance of offer versus demand ( the dynamic inherent in all screening offers between general populace request or demand for service access and information, and the need for services to actively promote their offer and engage the p[populace) needs to be addressed in order for the condition and treatment options to be generally understood and this relative risks and benefits of AAA screening to be delivered in a supportive non coercive manner.
6 Overall Health Service Championing of the AAA offer in London – Outside of the programme and commissioning team awareness of the AAA offer within the health and social care economy is low. General primary care awareness of the programme is patchy, with significant support in some areas of the UK (in particular the Gloucester area from which the NAAASP originated) and little in others, resulting in an overall push to take up or consider AAA screening as a routine health intervention offered to men in the 65th year and over. Currently the programme is not represented in QOF and until this occurs the financial incentive to engage with and promote is not present. We do not at present have an overarching “champion” for AAA screening either in NCL or London as a whole.
7 The national phased roll out - The iterative roll out of the programme has created areas of programme availability and areas where no programme exists. With the advice given to engage with AAA scans in areas of non availability via primary care and GP to acute referrals there is a functioning work around, but as yet the London Network has not achieved full maturation. With the South West and North Central London programmes up to speed and other areas either commencing shortly or still planning their programmes, there is a need to ensure that the London offer is advanced in a collegiate and collaborative manner and that accordingly this uptake promotin and communications plan is scalaeable to the other areas of London and can provide useful material to augment the NAAASP communications offer in support of the national Go Live in April 2013.
There are wider issues affecting general screening access in the UK which are worth examining here and to which specific responses are required in order for a mass screening programme to achieve success. Multiple barriers exist to uptake of screening programmes .
The following table is adapted from the COI and CSL research into barriers to uptake of Cancer and Non Cancer Screening access programme 2009
Summary of audience with low uptake and Barriers to screening
Audiences with low Uptake
Barriers to screening
Out of Date GP Lists
Out of Date GP Lists
Lack of GP Involvement/contractual obligation
Lack of resources and admin/ICT issues
Poor Screening experience
Inconvenient Screening Location
Client Functional Factors
Client Knowledge and Attitudes
Low perceived Risk
Belief Screening is diagnostic
Belief Screening is not necessary
Fear of Condition
Fear of Screening
& Lifestyle choices
There are multiple areas of systemic and client based confounding issues to be addressed to achieve the penetration of population required by any successful programme. Only by addressing the diverse nature of the barriers to uptake will a screening programme succeed.
Core messages from screening programmes research conducted by COI and CSL determined.
Endorsement by community spokespeople may help to increase screening uptake among minority groups
Web based interventions show potential for increasing knowledge about screening and as a means of arranging appointments
Using community groups and gatherings to help disseminate information about screening is recommended to help increase uptake among ethnic minority groups
Educating whole communities, starting at school has been suggested as a means of encouraging participation
There is some evidence that advertising campaigns may help to increase screening uptake
Advertising campaigns are likely to be less effective among ethnic minority and less educated audiences
Literature and materials using culturally sensitive imagery and patient testimonials may help to increase uptake among hard to reach groups
Leaflets and DVD’s used in conjunction with GP endorsement seem to increase screening uptake
Believing that screening is personally relevant and beneficial increases the likelihood of attending
For some looking after oneself is not a priority and hence screening is viewed as unimportant
Fear or experience that screening will be painful is a key barrier to uptake
Embarrassment is a strong inhibitor to uptake for all programmes
Fear itself is a barrier to uptake for all programmes
Many who decline do not understand the link between screening and survival and hence do not think it is necessary
A lack of understanding of the purpose of screening is also a barrier to uptake for all programmes
A lack of understanding of the factors influencing risk are key to low uptake
Perceiving oneself to be at low risk is a key barrier to screening uptake across all programmes and a particular issue among some ethnic minority groups
Telephoning non responders can increase screening uptake where it is possible to make contact and provides the opportunity to address barriers
More flexible appointment times and making it easier to change appointments is key to increasing screening uptake
Cost does not seem to be a significant barrier to screening uptake
Telephone and text reminders have been shown to increase screening uptake
Second appointments can increase uptake of screening
Among some non attendees the intention to attend l screening may be strong, but is impeded by the hassle of organising this.
Inconvenient appointment times is a particular barrier to attending appointments and an issue for screening
Imagery may help to increase understanding among those with low literacy as well as helping to convey screening in a less ‘clinical’ way
Poor literacy is a key barrier to uptake across all screening programmes
Translated audio visual aids may help to increase understanding of screening programmes.
Translators can help ethnic minority clients to feel more comfortable at clinics
Identifying language preference would enable screening teams to send invitations and materials in the preferred language
Language is a key barrier to uptake across all screening programmes and a particular problem for London
Strategically placed mobile units and drop in clinics might help to increase screening uptake
Information sharing on the effectiveness of initiatives to improve uptake could be beneficial
It is important to ensure that the screening experience is as positive as possible, paying particular attention to providing reassurance and privacy
A negative screening experience can put clients off being screened in future
A positive and proactive attitude among GPs is key to increasing uptake of screening programmes
A lack of interest and incentives among GPs to promote screening programmes is thought to contribute to low uptake in London
Regular GP list cleaning would improve screening targeting and hence uptake
GP admin staff can play a key role in targeting non responders. Training staff to be sensitive to the needs of BAME clients may help to increase screening uptake among this audience
Screening programmes in development in the UK
In recognition that individuals may have more than one disease, and that some diseases may be interrelated, the National Screening Committee in the UK is developing five integrated population screening programmes. These are focused on different life-cycle stages:
This has been graphically expressed below.
Evidence Base and Best Practice
The first national review of health-related campaigns and social marketing in England, was jointly commissioned by the Department of Health (DH) and the National Consumer Council (NCC) as part of its 'Choosing Health' White Paper commitments, published its key findings in 2006:
Providing information and urging people to be healthy does not work. Rather than attempting to sell health, we need to understand why people act as they do and therefore how best to support them
Public health promotion programmes work best when the research base underpinning the campaigns were robust; a clear evidence based strategy should be articulated for every campaign use to identify messages and imagery that people will best engage with
With regard to target groups and messages… it is recommended that there is joint working to ensure consistency of messages
Test ideas to connect them more directly with their target audience - at the same time, there is a clear need to avoid over-reliance on relatively small scale pilot testing. There also needs to be a focus on non-target audiences qualitative research using; Focus Group Discussions
The Central Office for Information (COI) and the Department of Health (DH) also reviewed a number of public health communications in the UK and abroad. This was supplemented by extensive case histories of effective commercial youth advertising and promotional campaigns and determined a number of key features that are likely to be effective in changing people’s behaviour:
Humour was a good way of dealing with sensitive topics
There must be a clear central message – this needs to be repeated in different forms to avoid boredom and to maintain impact
The message must be positive – messages that are factual and non-judgmental have more success
The message must be consistent over several years – young people do not value messages that are not constantly re-inforced
The same message can be communicated in a number of different ways
Different types of mass media are appropriate for different elements of the message
People need to feel that any campaign developed is part of their culture, and not ‘top down.’
Underpin campaigns with a sound evidence base
Strong grass roots support can make or break a campaign
Communicate with individuals , carers and society at large
Bring the local media on side in advance of any large campaigns
The COI and DH have issued further advice on effective Public Health campaigns:
Explore various media channels that can reach disadvantaged people.
Develop materials that are appropriate for the life stages of the target population and speak to their experiences and in a language that suits them
Set aside resources for designated people in each area to take an overall lead on the campaign as it rolls on through the delivery areas to keep the momentum of the campaign moving forward
Develop a database of creative materials to support best practice; share what works and what does not work
Build the evaluation component at the beginning of the campaign; this would yield a comparative analysis of awareness before and after the campaign.
Undertake further research into the background circumstances that contribute to low screening access levels and user experience satisfaction
As can be seen there is a clear call to develop uptake and communications responses capable of :
1 Promoting specific screening offers
2 Promoting, in addition, relevant life course appropriate onward referrals and coterminous health service agendas.
Social Marketing Core concepts
The cross-government white paper 'Choosing Health' recognised that encouraging positive health behaviour (and related behaviour change), can be complex and challenging. Social marketing was specifically highlighted in the white paper as an important and currently under-utilised approach. As a result a national review was undertaken jointly by the Department of Health (DH) and the National Consumer Council (NCC) in 2005 to examine ways to improve the impact and effectiveness of health promotion, and in particular to consider the potential contribution of social marketing at national and local levels. The report was published in 2006 ‘It’s Our Health! Realising the potential of effective social marketing’ and provides a Framework for the First National Social Marketing Strategy for Health.The core concepts and principles of social marketing are:
The customer or consumer is at the centre – need to understand where the person is at now rather than where we want them to be
It is based on clear behavioural goals – looks at positive and problematic behaviours to understand the relationship between them and looks to identify patterns and trends over time and what influences these.
Developing insight – moving beyond traditional information and intelligence (e.g. demographic or epidemiological data) to looking much more closely at why people behave in the way that they do. Consideration is given to the possible influences and influencers on behaviour, and specifically what people think, feel, and believe
Exchange – understanding and identifying what is to be ‘offered’ to the intended audience, based upon what they value and consider important (e.g. short-term v long-term benefits). It also requires an appreciation of the ‘full cost’ to the audience of accepting the offer, which may include: money, time, effort, social consequences, etc.
Competition - all the internal and external factors that compete for people’s attention and willingness or ability to adopt a desired behaviour
Segmentation – beyond traditional ‘targeting’ approaches that may focus on demographic characteristics or epidemiological data, by considering alternative ways that people can be understood and profiled
‘Intervention mix’ and ‘social marketing mix’ – at a strategic level the intervention mix and at an operational level the social marketing mix (local communication and media strategies/ programmes/ campaigns)
National Social Marketing Centre – Benchmarking Criteria
In line with best practice in Health promotion and a rich evidence base the UCSAP has been drafted within the following principles laid out by the National Social Marketing Centre and are quoted below in full.
The following can be found at http://socialmarketing-toolbox.com/content/nsmc-benchmark-criteria-0
The benchmarks are designed to:
increase understanding of core social marketing concepts and principles
increase consistency of approach and thereby their potential impact and effectiveness
maintain maximum flexibility and creativity, to craft and develop interventions to different needs
assist more systematic capture and sharing of transferable learning between interventions
assist effective review and evaluation of different types of intervention
It is important that the benchmarks are not confused with a process of how to do social marketing.
They have been framed in such a way as to ensure that they do not restrict the ability of practitioners to develop creative, imaginative and flexible solutions to the different types of behavioural challenges they face. However the criteria provide a robust framework to assist those planning and developing interventions to ensure they are consistent with best evidence-based principle and practice in the social marketing field.
1. Customer orientation
Helps develop a robust understanding of the audience, based on good market and consumer research, combining data from different sources.
What to look for:
A broad and robust understanding of the customer is developed, which focuses on understanding their lives in the round, avoiding potential to only focus on a single aspect or features
Formative consumer / market research used to identify audience characteristics and needs, incorporating key stakeholder understanding
Range of different research analysis, combining data (using synthesis and fusion approaches) and where possible drawing from public and commercial sector
Has a clear focus on behaviour, based on a strong behavioural analysis, with specific behaviour goals.
What to look for:
A broad and robust behavioural analysis undertaken to gather a rounded picture of current behavioural patterns and trends, including for both the ‘problem’ behaviour and the ‘desired’ behaviour
Intervention clearly focused on specific behaviours i.e. not just focused on information, knowledge, attitudes and beliefs
Specific actionable and measurable behavioural goals and key indicators have been established in relation to a specific ‘social good’
Intervention seeks to consider and address four key behavioural domains:
formation and establishment of behaviour
maintenance and reinforcement of behaviour
behavioural controls (based on ethical principles)
Is behavioural theory-based and informed, drawing from an integrated theory framework?
What to look for:
Theory is used transparently to inform and guide development, and theoretical assumptions tested as part of the process
An open integrated theory framework is used that avoids tendency to simply apply the same preferred theory to every given situation
Takes into account behavioural theory across four primary domains:
environmental / ecological
Based on developing a deeper ‘insight’ approach – focusing on what ‘moves and motivates’.
What to look for:
Focus is clearly on gaining a deep understanding and insight into what moves and motivates the customer
Drills down from a wider understanding of the customer to focus on identifying key factors and issues relevant to positively influencing particular behaviour
Approach based on identifying and developing ‘actionable insights’ using considered judgement, rather than just generating data and intelligence
Incorporates an ‘exchange’ analysis - understanding what the person has to give in order to get the benefits proposed.
What to look for:
Clear analysis of the full cost to the consumer in achieving the proposed benefit (financial, physical, social, time spent, etc.)
Analysis of the perceived / actual costs versus perceived / actual benefits
Incentives, recognition, reward, and disincentives are considered and tailored according to specific audiences, based on what they value
Incorporates a ‘competition’ analysis to understand what competes for the time and attention of the audience.
What to look for:
Both internal (psychological factors, pleasure, desire, risk taking, addiction etc) and external (wider influences / influencers competing for audience’s attention and time, promoting or reinforcing alternative or counter behaviours) competition are considered and addressed
Strategies aim to minimise potential impact of competition by considering positive and problematic external influences & influencers
Factors competing for the time and attention of a given audience considered
Uses a developed segmentation approach (not just targeting) avoiding blanket approaches.
Deeper segmented approaches that focus on what ‘moves and motivates’ the relevant audience, drawing on greater use of psycho-graphic data
Interventions directly tailored to specific audience segments rather than reliance on ‘blanket’ approaches
Future lifestyle trends considered and addressed
8. Methods mix
Identifies an appropriate mix of methods being utilised.
What to look for:
Range of methods used to establish an appropriate mix of methods
Avoids reliance on single methods or approaches used in isolation
Methods and approaches developed, taking full account of any other interventions in order to achieve synergy and enhance the overall impact
Primary intervention domains considered:
informing / encouraging
educating / empowering
servicing / supporting
designing / adjusting environment
controlling / regulating
The Uptake And Communications Strategy Overarching Aims for Uptake and Communications
To increase awareness of the AAA Screening programme in NCL prior to the April 2013 national programme roll out and ensure congruence between local and national uptake, systems and communications developments.
To deliver a scaleable, methodical, evidence based response to the challenges of promoting the AAA screening offer in North Central London.
To deliver supportive, accessible, non coercive messages encouraging men in the 65 year to assess the relative risks and benefits of taking up the screening offer.
To raise overall public and health and social care “system” awareness of the condition, screening programme and treatment options available in support of uptake of the screening offer
To provide materials and delivery options suitable for a diverse and changing population that fully supports national and local Equality Impact Assessments and the differentiated access needs and communication styles of the community.
To maximise the innovative use of available promotional and uptake related resources in NCL in a way that delivers value for money and provides measurable proof of impact on service uptake levels.
General Strategic Themes To promote uptake and awareness of the AAA screening offer for men and the communities in which they live and establish a significant upswing in uptake and awareness for the programme and coterminous agendas and health offers.
1. 1 To co-ordinate the dissemination and further develop a range of materials to promote AAA screening services to service users in NCL localities and develop in line with the 2013 national roll out.
Develop a partnership to better coordinate screening promotion programmes.
Ensure all cohort service users are (if and when appropriate) regularly offered information and access to AAA screening services in their locality areas. Ensure all relevant patient facing National and London AAA programme information is collated and available to address issues of “out of borough” and cross border service access prior to 2013.
Establish a segmented, time specific and realistic action plan to promote uptake and communications
To prepare relevant health and social care partners for their roles is supporting the programme roll out
develop a model that the NAAASP can utilise adapt or adopt for deployment outside of NCL
address the large numbers of DNAs and low take up of the programme in advance of the main national roll out in 2013 and beyond.
2. 2 To provide access to screening programmes for service users in line with screening rounds
Identify and support the role of primary care contractors and voluntary sector agencies in service provision and or signposting for service users alongside existing networks of provision Deliver a high quality, assured and patient focussed value for money AAA screening programme for NCL
increase the programme uptake rate from 54% to 70% in the run up to realisation of the national programme 2013
3. 3 To promote the importance of AAA screening as part of the overall Public Health and Primary Care offer
Promote awareness and collaboration with the local and national programme with a wide array of professional, statutory and non statutory stakeholders (Primary care, Local Authorities, third sector, allied health professionals etc)
Proactively promote the importance of a screening for service users and key clinical and other professional groups. Raise the profile of the importance of screening in relationship to maintaining a healthy lifestyle.
Recruit and deploy a clinical and or professional screening champion (outside the programme clinical team) with experience of leading/influencing Primary Care practitioners to deliver screening both in and outside of London.
Ensure AAA and related screening offers are represented within system operational, reporting, scrutiny and commissioning arrangements – CSP, Health and Wellbeing Boards QUOF, QIPP et al
deliver target and promotional sessions supporting the programme in all localities of NCL before April 2013 to ensure stakeholder preparedness and drive uptake increase
4. 4 To provide access to a range of screening opportunities and materials to support access to programmes for diverse communities
Raise the profile of the importance of AAA screening for specific targeted communities
Make available differentiated access resources and establish language and access support for the NCL programme
Adopt and use existing cohort methodologies such as Mosaic ( SEE APPENDIX C) to segment the target cohorts and develop appropriate uptake responses to fit with multiple sub groups (Silver Surfers, Wetherspoons Generation etc) Map community assets and develop suitable outreach capability to engage and recruit them.
Ensure internal programme communications ( within the screening session – reulsts and treatment options) are suitably developed and nuanced to improve user experience assist choice in a non coercive manner and allow for service users to balance risk and benefit for procedures post screen –ensure deployment of NAAASP risk communication tool when available. augment the reach of coterminous agendas and services seeking to expand the take up of screening and related health service offers in NCL.
provide sustainable and future proofed uptake engagement and communications capacity across all NCL localities that adequately balances and addresses unique local circumstances whilst delivering the local and national programme aims
5. 5 Increase awareness and understanding of the health benefits of screening uptake, in order to create a culture of change.
Run a rolling programme of training for staff groups working with service users on the benefits of screening programmes and referral/self referaal options
6. 6 Develop an integrated care pathway and clinical guidelines for referrals into screening services for clinicians and community assets.
Develop an integrated NCL/London/National facing care pathway for increasing self referrals into screening
Disseminate national policy and guidance NICE, VSGBI, etc in support of AAA screening
8. 7 Empower local communities to make choices regarding screening uptake address the barriers to access and address service user experiences.
Develop a partnership to promote an environment in which is it easier to access /normalised to access screening services
Develop a plan to produce and communicate consistent messages about screening to the public and to staff groups
Scope local /national media ( print/web/broadcast) in line with NAAASP steer to work up channels and messages prior to 2013.
9. 8 Address need by identifying and acknowledging cultural, religious and gender issues affecting those individuals who would benefit most from accessing screening services offers
Develop an intelligence lead plan to produce and communicate consistent messages about screening to the public and to staff groups Develop low cost high spread promotional resources ( web 2.0 etc) to ensure scaleable promotion is delivered in synergy with community development and stakeholder enagement. Capitalise on core demographic cultural assets and positive actions to support the programme – ie Use the Silver Surfers” Capture and develop case studies portfolio and advocates to deliver AAA to any community sub group or wider network
10. 9 Promote an environment and culture where screening is de stigmatised and screening interventions are the norm.
Ensure that the wider community in involved in the future implementation of the strategy, to ensure ownership participation and maximise community advocacy
Run a rolling programme of training/awareness for staff groups working with services users on the overall principles and purposes of screening
Ensure that staff in primary care are trained, resourced and supported to manage refer and support service users in the first instance in the primary setting, making use of the range of community based interventions available
Develop a plan to educate and develop the skills of the whole population to enable the population to influence and access coordinated screening promotion programmes.
11. 10 Ensure that all actions are based on reliable evidence and that evaluation is an integral part of all work.
Identify an evidence-based service delivery model for the delivery of screening in the Consortia
Work with primary care to encourage referrals, opportunistic discussion of screening offers in line with screening rounds and early identification of patients who would benefit from referrals.
Develop an integrated care pathway across primary, secondary, tertiary and community care services
Analyse and through system development reduce session DNA rates from 50% to 30%
Key Messages for Uptake and Promotion Key messages for implementing this strategy (through the action plan) are in line with good practice derived from the national level resources, social marketing principles and address the key themes of screening campaigns:
Screening is a serious issue – with life threatening consequences if we do not get better access available to all who require it (ALL)
Taking up a screening offer is an important and vital step in looking after your health ( individuals)
Individual’s need to have the right information to make a decision on the relative benefits and risks of screening ( All)
It is widely believed that Screening doesn’t have merit as a clinical approach IT DOES HAVE AN ENORMOUS CONTRIBUTION TO MAKE!! (ALL)
Screening uptake is a major challenge for the NHS and the community and we all have to take action if we are going to successfully address it (ALL)
NHS, Local authority, third sector and other organisations are working together to deliver screening and improve uptake((ALL)
The costs to individuals and the NHS and to all of us can be very serious if we do not take up the offers we are given (ALL)
We need you to support the screening strategy by seeing how you can help with the screening strategy (clinical professionals)
We need you to help us to act now to address screening uptake levels in NCL and the UK (Political, community leads, individuals)
We need you to help us to act now to address screening in Partner areas (Commissioning Leads in local NHS and authorities, Allied health professionals etc)
Methodology for Delivery of the UCSAP:
NCL Screening round To encourage a proactive management of capacity and the optimal use of uptake and promotion resource a “screening round has been established. Broadly speaking this allows for the targeting of materials within specific NCL localities within the context of general screening delivery available throughout NCL.
The programme for North Central London will roll out to the following areas:
NCL Locality area
Date screening invites go out
2012/2013 Date screening starts
The Uptake And Communications Action Plan (UCSAP) The UCSAP broadly addresses four groups and has four overlapping core themes
This communications and uptake programme is specifically designed to address the current low levels of enagement wihyt our core stakeholders ranging from our patients and their families and communities and primary care and other allied health and social care representatives and organisations. There are three phases for the overall communications programme within which these initiatives sit.
The Public (Patients and their families)
Analysis of take up/ efficacy of communications access to screening, development of refreshed communications offer.
Promotion of AAA – provision of revised materials and briefings
Promotion of AAA – provision of revised materials and briefings
Development and delivery of appropriate messages through available channels