This Independent Assurance Review for the National Bowel Screening Programme was established in March 2018 in response to a number of issues that arose from the Waitemata Bowel Screening Pilot. The purpose of the review is to provide assurance that the National Bowel Screening Programme is positioned to successfully implement and deliver bowel cancer screening across New Zealand. This includes identifying where lessons can be learned from the pilot, any potential risks to the programme, and wider learning for future national initiatives.
The review panel was led by Professor Gregor Coster, Dean of the Faculty of Health at Victoria University of Wellington; the other members are Dr William Rainger, Dr Mary Seddon and Professor Graeme Young. During the course of the review, the panel interviewed over 60 individuals, received eight written submissions and reviewed over 200 documents relating to the Bowel Screening Pilot and the National Bowel Screening Programme.
The panel recognises the considerable work by all involved to make the Waitemata pilot a success. The panel’s international expert, Professor Young, reported that by international comparisons the pilot was well conceived, had performed well and in several respects was of higher quality than a number of other international pilots. The pilot demonstrated the feasibility and cost-effectiveness of introducing a bowel screening programme in New Zealand. It also resulted in significant learning for future roll-out, particularly around increasing screening uptake in priority groups.
In late 2016, following the Waitemata pilot and a successful business case, responsibility for the roll-out of the National Bowel Screening Programme was moved to the National Screening Unit within the Ministry of Health. To date, Hutt Valley, Wairarapa, Waitemata and Southern District Health Boards (DHBs) have successfully joined the national screening programme. Full roll-out across the country is due to be completed by June 2021.
The panel acknowledges the substantial effort undertaken by the National Screening Unit to transition from the pilot to a national screening programme. The scale of this challenge should not be overlooked, given the complexity and scale of the programme. As with any national implementation process, the programme is becoming increasingly refined as it progresses and as policies and processes are tested and formalised.
The panel is fully supportive of the National Bowel Screening Programme and endorses its continued roll-out as planned. The National Bowel Screening Programme is in a good position and has considerable strengths. The panel provides the following feedback and recommendations to support the continued improvement of the programme.