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The purpose of the paper is to demonstrate how a generic value chain and customer focused system as demonstrated by the Scottish and Irish breast screening programmes can be used to provide a high quality health service.

Literature relevant to aligning the entire operating model – the companies' culture, business processes, management systems to serve one value discipline, i.e. customer intimacy, is reviewed and considered in the context of the NHS Scottish Breast Screening Programme in Edinburgh and BreastCheck – the National Breast Screening Programme in Ireland.

This paper demonstrates how an emphasis on customer focus and operational excellence, as used in other service industries, can help to provide a better health service. It uses the Scottish and Irish breast screening programmes as illustrative examples. The paper applies the key requirements in the delivery of a quality service including an understanding of the characteristics of a service industry, the management of discontinuities involved in its delivery and the environment in which it operates.

System failure is commonly the cause of quality failure in the health system. Breast screening programmes are designed to prevent such a failure. This paper promotes and describes the use of the generic value chain by using the knowledge gained in delivering a mammography‐screening programme.

The National Health Service Breast Screening Programme set up 20 years ago in the UK has to evolve continuously to meet changing needs as a result of fundamental transformations in the age and ethnic profile of the population. This article draws on evidence generated as part of the Healthcare Commission's national study aimed at identifying issues that may contribute to different groups not having equal access to, experience of, or outcomes from services relating to breast screening and breast cancer treatment. Findings indicate that ethnicity has an effect on the awareness of services and of breast cancer. Access to screening and the experience of screening and treatment are influenced by the interaction of ethnicity with age. Younger women from certain black and minority ethnic groups face particular barriers. There can be additional barriers experienced by those from linguistic minorities. Equality of access, experience and outcomes does not mean treating everyone the same way.

The UK National Breast Screening Programme provides a challenge to management in terms of the substantial effort its establishment will require. There are problems of manpower resources and availability of training. If the objective of reducing mortality from the disease is to be achieved, process objectives will have to be met by managers whose role will be to marshal the resources, match these to the population to be served, motivate both providers and recipients of the service, maintain standards and monitor both process and outcome.

The purpose of this paper is to describe the role of the screening liaison nurses for adults with learning disabilities employed by Peninsula Community Health.

This paper reports on the national situation in regard to cancer screening for people with learning disabilities and explores the barriers which limit their participation in these screening programmes. It describes the screening liaison nurse role and presents case examples of the work they do.

The local screening rates for people with learning disabilities have increased since the creation of this role in 2011.

Increasing the uptake of cancer screening by people with learning disabilities is clearly in line with existing national priorities. To the author’s knowledge this is a unique role in this country and the authors propose that other areas would benefit from adopting this model of working.

Pamphlets are widely used by health authorities to inform the public about diseases, and it is essential that the information therein is accurate. This study reviewed the consistency of information on breast cancer screening in materials produced and distributed by Australian health authorities. The study found that there was a clear lack of consensus in terms of the stated lifetime risk of breast cancer; while most agreed that being a woman and increasing age were the major risk factors, there was far less agreement about other risk factors, and the specific representation of symptoms was one of the areas of greatest inconsistency. It appears that this lack of consensus is not unique to Australia, but exists in other countries. Material produced by health authorities is seen by the general public as “expert” opinion, and should be able to correct inaccurate perceptions generated by exposure to other sources. There is a need to develop and disseminate messages that provide women with an accurate understanding of breast cancer and breast cancer screening.

The purpose of this paper is to understand the centrality of emotion, and how that emotion both created and contributed to meaning, in the communication of health professionals who worked in a regional pilot program for cancer screening.

As the third phase of a larger study, thematic analysis of semi‐structured interviews was carried out with the 19 members of the professional groups, which comprised the service. Brief comments were included from the questionnaire survey in phases 1 and 2 of the study to demonstrate the overflow effects on those served by the organization.

Emotion was found to be a critical component in the communication interface between the groups. The complexity of the way in which emotion was managed with the client group overflowed into the management of the communication process between the professional groups in the organization. However, it was not always recognised, and thus created difficulties for a number of staff.

Although the research was limited to one health‐care organization, it is possible that other health professions are experiencing similar situations as they cope with the certainty of unending change. Also, although secondary interviews were carried out to ensure that themes were credible to participants, it is possible that carrying out the interviews in the work environment may have constrained some participants.

Stresses the importance of the emotional component of communication and how it is recognised to facilitate effective working relationships and support staff coping with change and heavy workloads in health‐care organizations.

While the concept of cultural competence has emerged as a major contribution to improving migrants' and minority ethnic (MME) health, what constitutes culturally competent health promotion is less well understood. This paper explores the tension between the concept of cultural competence and community empowerment through an analysis of the author's recent experience of a participatory video project in which four ethnic/language groups were involved in the production of a breast‐screening video. It illustrates the engagement of migrants and minority ethnic communities in different stages of the video production process, and critically reflects on how this experience could be understood. It concludes that culturally competent health promotion requires us to go beyond language and cultural sensitivity to engage critically with communities to participate in health promotion activities. Participatory video has the potential not only to promote health messages in the communities, but also to strengthen capacity and cultural identities.

Discusses the process of introducing a breast health strategy into schools through multi‐disciplinary working. Although breast screening plays an important part in the early detection of breast cancer, up to a third of women do not take up their invitation for screening. It is argued that breast health education is a vital step towards normalising discussions about breasts, promoting breast awareness and countering misconceptions about breast cancer and breast screening. The breast health strategy evolved from a motivation to introduce an educational intervention into schools through a collaboration between school and community. The process included some informal research and evaluation at each stage which helped the team to reflect, and to inform the next stage of the project. This indicated that many teenage girls have misunderstandings, and may benefit from breast health education in schools. Having established the beginnings of a feasible strategy, the need for more systematic research and evaluation is recognised.

Reviews antenatal and early childhood screening programmes to assess the impact of guidance from the National Screening Committee (NSC). Develops methods to investigate local practice (questionnaires and telephone interviews) and summarises best practice guidance from authoritative sources. Reviews 23 antenatal and 15 early childhood programmes, of which 22 and eight respectively are in place locally. Different types of authoritative sources varied in the aspect of screening on which they commented. Guidance from authoritative sources differed and local practice variations reflected this. In three programmes these variations needed to be addressed. Elsewhere, the NSC’s “watch and wait” stance was confirmed. Limitations to local quality assurance were also identified. Programmes are for the most part following authoritative guidance, but variations in authoritative guidance are a significant issue. Robust audit is required to ensure that the local programmes are achieving optimal health gain.