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Expert Advisory Group Welcome Balanced Report

8 December 2003

Expert Advisory Group Welcome Balanced Report

The Audit office report reviewing progress to put in place recommendations from the Gisborne Cervical Screening Inquiry has been welcomed as balanced by the chair of an independent cervical screening advisory group Dr Helen Rodenburg.

The National Cervical Screening Programme (NCSP) Advisory Group, which met for the first time in Wellington last month, provides independent, external advice to help improve the programme.

Dr Rodenburg says as with any area of health, significant improvements always take time. "But given that its just over two and a half years since the release of the Gisborne Inquiry, its clear that a significant amount of work has already been achieved. This report shows a considerable improvement since the second report prepared six months earlier this year by Dr Euphemia McGoogan, with 30 of the 46 recommendations completed or planned to be in place within six months."

The Advisory Group is pleased that the Audit Office recognises the need for stability and allowing time to settle in the still relatively newly strengthened National Screening Unit, which, among other things,has responsibility for implementing the Gisborne Inquiry recommendations.

The recommendation to continue with independent reviews is welcomed and the Advisory Group endorses the proposal to both widen the scope of the reviews to include the unit's wider work programme and stagger three reviews over the next seven years. This acknowledges that it is now nearly three years since the Gisborne Inquiry and the National Screening Unit's work programme is considerably broader than just implementing the Inquiry's recommendations and it also will assist in minimising the extra workload imposed on the unit by the reviews.

Dr Rodenburg says the Advisory Group sympathises with the call for quicker auditing of health providers to see whether they are meeting new standards but believes the National Screening Unit took the right approach in getting standards agreed and bedded in before auditing against them.

"The National Screening Unit is not separate from the rest of the health sector. By working with health professionals a wide range of expertise will lead to greater improvement in the quality of cervical screening That takes time and effort and care needs to be taken not to run the risk of losing support for these initiatives through rushing the process.

"The new colposcopy standards, which have only just been put in place, will take some time to bed down and gather full support from the health professionals using them. It makes good sense to allow time to develop systems before the National Screening Unit attempt to audit providers against the new standard and this is the kind of the pragmatic advice the Advisory Group is able to provide to the Ministry's National Screening Unit.

Similarly, the Advisory Group cautions the NSU against directly auditing the 5,300 smear takers as recommended in the Audit Office report. The Advisory Group notes that there is no contractual relationship between the smear takers and the National Cervical Screening Programme (NCSP).

"Far better that the NSU continue to work with the College of General Practitioners to review the smear taker standards and then examine options for implementation.
The NSU's approach to this shows that they are prepared to take a cooperative and collaborative approach, something the Audit Office themselves said was needed and the Advisory Group fully supports.

The Advisory Group firmly believes the focus is to continually improve the quality of the service and safeguard standards of care. It's important to recognise that different parts of the screening pathway are at different stages in this cycle and that it's important to get the process right whilst building sector support.

The Advisory Group will provide independent advice on the programme's direction, consulting widely within their own constituent groups, and discussing research and development opportunities.

"The basic building blocks are in place for the National Cervical Screening Programme to now make good progress with quality improvement in the programme. It's vitally important that all eligible women enrol and stay enrolled in the programme to get the benefits screening provides by reducing the harm caused from cervical cancer."

The members of the NCSP Advisory Group are:

Dr Helen Rodenburg (chairperson); Dr Phil Shoemack, Faculty of Public Health Physician representative; Dr Gary Fentiman, College of Gynaecologists representative; Dr Martin Whitehead, College of Pathologists representative; Dr Felicity Goodyear-Smith, Royal New Zealand College of General Practitioner's representative; Diane Newland, College of Practice Nurses representative; a Maori representative (to be appointed soon from the Maori advisory group); a Pacific representative (to be appointed soon from the Pacific advisory group); a Consumer representative (to be appointed soon from the Consumer reference group).

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