Design Gisborne Cervical Screening Inquiry
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The NCSP Today

Actions Taken to Strengthen the National Programme

July 1996

Medical Practitioners Act comes into effect, to protect the health and safety of the public and provide a mechanism to ensure competency.

 1996 - 1997

The National Cervical Screening Programme Register (NCSP-Register) is centralised in Wellington.

Beginning in 1997

All laboratories providing cervical cytology services to the NCSP are accredited with IANZ (successor to Telarc).

1998

Responsibility for national co-ordination and leadership of the NCSP is located within the then HFA's National Screening Team. 

December

1998

A multi-disciplinary Expert Advisory Group to the national screening programmes established.  The Group provides expert advice on strategic policy issues and programme monitoring and evaluation as well as other technical advice when required.

September 2000

 

An Independent Monitoring Group was contracted in September 2000 to provide routine monitoring of the NCSP.  The Group provided its first quarterly report in July 2001.

November 2000

NCSP Interim Operational Policy and Quality Standards are finalised and distributed to all providers of the programme including health promoters, smear takers and providers of laboratory and colposcopy services.  Community laboratories sign contracts making the standards binding.

November 2000

Responsibility for national co-ordination and leadership of the NCSP is located within a separate unit - the National Screening Unit (NSU) - within the Ministry of Health.  Since 1 July the Unit has been responsible for all contracting and funding of programme providers except primary care smear taking.

March 2001

The National Screening Unit is enhanced and following its restructuring has 33 staff.  Within the Unit there are dedicated teams for the NCSP, BSA, information systems, Maori health and contract and finance.

 April 2001

The Ministerial Inquiry into the Under-Reporting of Cervical Smear Abnormalities in the Gisborne Region released its findings including 46 recommendations for improvements to the NCSP. One of the key recommendations was an Audit of cases of invasive cervical cancer to examine the screening histories of women diagnosed with cervical cancer to determine where improvements to the NCSP are needed.

The Audit was acknowledged as the largest and most complex of the projects to implement the Inquiry Recommendations. Accordingly considerable effort was expended during 2001/2002 on the crucial set-up and design phases.

May 2001

A Ministry of Health-wide steering group chaired by the NSU Group Manager is established to monitor the implementation of the Inquiry Recommendations.

June 2001

The three-part evaluation of the NCSP continues. The first part was completed by the Otago University research team.  The second part, which relates to the evaluation of the treatment of women with abnormal smears was also carried out by the Otago team.  Planning for the third part of the evaluation has been concluded.

By July 2001

Community Laboratories are required to meet all of the 22 laboratory standards covering minimum staffing numbers, staff training, minimum volumes and other quality control measures. 

Hospital laboratories have been required to meet these standards since 1 July, within the contracts negotiated with District Health Boards.

 

1 July 2001

Laboratories are required to process an annual minimum of 15,000 cytology smears.

Additional time is being given to the two hospital laboratories providing a cytology service to meet these minimum volumes.

2001/02

The third part of the (three-part) evaluation covering an audit of the screening histories of women who have had cervical cancer is implemented.

 

Of the 13 sub-projects of the 1997 Evaluation Plan for the NCSP, 7 sub-projects are completed or are underway.

November 2001

Expert cytopathologist Dr Euphemia McGoogan visited New Zealand and provided a six month progress report to the Minister. Dr McGoogan made further recommendations to improve the NCSP and the  implementation of the Gisborne Inquiry recommendations, which were incorporated into the NCSP action plan.

December 2001

Considerable work is completed on the development of a Workforce Development Strategy which was published in draft form for consultation.

Early 2002

Project sponsorship for the Audit changed and the project moved out of the NSU to provide independence from the ongoing operational aspects of the NCSP and NSU functions. It remains within the Ministry.

March 2002

The 1996-98 NCSP Statistical Report was published and distributed to stakeholders and work on the 1999-2000 report commenced

April 2002

Expert cytopathologist Dr Euphemia McGoogan visited New Zealand for a  second time to monitor the implementation of the Gisborne Inquiry Recommendations.

May 2002

The NSU played a key role in the development of the new Health (Screening Programmes) Amendment Bill. Introduced to Parliament on 16 May 2002, the Bill will be an important statute for the enhancements it will bring to the safety and effectiveness of the NCSP.

 

June 2002

A significant milestone was achieving ethics committee approval allowing the Audit to fully proceed.

June 2002

A detailed booklet for women regarding the NCSP and the benefits and risks of screening was developed by Women’s Health Action (WHA) and published by the NSU

July 2002

The successful migration of the NCSP-Register on to the Health Intranet has laid the groundwork for the New Zealand Cancer Registry to establish a read-only link to the NCSP-Register. This allows appropriately authorised staff to view the data on the NCSP-Register and improve the existing data quality assurance processes. Enhancements are ongoing to improve accessibility for laboratory staff.

September 2002

Three new clinical leadership positions were created within the NSU – the Public Health Leader Screening and Clinical Leader positions for each of the two screening programmes.

January 2003

Expert cytopathologist Dr Euphemia McGoogan visited New Zealand for a third time to monitor the implementation of the Gisborne Inquiry Recommendations.

Dr McGoogan acknowledged that a colossal amount of work by the NSU has been completed to strengthen the NCSP and its implementation of the Workforce Development Strategy.

March 2003

A updated general pamphlet for women was produced outlining information on the cervical smear test and the NCSP programme. It was titled “Cervical smear tests – what women need to know” 

2002/03

Many of the 2002/03 implementation activities now form part of the NSU’s ongoing core business, including

·        publication of regular quarterly monitoring reports

·        publication of annual reports

·        ongoing development and implementation of policies and quality standards

·        ongoing review and development of health promotion resources

·        liaison with Colleges and other professional organizations

·        sharing of information with Accident Compensation Corporation, the Health and Disability Commissioner and the Medical Council of New Zealand

·        NCSP-Register and the New Zealand Cancer Registry data assurance processes.

·        direct contractual relationships with NCSP Providers

  2003/04

In 2003/04 emphasis will be on the following activities

·        the Audit of Invasive Cancer phases 4 to 6

·        implementation of direct NCSP Laboratory Agreements by the end of November 2003

·        introduction of new legislation

·        improvements to the NCSP-Register

·        laboratory workforce initiatives

·        population register development

·        commencement of NCSP provider audits

 

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