Breast screening modernisation programme: final report

Chair’s closing remarks

This report is the culmination of three years hard work and commitment on the part of the Modernisation Board, SOAS, the Programme Team and the staff of the Scottish Breast Screening Programme (SBSP).

Scottish Government support for a Modernisation Board for the Scottish Breast Screening programme was visionary. Following their acceptance of the recommendations of the 2021 SBSP review, the impact of the pandemic, the shutdown and the recovery, it was clear that the Breast Screening service was genuinely in need of some reform.

I was grateful for their acceptance that this would be a three-year programme of work as a minimum and for the huge support that was provided via NSS in the form of the programme team and the senior screening team at NSS.

Breast Screening in Scotland is at a crucial point in its existence. Diversification of practice at Board level has led to varied and inconsistent delivery for our target population. Waiting times and slippage remain higher than is acceptable. Staffing and recruitment continue to be challenging, with vacancies reducing capacity throughout the country, and equipment and facilities outages having a similar impact. Through all these challenges, the leadership within the programme faces an increasingly difficult task keeping the service running as they and the clients would wish.

Breast Screening also sits in a marginal position within health service provision. It plays strongly to the public health agenda and is enormously popular with the public. However, it is expensive and in straitened national financial circumstances, it needs to be performing to, and above, the QA standards in order to continue to deliver the mortality benefits that justify its costs. This will require investment and support, without which the programme is at risk of further deterioration.

The recommendations made in this report represent an opportunity for us to sustain and rejuvenate what is undoubtedly a cherished and well-respected public health programme.

From the start, there has been a consistent and sustained consensus within the Board and the wider Breast Screening Community about what needs to change and why. Priorities were agreed early on and the Board and members of staff within the Service have given their time unstintingly to complete the workstreams for the Board.

We have done the very hard work to show what we think the service needs. This has delivered realistic and achievable projects for a sustainable, safe, effective and resilient screening programme. It is up to Scottish Government to decide if they happen.

Marzi Davies

Chair, Breast Screening Modernisation Programme

April 2025