Cheshire & Merseyside
Working Arrangements for
Lead and Screening Colonoscopist, Pathologist & Radiologist
Introduction
Bowel cancer is the second largest cause of cancer deaths in the UK with around 30,000 new
cases each year. In 2003 over 16,000 people died from this disease. Bowel cancer can occur in
younger people but 8 out of 10 people who get cancer of the bowel are over the age of 60. Early
detection of cancer can have a significant impact upon overall survival rate. The Department of
Health has been striving for earlier detection of cancers by improving screening techniques and
diagnostic investigations and by ensuring that patients receive prompt treatment.
The disease progresses slowly. However, currently 20% of patients first present at A&E
departments after experiencing mild symptoms for weeks or months. About 55% of patients are
not diagnosed until the disease has spread to lymph nodes or elsewhere.
Research undertaken in Nottingham and Funen in the 1980s showed that screening men and
women aged 45-74 for bowel cancer using the faecal occult blood test (FOBt) could reduce the
mortality rate from bowel cancer among the screened population by 15%. An independently
evaluated pilot in Coventry, Warwickshire, and in Scotland, showed that this research can be
replicated in an NHS setting.
The bowel cancer screening programme (BCSP) is being phased in over a three-year period. The
plan is to achieve full coverage across England by the end of 2009. Delivery of the BCSP will cost
£37.5 million in its first two years of roll out. Both men and women aged 60-69 will be invited to
take part in screening every two years. A further announcement in recent weeks has confirmed
that the screening age will broaden from 60 up to 75, commencing in 2010.
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Local Overarching Structure
National Office
North West SHA
Cheshire & Merseyside Screening
Centre
Collective
Commissioning
Cancer Network
Managers Forum
Primary
Care
CNG
Public
Health
Network
PCTs
Cheshire &
Merseyside
Colorectal
CNG
Colorectal
MDTs
Operational and Primary Care & Public Health Groups
Primary Care
Public Health/Health
Promotion
Health
Inequalities
Patient Public
Involvement
Cheshire & Merseyside BCSP
The Cheshire and Merseyside BCSP covers 1,150 square miles and a population of 2.38 million
people in the North West, working across eight primary care trusts (PCTs). It is the largest BCSP
in England. A central management and administrative centre oversee the programme delivery.
Specialist Screening Practitioner (SSP) clinics are held in up to 15 community-based settings with
screening colonoscopy being carried out at Aintree Hospital, Royal Liverpool Hospital and Leighton
Hospital. Aintree is the host organisation for the programme. Team members are:
Programme Director – Richard.sturgess@aintree.nhs.uk
Programme Manager – marie.coughlin@aintree.nhs.uk
Lead Nurse – lynn.tobin@aintree.nhs.uk
SSP – Brenda.morton@aintree.nhs.uk
SSP – Christine.rhall@aintree.nhs.uk
SSP – Sharon.mcgowan@aintree.nhs.uk
SSP – Julie.pieczarka@mcht.nhs.uk
SSP – joanne.everall@mcht.nhs.uk
Administrator – sue.gilhooley@aintree.nhs.uk
Administrator – Deborah.parr@aintree.nhs.uk
Administrator – Shirley.styers@aintree.nhs.uk
Health Improvement Practitioner – Maureen.sayer@aintree.nhs.uk
Lead & Screening Colonoscopist – paul.otoole@aintree.nhs.uk
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Screening Colonoscopist – tony.morris@rlbuht.nhs.uk
Screening Colonoscopist – sanchoy.sarkar@aintree.nhs.uk
Screening Colonoscopist – simon.lal@aintree.nhs.uk
Screening Colonoscopist – ian.london@mcht.nhs.uk
Screening Colonoscopist – drcarol.francis@coch.nhs.uk
Screening Colonoscopist – Philip.bliss@wwl.nhs.uk
Lead Pathologist – fiona.campbell@rlbuht.nhs.uk
Screening Pathologist – veena.tagore@aintree.nhs.uk
Screening Pathologist – paul.simcock@mcht.nhs.uk
Lead Radiologist – Andrew.smethurst@aintree.nhs.uk
Screening Radiologist – conall.garvey@rlbuht.nhs.uk
Screening Radiologist – ming.tee@mcht.nhs.uk
Job requirements for Lead and Screening Clinicians.
Lead Colonoscopist



Take responsibility for the quality of colonoscopy for all screening patients in the screening
centre and ensure that NHS BCSP standards are met.
Ensure that advice is available to SSP clinics on patients who are of uncertain fitness for
colonoscopy.
Meet regularly with other screening colonoscopists in the screening centre to ensure that
screening is delivered in accordance with common protocols and to monitor screening
outcomes.
Screening Colonoscopist





Ensure an undertaking of 150 or more screening colonoscopy to maintain accreditation
status.
Collate quality monitoring data on at least an annual basis.
Maintain acceptable levels of complication over a prolonged period, below national average
as defined in recent published series (Bowles et al 2004).
Ensure timely sign-off of histology reports.
Participate in cross-cover of lists.
Lead Pathologist



Take responsibility for the quality of pathology support for the programme and ensure that
NHS BCSP standards are met.
Meet regularly with other screening pathologists in the screening centre to discuss
screening outcomes.
Develop a special interest in bowel cancer pathology.
Screening Pathologist

Ensure that pathology results are available within 7 days for patients who have had a tissue
sample taken at colonoscopy.
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Lead Radiologist


Ensure that radiology support for the programme meets NHS BCSP standards (these are
currently being developed).
Meet regularly with other screening radiologists in the screening centre to discuss
outcomes.
Screening Radiologist

Ensure that appropriate arrangements are in place to offer alternative investigations in a
timely manner to patients in whom colonoscopy has failed or who are not suitable for
colonoscopy. This includes double contrast barium enema (DCBE) or CT colonography
(where available).
Quality Assurance
Initial process quality standards have been developed based on the process measures in the
screening trials and elsewhere in the literature. Regular review of performance against these
standards will begin to take place once the NWSHA QA group has been formed. This group
should be in place by May 2008.
Terms and Conditions
Pay remuneration for BCSP sessions are further to discussions with the primary employer.
Honorary contracts will be implemented where necessary.
Additional Information
www.bcsp.nhs.uk
www.screenersupport.nhs.uk
www.mccn.nhs.uk
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