iPLATO, Working to Save Lives

India Maycock

iPLATO, Working to Save Lives
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Background and Challenge

If all eligible women participated in screening regularly, 83% of all cervical cancer deaths could be avoided.  In the UK, currently over 870[1] women die from cervical cancer a year which means 722 lives could be saved per year with optimal screening uptake.

Cervical screening is largely delivered in GP practices, with five million women invited to attend screening appointments every year in the UK. Worryingly, attendance has fallen over the last 10 years and is now at a 20-year low. London has the lowest screening uptake in the UK at just 65%.[2]

To save lives, an initiative across London was implemented. This was overseen by a steering group comprising NHS England (NHSE)/NHS Improvement (NHSI), Public Health England (PHE), Cancer Alliances, Jo’s Cervical Cancer Trust, Cancer Research UK, Primary Care Support England, The Healthy London Partnership, Academic Institutions, Clinical Commissioning Groups and Local Authorities. The group introduced GP endorsed text reminders across the region to complement the traditional letter inviting individuals for cervical screening.

Response

The commissioning parties were attracted to involving iPLATO because of the organisation’s proven ability to manage large scale multi-channel messages to a targeted audience. Rather than only sending individuals a letter, which as people move frequently and don’t always update their GP practice, an iPLATO text reminder would aim to address the issue of falling attendance for screening.

Between September 2018 and March 2019, 97% of London practices signed up to the project with a total of 384,112 women invited for screening. Messages were successfully delivered to 75% of the group reminding and prompting individuals to book an appointment.

Outcomes

The commissioning parties requested Primary Care Support England quantify the effectiveness of the approach and outcomes from the programme. Specific outcomes included:

  • Savings in Time, increasing the speed in which patients are booking an appointment:
    • When only communicating by letter to the audience, the time between invitation and screening was 71 days
    • This fell by 24%, to 54 days, when the women received an invitation letter and an iPLATO generated text reminder
  • Participation:
    • The programme evidenced a significant uptake of appointments across all groups. The original project goal was to achieve an uplift of 4% in attendance rates
    • 4.8% uplift in women aged 25 – 49 has been achieved
    • 5.9% uplift in women aged 50 – 64 has been achieved

All stakeholders are delighted with the results of the programme. The average cost to the NHS of an individual diagnosed with stage 2 or later cervical cancer amounts to £19,261, whilst for those at stage 1a, the cost is around £1,379 per person.[3] Greater participation and take-up of cervical screening tests clearly leads to significant cost savings.

[1] CRUK. Cervical Cancer Statistics. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer. Accessed: September 2019

[2] NHS Digital (2018). Cervical Screening Programme. https://files.digital.nhs.uk/B1/66FF72/nhs-cerv-scre-prog-eng-2017-18-report.pdf. Accessed: September 2019

[3] Jo’s Cervical Cancer Trust. Behind the Screen Report. https://www.jostrust.org.uk/get-involved/behind-the-screen. Accessed September 2019

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