Quality Assurance
Quality assurance (QA) is a fundamental part of all screening programmes. The aim of QA is to maintain minimum standards and continuously improve the performance of all aspects of the screening programme in order to ensure that women have access to a high quality service wherever they reside.
Quality assurance is a shared responsibility between:
- The HSC Trusts and breast screening units that provide and support the service
- The Cancer Screening Team in the Public Health Agency.
Quality assurance helps to ensure that the benefits of breast screening outweigh the harms. It is a continuous process that is carried out externally by the Public Health Agency (by the Cancer Screening Team) and internally by the breast screening units and HSC Trusts.
Core QA activities undertaken by the PHA include:
- Monitoring and review of programme management and delivery
- Monitoring performance against agreed standards
- Multidisciplinary QA visits to the breast screening units, including the VHR unit in Antrim
- Incident review and advice
- Review and monitoring of HSC Trust action plans
QA Leads
The QA function is underpinned by an organised structure of public health and professional leads, supported by programme managers, information and administrative staff. Individual QA Professional Leads within the Breast Screening Programme are appointed through an interview process with agreed job descriptions and sessions dedicated to the role, in keeping with the PHA’s Standard Operating Procedure for the recruitment process for QA professional leads. They are responsible to the Public Health Consultant Lead for Breast Screening and accountable to the Assistant Director for Population Screening and Professional Standards, PHA.
The Role of QA Leads
It is the role of the QA leads to assist with the coordination and implementation of quality assurance activities for the Northern Ireland Breast Screening Programme (including the VHR Surveillance Screening Programme) and provide professional advice to the PHA on issues relevant to the commissioning of the screening programme within their area of expertise. QA Leads should work collaboratively with all relevant stakeholders to quality assure the programme. This includes working to ensure relevant national and local standards are met and appropriate continuous quality improvement processes are in place.
List of Professional QA Leads
There are 7 QA Leads in the Breast Screening Programme covering each discipline involved in delivering the service. They are employed by HSC Trusts in their day-to-day role and payed sessionally by PHA for their role as QA Lead.
| QA Lead for Administration | Denise Park, Office Manager, SHSCT |
| QA Lead for Medical Physics | Dr Adam Workman, Medical Physicist, NI Medical Physics Agency |
| QA Lead for Nursing | Vacant (currently covered by Brenda O’Kane Specialist Breast Care Nurse, BHSCT) |
| QA Lead for Pathology | Dr Clinton Boyd, Consultant Pathologist, BHSCT |
| QA Lead for Radiography | Marietta Conor, Superintendent Radiographer, WHSCT |
| QA Lead for Radiology | Dr Elaine Davis, Consultant Radiologist, BHSCT |
| QA Lead for Surgery | Mr Brendan McFall, Consultant General & Breast Surgeon, NHSCT |
QA Visits
The Northern Ireland Breast Screening Programme will normally carry out a QA visit to the NHSCT Breast Screening Unit every 4 years, as part of its Quality Assurance Programme. The VHR Screening Programme is included in the scope of this QA visit. The process for visits is based on national guidance.
For further information on the national guidance click on the link below –
https://www.gov.uk/government/publications/breast-screening-programme-specific-operating-model
Annual Review
A programme of annual reviews, to allow the PHA to assess programme performance on an interim basis in terms of safety and quality is planned. The assessment will facilitate the regular QA meetings that are held with Trust management, provide assurance to senior management and ensure rapid action is taken as appropriate. This process does not replace the process of regular QA visits, but rather supplements them.
Audit
Annual QA audit is undertaken in line with guidance to ensure the service is delivered to the best possible standards. The programme retains MRI and mammograms for at least 8 years. These are saved securely. The programme regularly checks records to make sure the service is as good as possible. The programme reviews previous screening results if a woman is diagnosed with breast cancer between screening appointments here. Women can ask for the results of these reviews.