Screening – potential weak links in the chain

Abstract

Superficially, screening programmes may seem relatively straightforward to organize. However they are much more complicated than appears at first sight. The UK National Screening Committee, set up in 1996, advises all four nations on the introduction of new screening programmes and the improvement or, less commonly, cessation of an established programme. Most of the established programmes have a Programme Centre which advises on the running of the programme and sets standards. Because true outcomes may be some years hence, these standards usually relate to the process, rather than health improvement. There are many different stages in the programmes from ascertaining the target population to timely diagnosis and prompt management. This means there are a number of places where the system might fail. Therefore, part of the advice offered by the Programme Centres relates to failsafe mechanisms. These are backup systems, designed to make sure that no child slips through the net and all are correctly assigned to high or low risk groups. These systems may be expensive, but are necessary and cost effective. A missed diagnosis causes unnecessary disability to the child and distress to the parents, and may be very costly to the health service.