Experiences of Cancer Screening Services in Tower Hamlets

Healthwatch Tower Hamlets wanted to explore why local people were not taking up cervical, breast and bowel screening despite cancer being the main cause of premature deaths in the borough.  They undertook a survey to which 73 people responded.

Cervical screening

Telephone was the most used method of booking a cervical screening appointment. However, some respondents mentioned experiencing long wait times and language barriers over the phone. Introducing an online system that can be translated into multiple languages could help to improve accessibility.

Most people reported being able to book an appointment for a date and time that suited their schedule. However, some residents did mention having to change their work schedule or take time off work to be able to attend their appointments. A few respondents also had their appointment before work which  caused some concern about being late for work adding further anxiety to what can already be a stressful situation.

Respondents reported not always being asked whether there are any specific requirements such as a disability, anxiety, or needing an interpreter that should be considered before and during the appointment. In addition, respondents with pre-existing medical conditions reported finding travelling to their appointments difficult.

Respondents reported being scared of the procedure which was described as uncomfortable and painful. Some respondents suggested being provided relaxation techniques to help alleviate the anxiety around the procedure and to help make it more comfortable.

Patients reported not always being told who would perform the test, or what would happen during the appointment. In addition, the procedure for the cervical test was the main barrier for non-attendance.

Several people mentioned that information about the test should be provided in different languages, such as Bengali, to help people understand why the test is important and who it is relevant to as 4 respondents selected not being sexually active as a reason for not attending their appointment when invited.

Breast screening

The majority of respondents had used public transport to travel to their breast screening appointments and reported travel times of up to an hour. This is costly and time-consuming making it more difficult for people who, for example, work or have caring responsibilities to attend these important appointments. 

Although the majority had found booking their appointment easy, a fifth had found it difficult because they were not able to choose a suitable appointment time. Some respondents mentioned being able to book their appointment for the weekend which had made the appointment time suitable for them. This could also help to reduce travel costs and time if patients are able to travel to their appointment outside peak travel times.

Only a fifth of the respondents had been asked about additional requirements while just a small proportion had been offered an interpreter for their appointment. One respondent told us that they had previously not attended their screening appointment because of their disability which makes it difficult for them to attend appointments.

Less than half of the respondents had been told who would perform the screening, and one person had previously not attended their screening appointment because of feeling embarrassed. Providing more information about what to expect from the appointment can help to reduce negative feelings such as embarrassment.

The majority agreed that staff treated them with respect and dignity, they felt comfortable asking questions and were given a private space to undress. However, fewer people agreed that staff had explained the procedure in a way that was easy to understand and that they felt comfortable to raise concerns or ask to stop the procedure. One respondent also reported having had an experience with a “disgruntled” nurse.

Three respondents who have not attended a breast screening appointment in the last 3 years but have attended one in the past, mentioned that they have not received an invitation. This could indicate a potential issue with the invitation letters

Bowel screening

Although the majority of the respondents found the test kit easy to use and the instructions easy to follow, some people mentioned they had not been given information on when and how they would receive the results and that the information was not provided in a way that was easy to understand. One respondent mentioned struggling to understand the instructions and having to ask someone to explain. Participants also suggested that the instructions should be provided in other languages.