1. people lives communities Access to bowel screening services

2. people lives communities What the Confidential Inquiry said Many people did not respond to the invitation to participate in bowel screening Little support was provided to enable people to participate No evidence that people had received accessible information No evidence of reasonable adjustments to support participation Carers confused about what their role should be

3. people lives communities Case study Following a positive result, a man with mild learning disabilities was invited for a colonoscopy. Three months later the GP was told the man had not turned up despite two appointments being arranged with hospital transport. On investigation, it was found that the man had sent the hospital transport away each time as he was unwell. He had not understood that the medication he had to take before the colonoscopy resulted in diarrhoea

4. people lives communities Joint Health and Social Care SAF data – bowel screening The median of the reported proportions of people with learning disabilities being screened for colorectal cancer was 25.8% The highest reported median proportion, in the East of England (48.8%) represented only one partnership board; the highest from a region with a more substantial proportion reporting was in the East Midlands: 43.1% The lowest reported median proportion was in the West Midlands: 23.4% For comparison, colorectal cancer screening in eligible people in the total population had reported median coverage of 39.4%

5. people lives communities Joint SAF

6. people lives communities The bowel screening pathway Information in accessible formats is available No way to identify people with learning disabilities on the national registers A standard letter is sent to all Failure to respond triggers a letter to the GP 13 weeks after initial invite If services are well co-ordinated, support can be given now

7. people lives communities Consent / Best Interests and bowel screening The initial bowel cancer screen in non-invasive If the result is positive, a colonoscopy is required This is invasive – and potentially life threatening What has been happening / should be happening?

8. people lives communities Screening strategy and toolkit Work with the SW peninsular Suggests access to screening nurses employed by screening services www.ndti.org.uk/publicatio ns/ndti- publications/screening- services-strategy-and- toolkit

9. people lives communities Supporting better access to screening Worked with social care providers Charter includes support to access health appointments Social care providers can sign up on VODG website: http://www.vodg.org.uk/ http://www.vodg.org.uk/

10. people lives communities IHaL Wrote a Reasonable Adjustments digest regarding access to cancer screening Now updating this Examples welcome! Also working with PHE

11. people lives communities National bowel screening hubs Developing guidance Wrote an article for their digest

12. people lives communities Thank you! www.ndti.org.uk @Ndtisue ndti.org.uk