Screening and Recall
Policy
Our practice participates in the Manatū Hauora | Ministry of Health's national screening programmes provided by the National Screening Unit:
Pregnancy and newborn screening is usually organised by the mother's lead maternity carer, and/or carried out in hospital, but may be suggested opportunistically if the mother visits the practice before the baby's 6-week check.
In addition to the National Screening Programme, we offer 
opportunistic screening to help detect diseases early in those who may be at risk, and routine screening for existing conditions.
New clinical staff are trained on the practice's screening and recall processes, including the importance of keeping complete and accurate clinical records, during induction and orientation.
We communicate with patients about screening programmes by text, phone, letter, or another method that best suits the patient.
We aim to reduce inequities and barriers to accessing screening services by regularly reviewing patient data, and offering appropriate screening to all eligible patients.
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The nurse manager is responsible for overseeing screening and recalls. |
See also Notifying Patients of Results
Enrolling patients onto screening programmes
We identify patients who are eligible for national screening programmes by:
- using monthly query builds to identify registered patients as they become eligible
- checking a new patient's eligibility at enrolment
- adding the patient's clinical and family history to Medtech, and updating as appropriate during consultations.
We follow processes appropriate to each screening programme:
We may refer at-risk patients who fall outside of National Screening Programme criteria, for screening. If necessary, we contact patients to obtain their consent to participate in a screening programme.
Information is also available in our waiting room, for patients who wish to self-refer to screening programmes.
Recalling patients
All recalls are managed within Medtech by the nursing team:
- The practice uses query builds, Medtech recall function, Dashboard, Advanced Forms, and PHO reports to identify patients who need to be followed up.
- Every month the recall list is reviewed, and a recall is sent to each patient.
- Overdue recalls will be followed up the appropriate number of times (usually once per month) and each attempt will be documented in the patient record.
- Team members should check the recall status of a patient at each appointment, and should encourage patients to book an appointment for any screening due.
- Screening declines are documented in the patient record.
Patients who don't respond
If follow up is not carried out by the relevant screening programme, and our attempts to contact a patient have failed, we manage the process accordingly:
- Check that patient's details are correct in Medtech.
- Ensure the non-responder code is allocated, or leave overdue recall and enter a notation in the recall note area.
- Ensure an alert is on the patient record.
- Update the recall as appropriate.
Audits
We regularly audit our screening and recall procedures to ensure screening is effective, and to identify inequities and under-screened groups within our patient population. Screening rates by ethnicity are identified, and Māori data is included in our Māori Health Plan.
Clinical governance
Audit outcomes are reviewed by our clinical governance group and may become the subject of a quality improvement (CQI) or equity initiative.
Equity
Some patients opt out of screening, and we understand that for some patients or patient groups, there may be barriers to accessing screening services.
To better enable equitable access to screening, we provide information and support by:
- collaborating with outreach programmes
- offering free clinics
- organising or delivering workshops that are appropriate to the population.
Patients who experience barriers to accessing breast or cervical screening services may be directed to Screening Support Services, to help them find an outreach service, or other alternative provider.
Disruptions
If the practice's screening recall programme is disrupted e.g. during a pandemic, we prioritise patients as follows:
- High priority: Patients with symptoms should be seen as soon as possible.
- Priority: Annual surveillance re-screens, overdue screens, and priority populations.
- Where capacity allows: Newly eligible patients and those due for a regular scheduled screen.