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| 1 | +--- |
| 2 | +title: Breast screening invitations pilot overview |
| 3 | +description: An overview of Team Invite’s invitations to breast screening pilot December 2024 – February 2025 |
| 4 | +date: 2025-06-27 |
| 5 | +--- |
| 6 | +Team Invite is working on inviting people to breast screening appointments using a digital-first communication strategy. This approach aims to reduce the number of letters sent and save the NHS significant cost, while providing breast screening participants with modern, reliable and safe ways of being invited to their mammography appointment. Also, we hope that introducing NHS Notify will help breast screening offices manage invitations more effectively, achieve productivity gains, and shorten book to invite time. |
| 7 | + |
| 8 | + |
| 9 | +## Current invitation process |
| 10 | + |
| 11 | +Anyone who is eligible for breast screening is invited to a timed appointment by paper letter. It’s usually sent 4-6 weeks before the scheduled date. Breast screening offices (BSOs) send text reminders closer to the visit (exact timings vary). |
| 12 | + |
| 13 | +The letter includes the appointment time, date, location, and how to prepare. It also includes information on when someone should get in touch with their BSO before the appointment and how to reschedule or cancel. |
| 14 | + |
| 15 | +Currently, there are no tools allowing people to access the details of their appointment online – in the NHS App or other patient portal. |
| 16 | + |
| 17 | + |
| 18 | +## Proposed changes to how people are invited to screening |
| 19 | + |
| 20 | +Introducing digital-first communication means inviting people to breast screening appointments through the NHS App first and enabling other channels when the NHS App message can’t be delivered or is not read quickly enough. |
| 21 | + |
| 22 | +This will enable people to access their appointment details online and on their phone. Sending digital messages also means people can use accessibility tools on their computer or phone. |
| 23 | + |
| 24 | +We’re using NHS Notify to send these messages through the NHS App, text messages and letters. |
| 25 | + |
| 26 | + |
| 27 | + |
| 28 | +1. NHS App message invitation is sent. |
| 29 | +2. If an NHS App message is not opened within 24 hours, an SMS is sent. |
| 30 | +3. If an SMS is not delivered within 72 hours, a letter is sent. |
| 31 | + |
| 32 | +We designed the app message and SMS to maximise readability and usability in each format. |
| 33 | +Visit https://www.notifications.service.gov.uk/using-notify/message-status/sms for details on the statuses of messages sent by notify and to understand why messages may not be delivered. |
| 34 | + |
| 35 | +## Pilot overview |
| 36 | + |
| 37 | +The main goals of the pilot were to: |
| 38 | + |
| 39 | +* test the digital-first messages |
| 40 | +* make sure the technology we used worked well in breast screening settings |
| 41 | +* gather insights from the participants on their experience of receiving invitations through digital channels |
| 42 | +* Investigate the impact of new processes on BSOs. |
| 43 | + |
| 44 | + |
| 45 | +We worked with 3 BSOs: |
| 46 | + |
| 47 | +* Dorset Breast Screening Service |
| 48 | +* South West London Breast Screening Service |
| 49 | +* Milton Keynes Breast Screening Service. |
| 50 | + |
| 51 | + |
| 52 | +We sent digital-first invitations to 50 people in each, 150 in total. The participants invited in the pilot were people who: |
| 53 | +* were already engaged with the service and returning clients |
| 54 | +* had no known access needs |
| 55 | +* were screened in a routine recall pathway (meaning they weren’t at an increased risk of getting cancer due to family history or their background). |
| 56 | + |
| 57 | +The SMS reminders sent by individual breast screening services continued as usual. As part of our research, we asked service providers to follow up with the pilot participants who did not attend (DNAs), so that we could understand the reasons better. We also provided them with some guidance for how to navigate the NHS App if people called asking for support. |
| 58 | + |
| 59 | +As the pilot clinics were scheduled on certain dates, we could travel to BSOs to do in-person interviews with some of the participants. It helped us understand the benefits of the new channels (including accessibility), some disadvantages of the digital-first approach for certain groups (especially those who needed paper letter communication) and hear feedback. |
| 60 | + |
| 61 | + |
| 62 | +## The outcome of the pilot: |
| 63 | + |
| 64 | +When assessing the impact of the pilot, we used data from NHS Notify and feedback from the live services and participants. We’ve learned the following things. |
| 65 | + |
| 66 | +* The digital-first cascade worked well from a technical perspective. |
| 67 | +* Although pilot processes, such as receiving and sending relevant clinic data, and reporting, were suitable for a small-scale release, they wouldn’t allow us to efficiently scale. We’d need to replace them with an automated solution. |
| 68 | +* BSOs’ experiences of taking part in the pilot were positive, they’d be keen to implement an automated solution in the future. |
| 69 | +* Participants' experiences of receiving NHS App or text message invitations were mostly positive. They saw huge benefits of the channel shift, such as convenience and easier findability of information when needed. However, as this was an unexpected change, people were sometimes worried that a text message could be a scam. |
| 70 | +* We confirmed that digital channels enhanced accessibility of communication. |
| 71 | +* We learned that for a small number of participants the physical letter was the only way they wanted to be contacted. |
| 72 | +* We confirmed a gap in knowledge of how we can successfully reach: |
| 73 | + * first time attendees |
| 74 | + * those who haven’t engaged with the service in the past |
| 75 | + * underserved communities |
| 76 | + * people with access needs. |
| 77 | +This will be prioritised in further research. |
| 78 | + |
| 79 | +Overall, the outcomes were promising and – even more importantly – helped us see opportunities for further improvement. We’re now taking feedback on board and preparing for the next phase of the project, an early adopter roll-out. |
| 80 | + |
| 81 | + |
| 82 | +If you have any feedback to share, please contact us by email at [email protected]. |
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