Health New Zealand | Te Whatu Ora (Health New Zealand) has today released the BreastScreen Aotearoa (BSA) Quality Improvement Action Plan (the Plan), a year after the release of the Quality Improvement Review of Clinical Quality and Safety for BreastScreen Aotearoa (the Review).

The Plan responds to the implementation of the 26 recommendations from the Review and how those recommendations are being achieved by outlining local, regional, and national actions for the first year of implementation to 31 December 2024.

The Action Plan outlines a focus on:

  • a dedicated workforce recruitment and retention strategy for Māori, Pacific peoples and people with lived experience of disability
  • co-designing bespoke services for Māori and Pacific women, including targeted programmes and a new whānau and consumer panel
  • broadening the focus of the screening programmes to include wellbeing and hauora health gain for individuals, whānau and the community
  • better integrating all cancer screening services, so that cancer screening is a better experience and women can access all cancer screening programmes
  • co-design of a kaupapa Māori accreditation programme for breast screening providers
  • new research to improve access to screening for wāhine Māori, Pacific women, tangata whaikaha and consumers with lived experience of disability, and other groups at increased risk of breast cancer death who are underserved by the screening programme including rural and lower socio-economic communities.

Some of the initiatives from the Plan currently underway include:

  • the delivery of a new national ICT breast screening system which will help to support more women to access breast screening by making it easier for women to enrol and book an appointment online where they can self-enrol their details and choose a booking time that suits them. The new system is set to roll-out across the motu before the end of 2024.
  • co-design breast screening pilots in Kirikiriroa (Hamilton) with wāhine Māori and in the Counties Manukau area with Pacific women to inform the BSA screening pathway
  • the roll-out of a series of co-design workshops/wānanga/fono to develop and pilot new solutions that better serve wāhine Māori and Pacific women. The first wānanga/fono was held in Kirikiriroa in May 2024, with more workshops set to follow across the motu
  • a specific focus on recruitment and retention of Māori and Pacific kaimahi by working with hauora Māori providers and Pacific providers
  • trialling a breast screening initiative (the Touchpoint Project) in large organisations with significant numbers of wāhine Māori and Pacific women to increase access to breast screening.
  • reviewing the National Policy and Quality Standards for breast screening and ensuring consumer and whānau consultation in the development of revised standards.

Pae Whakatere, the governance group established in June 2023 as part of the Review’s recommendations, are overseeing the implementation of the Plan.

Pae Whakatere Chair Dr Nina Scott (Waikato, Ngāti Whātua and Ngāpuhi) says that the national breast screening team has been working incredibly hard in the year since the release of the Review. In this time, she says, the team have laid the groundwork needed for improving services and creating new services so that many more wāhine Māori and Pacific women can access breast screening.

“This is important because breast screening saves lives and improving access to screening will make big hauora gains for wāhine Māori and Pacific women and their families. Our Action Plan includes co-designing services with wāhine Māori, Pacific and other priority women who currently have low access to cancer screening. In this way we know that the services will work for these women.” Dr Scott says.

“We’ve been putting into place the resources and structure needed to accelerate the mahi that needs to be done. Now we’re moving into our next phase of seeing some of the initiatives in the Plan coming into fruition.”

The Plan will continue to be updated each year to track progress until the Review’s recommendations are achieved.

Background on the Quality Improvement Review of Clinical Quality and Safety for BreastScreen Aotearoa

The Review, conducted by a panel led by Dr Dale Bramley that was independent of the National Screening Unit, included 26 recommendations to help improve access to screening along with experiences and outcomes for women. The recommendations relate to governance; monitoring, research and evaluation; workforce; consumer involvement, clinical and quality safety; and identification and reporting.

The Review found that breast screening services continue to play a critically important role in helping to improve outcomes, reduce recovery times, and prevent women from dying from breast cancer. Women who access the national breast cancer screening programme have a 34% reduction in their risk of breast cancer death.

The Review was commissioned in May 2022 by Health New Zealand CE, Margie Apa, to help ensure that the BSA programme was equitable and effective. This followed the discovery that a number of women in the Wellington region had been waiting longer than the 60 working day target from enrolment to offer of an appointment for their first screening mammogram. This incident was subject to a separate review by Capital, Coast and Hutt Valley.