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Essex contributed to the independent evaluation of the UK NHS Bowel Cancer Screening Pilot programme by conducting the psychosocial aspects of this research. The evaluation recommended full roll-out, and was used to inform the programme's subsequent development and implementation. Nationwide screening for 60-69 year olds, using the Faecal Occult Blood test, began in 2006 and in 2010 the programme was extended to include adults up to their 75th birthday. Since July 2006 over 17 million screening episodes have been completed and 15,000 cancers detected. It is estimated that the programme is on track to cut deaths by 16%.
The North Atlantic Treaty Organisation (NATO)/Euro-Atlantic Partnership Council (EAPC) Guidance on "Psychosocial Care for People Affected by Disasters and Major Incidents: a Model for Designing, Delivering and Managing Psychosocial Services for People Involved in Major Incidents, Conflict, Disasters and Terrorism" is a conceptual and practical resource for: developing government policy; planning services, and providing training for health and social care staff. It was informed by underpinning research conducted in Aberdeen following the 1988 Piper Alpha oil platform disaster and evidence briefings generated from a comprehensive review of the world literature. Adopted as best practice guidance by all 28 NATO Members and Partner Nations, it has had regional, national and international impact by: enabling authorities to deliver integrated psychosocial care and mental health services; enhance training; raise awareness, and facilitate the effective utilisation of resources in responding to psychosocial/mental health needs post- incident.
The UK Faecal Occult Blood Test Screening Programme, based on Dundee-led research (Steele), offers bowel cancer screening through mailed test kits followed up with colonoscopy when faecal blood is detected. It is estimated to prevent about 2,000 UK deaths annually. Steele's Screening Research Unit also trialled immunological faecal occult blood testing, which was subsequently incorporated into the Scottish screening algorithm. In addition to demonstrating a 27% reduction in bowel cancer deaths through participation in Faecal Occult Blood screening, the Unit has researched the incidence of interval cancers and the impact of repeated invitations, development of new tests, and strategies for increasing participation. All of these drive the National Screening Programme, and will further reduce mortality.
Antenatal screening aims to identify genetic carriers of sickle cell/thalassaemia in order to provide prospective parents with "informed choice". Throughout the period January 2008-July 2013, the NHS in England has used a Family Origins Questionnaire in connection with sickle cell/thalassaemia screening derived from our research programme. The original policy issue concerned whether or not it is possible/desirable to target antenatal screening for sickle cell/thalassaemia by means of an ethnicity question. The policy problem was that socially constructed "ethnicity" categories correspond imperfectly and to an unknown degree with actual prevalence of genetic carriers. The screening question based on our research now guides the offer of initial screening and/or further laboratory tests for all pregnant mothers in England.
School dental screening was a statutory function of the NHS. University of Manchester (UoM) research demonstrated that the national screening programme was ineffective and likely to increase inequalities in health and service utilisation. As a direct result of UoM research, the National Screening Committee recommended that the national programme should stop. This changed Departments of Health policy resulting in new guidance to the NHS, which stopped the screening programme and redirected resources to treatment services for vulnerable groups and prevention programmes. In 2010 in England the costs of a national screening programme were estimated to be £17m per year; money released for reallocation to other dental services.
IOE researchers have helped the NHS to maximize the number of babies in the UK who are screened for a range of serious but treatable conditions when they are about a week old. This means that more children with one of the screened-for conditions can start a course of treatment quickly. The fruits of the IOE team's work — a suite of training materials for healthcare staff and information leaflets for parents — have had another important consequence. They have enabled parents in the UK and in other countries to make much more informed decisions on screening than they could in the past.
Research undertaken at the University of Sheffield in 2005 to evaluate the cost-effectiveness and resource implications of potential screening programmes for colorectal cancer informed the decision to launch a national colorectal cancer screening programme in England. Upon their 60th/61st birthday, all individuals in England are now invited to participate in biennial bowel cancer screening using faecal occult blood testing (FOBT) until the age of 74. The programme identifies individuals with less advanced colorectal cancer and there is emerging evidence that it has led to an overall improvement in prognosis. Projections suggest that the programme is on course to reduce colorectal cancer deaths by 16%.
Amongst others, follow-on research includes an options appraisal of screening in Ireland that has informed national policy and a re-appraisal of colorectal screening options following publication of a pivotal trial of flexible sigmoidoscopy (FSIG) screening for NHS Cancer Screening Programmes.
Research by Professor Judith Stephenson and colleagues at the UCL Institute of Women's Health into the effectiveness of chlamydia screening has led to guidance to health policy makers in the EU about national strategies for chlamydia control, and has influenced NICE guidelines on the subject. In particular, our work has informed debate on the value for money of the National Chlamydia Screening Programme (NCSP). Stephenson advised the National Audit Office on this topic, and a resulting report led to the NCSP focusing on chlamydia testing in sexual health services and primary care rather than screening in low risk groups. These changes are expected to make considerable cost savings to the NHS.
Dr Lina Gega's research has been instrumental to the development and take-up of computerised Cognitive Behavioural Therapy (cCBT) and other technology-mediated interventions for common mental health problems in the UK and internationally. Gega's adjunct on-line methods form a key foundation for the training of professionals to support cCBT, and the National Institute for Health and Care Excellence (NICE) guidelines now include cCBT for first line intervention for common mental health problems. These developments have resulted in a greater patient reach for cCBT internationally, with resultant decreases in waiting time for patients (with associated economic benefit) and improved outcomes.
Research at Edinburgh Napier University regarding psychosocial interventions for trauma has pioneered management of mental health problems. We have developed and tested a number of individual, group and self-help interventions aimed at promoting recovery following psychological childhood and adulthood trauma. We have trained a large number of healthcare professionals on our interventions in the voluntary and statutory sectors. Our research has also informed policy regarding the management of psychological trauma. Self-help materials developed through our research are currently being used by health and social care workers in Scotland and abroad, making an impact on the wellbeing of survivors of trauma.