This document explains the process for how conditions become part of NHS population screening.
Screening is the process of identifying individuals who may be at higher risk of a disease or condition amongst large populations of healthy people.
Once identified, those individuals can consider further tests, and healthcare providers can offer them interventions of benefit.
A screening programme needs to offer more benefit than harm, at a reasonable cost to the NHS.
Recommendations for screening
Recommendations on whether to screen for a condition are based on internationally recognised criteria and a rigorous evidence review process.
The UK National Screening Committee (UK NSC) makes recommendations on all aspects of population screening. Recommendations could be on the introduction, withdrawal and changes to screening programmes.
The UK NSC’s database of recommendations sets out over 100 conditions, including recommendations to screen for more than 30.
The UK NSC meets 3 times a year to make new recommendations or update existing ones based on reviews of the best quality evidence available at this time.
It is possible to propose a new condition for consideration, to add to the recommendations list.
The process for submitting topic suggestions is under revision. More information will be posted in due course.
Evidence review process
Reviews of recommendations are either cyclical or event driven. They occur at least every 3 years or sooner if new research evidence emerges.
The evidence review process has 4 main steps:
- stakeholder identification
- literature search and scoping
- external review and public consultation
- UK NSC recommendation
An evidence review can take between 6 and 24 months. The time taken varies depending on:
- how much new evidence is identified
- the complexity of the review
Stakeholders are identified based on The National Institute for Health and Care Excellence (NICE) guidance, on how to identify and put together a list of stakeholders.
Each condition has a stakeholder list which includes patient and professional groups, working at a national level, that have expertise in the relevant area.
A stakeholder group can ask to join the stakeholder list at any time.
Literature search and scoping
The literature search will identify relevant new research, based on the key priorities of the evidence review. The key priorities are usually derived from the conclusions of the previous evidence review. In the case of new topics, discussion with stakeholders and review of literature searches help define priorities.
Literature searches are developed for the external review document. Stakeholders can see how the committee identified evidence and whether anything is missing by reviewing the search strategy in the review document or by requesting the results of the search from the UK NSC secretariat.
All conditions on the UK NSC database are regularly reviewed.
A national expert in the field, an approved external with expertise in systematic reviews or an academic institution carries out the review.
The scoping exercise and literature search are usually the basis for any change recommendations.
This process results in a detailed report on which conclusions are made, based on the UK NSC criteria.
Stakeholders have 3 months to comment on the report. The draft review will appear on GOV.UK. Anyone who isn’t listed as a stakeholder can also provide feedback.
The committee receives these comments, alongside the recommendation.
The evidence review may also be updated in line with stakeholder comments; this too will be presented to the UK NSC.
The committee can’t accept further submissions or correspondence once the consultation period is over.
UK NSC recommendation
The UK NSC recommends whether to screen for a condition based on:
- the external review
- any stakeholder submissions
The committee’s recommendations on screening for the proposed condition follows UK NSC criteria.
The UK NSC aims to publish its recommendations 4 weeks after meeting following ministerial approval.
There are currently 6 antenatal and newborn programmes in the England:
- sickle cell and thalassaemia
- fetal anomaly ultrasound scan
- infectious diseases in pregnancy
- newborn and infant physical examination
- newborn blood spot
- newborn hearing screening
The NHS young person and adult programmes screen for:
There are also 3 screening programmes that test for pre cancereous cell changes in the body.
In both men and women:
Screening in the rest of the UK
Each devolved administration is responsible for implementing screening programmes based on local need and the UK NSC’s recommendations. Find out more from each country: