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Publication, Part of

NHS Breast Screening Programme, England 2020-21

National statistics, Official statistics

National Statistics
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COVID-19 impact during 2020-21

The NHS Breast Screening Programme was seriously impacted by disruption from the COVID-19 pandemic during 2020-21

  • In March 2020, all 78 NHS Breast Screening Units (BSUs) made their own decision to pause screening for approximately 3 months (March-June 2020) in order to allow staff to be redeployed to respond to COVID-19, and to protect patients and staff from the virus.
  • In April 2020 NHS England and NHS Improvement (NHSEI) issued a system wide letter which set out that local NHS systems and organisations should fully step up non-COVID key services as soon as possible. Screening and immunisation services were listed as critical services as priority screening services needed to continue to be available for the recognised highest risk groups.
  • Most services continued with, or restarted screening very high-risk women by mid-April 2020 and all BSUs recommenced screening activity between April and September 2020 with the majority restarted by July 2020.
  • Routine screening for the total eligible population commenced across services in June/July 2020, resulting in backlogs of women waiting to be invited for screening and across the pathway​​.
  • COVID-19 restrictions (social distancing & additional infection prevention and control measures) impacted on lengthened appointment times and increased time between screening invitations. Workforce sickness/self-isolation and redeployment was also an issue.​​
  • Fewer women presented for breast screening; contributory factors may have included shielding and self-isolation.
  • Local variations in screening uptake were impacted by the geographical variation in COVID-19 incidence and in local restrictions throughout the year. 


NHSEI, supported by Public Health England, led a comprehensive restoration programme to support BSUs to restore all services

To maximise screening capacity and aid the restoration of screening:

  • Recruitment to the AgeX Trial was ceased in March 2020 enabling resources & capacity allocated to the trial to be utilised for restoration efforts. In May 2020 the AgeX investigators decided that further randomisation into AgeX should cease permanently
  • The screening of self-referrals aged 71 or over, was suspended between April and October 2020 as an interim measure.  Women were advised to contact their GP if they were concerned about any symptoms.
  • Open invitations were recommended rather than timed invitations in September 2020 to maximum utilisation of screening slots. Whilst open invitations may lead to lowered overall uptake in comparison to timed, there is a greater likelihood of attendance where a person has responded to an invitation to make an appointment than when they receive one with a fixed time, so maximising the likelihood of use of the limited capacity.
  • Following an equality impact assessment undertaken by NHSEI, women with learning disabilities continued to be offered timed appointments throughout 2020/21.
  • Regional commissioning teams and providers were asked to consider the needs of specific groups relevant to their locality, and the actions required to support them to engage with the screening programme, building upon existing work by cancer alliances, primary care networks and others.

Data collection and validation processes were completed as normal, therefore, the accuracy and reliability of the statistics published in this report are of a comparable standard to previous years.

Last edited: 24 February 2022 9:27 am