The recommendations in the consultation paper are the result of several years’ work by the Breast Assessment Project Board.
The Project Board included a total of 16 healthcare professionals who represent the various disciplines involved in providing breast assessment services: radiography, radiology, pathology, nursing, screening services, breast surgery and public health.
Oncologists are not involved in the provision of breast assessment services and were therefore not represented on the Project Board.
As part of its work, the Project Board engaged with staff from across the range of professional disciplines to discuss whether the current model was sustainable and also to consider the potential implications of consolidating the service on fewer locations.
There was broad agreement that one, two or three breast assessment service locations would meet the needs of the population, and would provide greater service sustainability.
There was general consensus that services provided at fewer sites would enhance sustainability.
The Project Board considered that there was relatively little difference in scoring between four services and a three services model, but that all other options scored significantly less.
The decision on the number of sites to be recommended was subject to further discussion at the Project Board and took account, in particular, of the population needs and likely longer term sustainability associated with four or a three services model.
Given the vulnerabilities in the current model particularly in relation to staffing, the Project Board considered that a move from five services to four would not secure sustainable services in the medium to long term.
Demand for breast assessment is increasing and is predicted to continue to do so. Given the pressures on the Belfast City Hospital site currently, it was considered that the Ulster Hospital would have greater capacity to take on the additional activity which would be associated with consolidation of assessment services on fewer sites.
The Department recognises that the successful implementation of the proposed service change would require a carefully managed, phased process. It is proposed that the new Breast Assessment Network would have responsibility for overseeing the phased implementation of the final recommendations, taking into account any impact on wider breast services.
At this stage the proposals relate purely to the provision of breast assessment. The Department will shortly commence a further review, to be clinically led, that will consider wider breast services.
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