Service Specification for breast symptomatic clinics

Mrs D Havercroft made this Freedom of Information request to Bristol Primary Care Trust (PCT)

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

The request was partially successful.

Mrs D Havercroft

Dear Bristol Primary Care Trust (PCT),

As host organisation for ASWCS (the Avon, Somerset and Wiltshire
Cancer Services Network) and Commissioner for some ASWCS Breast Symptomatic Services, please provide the following information for Specialist Breast Clinics in the ASWCS region:

1. Names and locations of all Specialist Breast Clinics.

2. Identify the Clinics listed in response to 1. that offer a one stop clinic.

3. For the clinics offering a one stop service, each clinics' definition and service specification for their one stop clinic.

3. The ASCWS breast Network Site Specific Group (NSSG) definition and service specification for a breast one stop clinic.

4. Identify the clinics listed in 1. that provide a diagnostic triple assessment for all new symptomatic referrals (physical examination, imaging - mammography and/or ultrasound, tissue biopsy).

5. For each of the clinics listed in 1. please indicate the percentage of symptomatic referrals that typically do not require a tissue biopsy as part of their diagnostic assessment (ie. do not have the full triple assessment).

6. The ASWCS Breast NSSG protocol for determining whether or not a tissue biopsy is required as part of symptomatic diagnostic assessment.

7. The documented ASWCS Breast NSSG histopathology reporting standards for all breast tissue biopsies.

Yours faithfully,

Mrs D Havercroft

Tucker Kathryn,

Dear Ms Havercroft

Please accept this as acknowledgment of your Freedom of Information
request. This has been given reference number FOI 1112 119 please use
this in all future correspondence.

We will respond to your request by 5th August 2011.

If following review of your request we require any further clarification
we will contact you as soon as possible.

Yours sincerely

Kat Tucker
Complaints & FOI Manager
NHS Bristol
0117 900 2494
From 1 June 2011, NHS Bristol, NHS North Somerset and NHS South
Gloucestershire have formed a primary care trust cluster. Each
organisation continues to be a legal body.

If you are providing any personal and/or confidential information to NHS
Bristol via email, please note that we are only responsible for the
information held within our network and cannot guarantee its security
until it reaches us. If you wish to provide this information in another
form please contact me to arrange.

Recipients should be aware that all e-mails received and sent by this
organisation are subject to the Freedom of Information Act (2000) and
therefore may be disclosed to a third party. You should also be aware
that the information contained in this message, or any of its
attachments, may be privileged and confidential and intended for the
exclusive use of the addressee. The views expressed in this e-mail may
not be the official policy of this organisation but the personal view of
the originator. If you are not the addressee, you must not read, copy,
disclose, forward or otherwise use the information contained within this
e-mail. If you receive this e-mail in error, please notify the sender
(whose contact details are above) immediately by reply e-mail and delete
the message and any attachments without retaining any copies. All
messages sent by this organisation are checked for viruses but this does
not, and cannot, guarantee that a virus has not been transmitted. Please
ensure that you take your own precautions for the detection and
eradication of viruses.

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Mrs D Havercroft

Dear Kathryn Tucker

to clarify, by "tissue biopsy", I mean Fine Needle Aspiration (sometimes called "needle biopsy") and Core Biopsy

Yours sincerely,

Mrs D Havercroft

Tucker Kathryn,

I will be out of the office until Monday 25th July 2011 - No emails sent to this account will be responded to until my return.

If your email is regarding a complaint or concern which you need to discuss urgently please contact [email address] or call 0117 9003433.

If your query is regarding Freedom of Information or Records Management please contact Tanzy Brown at [email address]

Messages left will not be responded to until my return on 25th July 2011.

Tucker Kathryn,

2 Attachments

Dear Mrs Havercroft

Please find our response to your freedom of information request attached
to this email. I trust this is satisfactory, but if you feel that it is
not then please do not hesitate to contact us again and we will
endeavour to assist you further.

Please note that if you are unhappy with the way in which your request
has been administered, you have the right to request a review.

You also have the right to appeal any response with the Information
Commissioner for Freedom of Information, as stated under the Freedom of
Information Act. Information regarding this is available on their
website www.ico.gov.uk .

'If you wish to re-use the information you have requested, in whole or
in part, please write to me stating the purpose(s) you wish to re-use
the information for. We will respond within 20 working days of
receiving your request with any conditions or charges that relate to the
re-use of the information. These will be determined in line with the
'Re-use of Public Sector Information Regulations 2005 (SI 2005 No.
1515).'

Yours sincerely

Kat Tucker
Complaints & FOI Manager
NHS Bristol
0117 900 2494
From 1 June 2011, NHS Bristol, NHS North Somerset and NHS South
Gloucestershire have formed a primary care trust cluster. Each
organisation continues to be a legal body.

If you are providing any personal and/or confidential information to NHS
Bristol via email, please note that we are only responsible for the
information held within our network and cannot guarantee its security
until it reaches us. If you wish to provide this information in another
form please contact me to arrange.

Recipients should be aware that all e-mails received and sent by this
organisation are subject to the Freedom of Information Act (2000) and
therefore may be disclosed to a third party. You should also be aware
that the information contained in this message, or any of its
attachments, may be privileged and confidential and intended for the
exclusive use of the addressee. The views expressed in this e-mail may
not be the official policy of this organisation but the personal view of
the originator. If you are not the addressee, you must not read, copy,
disclose, forward or otherwise use the information contained within this
e-mail. If you receive this e-mail in error, please notify the sender
(whose contact details are above) immediately by reply e-mail and delete
the message and any attachments without retaining any copies. All
messages sent by this organisation are checked for viruses but this does
not, and cannot, guarantee that a virus has not been transmitted. Please
ensure that you take your own precautions for the detection and
eradication of viruses.

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Mrs D Havercroft

Dear Bristol Primary Care Trust (PCT),

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Bristol Primary Care Trust (PCT)'s handling of my FOI request 'Service Specification for breast symptomatic clinics'.

I am content with the responses to questions 1 & 8, but not the responses to questions 2, 3, 4, 5, 6 and 7.

The NHS Constitution, states that "the NHS commits to inform you about the healthcare services available to you, locally and nationally.”

“the NHS commits to offer you easily accessible, reliable and relevant information to enable you to participate fully in your own healthcare decisions and to support you in making choices".

The information I have requested in questions 2, 3, 4, 5, 6 and 7 is about breast care services available to local people and is required to enable them to participate fully in decisions about their healthcare and making choices.

In relation to questions 5, 6 and 7, the ASWCS Guidelines for Assessment of Screen Detected Abnormalities or Symptomatic Problems and Clinical Management says "Assessment should occur in a multidisciplinary setting using the principles of triple assessment (clinical assessment, imaging and core biopsy or fine needle aspiration
cytology)."

It appears that despite NBT's Breast Service and the RUH's breast service being part of the ASWCS network, their application of diagnostic triple assessment is different.

NBT has publicly said that, of symptomatic referrals, “85 to 90 per cent of patients would not need tissue samples taken". However, the RUH's website says "It is standard practice that any woman with a breast lump is offered a 'triple assessment'. Using several tests increases the thoroughness of the examination, in case any of the individual tests fails to detect an abnormality.”

NICE Breast IOG says “The accuracy of triple assessment depends on the quality of each constituent test.”

Therefore one of the reasons for my questions is to find out what NBT's and the RUH's diagnostic protocols seem so different despite them being members of the ASWCS NSSG - and what that means for patient choice.

If ASWCS does not know the answers to my questions, it is a very simple matter to find out - it must ask its own Breast NSSG.

"Don't know" answers are not acceptable and breach my rights under the NHS Constitution, which says “the NHS commits to continuous improvement in the quality of services you receive, identifying and sharing best practice in quality of care and treatments.”

Please provide the missing answers to my questions.

A full history of my FOI request and all correspondence is available on the Internet at this address:
http://www.whatdotheyknow.com/request/se...

Yours faithfully,

Mrs D Havercroft

Tucker Kathryn,

Dear Mrs Havercroft

Thank you for your further email, I am sorry to hear that you are not
satisfied with NHS Bristol's response to your Freedom of Information
request. I have accepted your email as a request for an internal review
of our initial response.

I will ensure that a full review is carried out, and will ensure that a
further response is provided to you by 5th September 2011.

Yours sincerely

Kat Tucker
Complaints & FOI Manager
NHS Bristol
0117 900 2494
From 1 June 2011, NHS Bristol, NHS North Somerset and NHS South
Gloucestershire have formed a primary care trust cluster. Each
organisation continues to be a legal body.

If you are providing any personal and/or confidential information to NHS
Bristol via email, please note that we are only responsible for the
information held within our network and cannot guarantee its security
until it reaches us. If you wish to provide this information in another
form please contact me to arrange.

Recipients should be aware that all e-mails received and sent by this
organisation are subject to the Freedom of Information Act (2000) and
therefore may be disclosed to a third party. You should also be aware
that the information contained in this message, or any of its
attachments, may be privileged and confidential and intended for the
exclusive use of the addressee. The views expressed in this e-mail may
not be the official policy of this organisation but the personal view of
the originator. If you are not the addressee, you must not read, copy,
disclose, forward or otherwise use the information contained within this
e-mail. If you receive this e-mail in error, please notify the sender
(whose contact details are above) immediately by reply e-mail and delete
the message and any attachments without retaining any copies. All
messages sent by this organisation are checked for viruses but this does
not, and cannot, guarantee that a virus has not been transmitted. Please
ensure that you take your own precautions for the detection and
eradication of viruses.

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Tucker Kathryn,

1 Attachment

Dear Mrs Havercroft

Please find attached to this email NHS Bristol's response to your
request for an internal review.

Kat Tucker
Complaints & FOI Manager
NHS Bristol
0117 900 2494
From 1 June 2011, NHS Bristol, NHS North Somerset and NHS South
Gloucestershire have formed a primary care trust cluster. Each
organisation continues to be a legal body.

If you are providing any personal and/or confidential information to NHS
Bristol via email, please note that we are only responsible for the
information held within our network and cannot guarantee its security
until it reaches us. If you wish to provide this information in another
form please contact me to arrange.

Recipients should be aware that all e-mails received and sent by this
organisation are subject to the Freedom of Information Act (2000) and
therefore may be disclosed to a third party. You should also be aware
that the information contained in this message, or any of its
attachments, may be privileged and confidential and intended for the
exclusive use of the addressee. The views expressed in this e-mail may
not be the official policy of this organisation but the personal view of
the originator. If you are not the addressee, you must not read, copy,
disclose, forward or otherwise use the information contained within this
e-mail. If you receive this e-mail in error, please notify the sender
(whose contact details are above) immediately by reply e-mail and delete
the message and any attachments without retaining any copies. All
messages sent by this organisation are checked for viruses but this does
not, and cannot, guarantee that a virus has not been transmitted. Please
ensure that you take your own precautions for the detection and
eradication of viruses.

show quoted sections