Contracts for Innovation Cymru - Modernising the Bowel Screening Pathway in Wales

Innovative solutions to improve participant assessment, triage support and progression following a positive FIT result
Introduction
Bowel cancer is one of the most common cancers in Wales, with over 2,200 new cases diagnosed each year , and early diagnosis remains one of the most important factors in improving patient outcomes. It is more common as people get older, with most cases diagnosed in those over 50.
Bowel Screening Wales plays a vital role in identifying people aged 50-74 who might be at increased risk of bowel cancer, through the routine use of an at home stool sample kit, known as Faecal Immunochemical Testing (FIT) . Each year, more than 500,000 people are invited to participate in bowel screening, with around 12,000 participants receiving a positive FIT result and requiring further assessment and investigation.
Following a positive FIT result, screening participants are informed to contact the national bowel screening administration team to make a mutually convenient appointment for a nurse-led pre-colonoscopy assessment. This assessment is predominantly undertaken by telephone and uses a standardised assessment form with questions designed to determine an individual's suitability for colonoscopy, identify clinical risks and ensure participants receive the support they need before further investigation. The assessment lasts between 30 and 60 minutes, depending on the level of complexity. Appointments are available Monday to Friday, 9am to 4pm, and this is currently the only option available to screening participants.
The current process was established when the Bowel Screening Wales programme launched in 2008 and has remained largely unchanged since that time. Whilst the pathway continues to provide a safe and effective means of assessment, the environment in which it operates has changed considerably. Bowel Screening participation has increased, eligibility has expanded, workforce pressures have intensified and public expectations around digital...