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The Commission for Health Improvement report into the West of London Breast Screening Service recommended that a formal structure for the follow up of recommendations made at quality assurance (QA) visits should be implemented.  In the West Midlands, breast screening services are visited every 3 years as part of a rolling programme. Ad hoc visits can occur during this period to a service or one or more disciplines if there are issues or concerns with a particular aspect of a service. Following a QA Team visit, a breast screening service can expect 3-month and longer term recommendations, and occasionally immediate recommendations, which highlight areas that require action to improve service delivery.  In order to allow structured follow-up, recommendations are classified into the following disciplines; administration and clerical, radiography, radiology, medical physics/user QA, pathology, surgery, nursing and management. A detailed process has been put into place that tracks the receipt of recommendation responses from the service, which allows completed recommendations to be analysed by discipline, type and time to completion.  This detailed analysis can be used to identify which recommendations are completed effectively and within the set timescale, to identify which types of recommendations take longer to complete than anticipated, and to identify ways in which the arrangement and/or wording of recommendations can be improved in order to ensure that recommendations are achieved.

Analysis of QA Team visit recommendation responses in order to find ways of improving the probability of completion