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The Commission for Health Improvement report into the West London Breast Screening Service recommended that a formal structure for the follow-up of recommendations made at QA Team visits is implemented.  In the West Midlands, breast screening services are visited every 3 years as part of a rolling programme. Following a QA Team visit, a service can expect 3-month and longer term recommendations, and on rare occasions immediate recommendations concerning areas that require improvement. Written conformation of immediate and 3-month recommendation is issued to the service within 1 week of the visit. Longer term recommendations are included in the written QA Team visit report, which is issued within 4 weeks of the QA Team visit. A detailed process has been put in place that tracks the receipt of recommendations within the required timescales, highlights nonresponses and distributes the recommendations to the relevant QA Team members for classification and further instruction.  One-year post visit, all recommendations must be completed to the satisfaction of the visiting QA Team. At this point a formal document is compiled that details the recommendations and responses from the breast screening service. This document is then sent to the host trust chief executive, director of breast screening and lead primary care trust coordinator to sign, indicating that the resulting actions have been incorporated fully into the service's policies and procedures. In the event of noncompliance, separate reporting mechanisms have been introduced.

Maintaining standards through coordinated follow-up of Quality Assurance (QA) Team visit recommendations