• The signal: NHS data show breast screening coverage rose to 70% in 2024/25 (+3.6pp since 2022/23), but cervical screening stagnated at 68.8%, and MMR uptake sits at 84.5%, well below the WHO 95% target.

 

• Why this matters: Prevention is the long-term lever of the 10-Year Health Plan. Flat or falling screening uptake will translate into rising cancer and infection costs.

 

• What to do now: Scale digital recall systems, pair them with targeted outreach, and embed equity guardrails to raise completion rates.

 

Context & system signals

• The Integrated Performance Report (Sept 2025) spotlights prevention as a weak point: some progress in breast screening, but cervical and immunisation flat or underperforming.
• The NHS Oversight Framework warns prevention and inequalities will form part of oversight, making these performance gaps visible in accountability reviews.
• The Healthcare Inequalities Improvement Programme confirms uptake gaps are concentrated in deprived and minority communities.

Strategic implications

1. Breast proves digital recall works. Gains are linked to automated invitations and better cohort management.
2. Flat cervical coverage is an equity failure. Cultural stigma and access barriers remain unsolved.
3. MMR under target is a public health risk. Outbreaks will create both operational and reputational strain.
4. ICSs will be judged on equity. Failure to close gaps risks financial and regulatory consequences under the new oversight regime.

Blueprint: rebooting prevention through recall & outreach

1. Digital recall as default
   • SMS, email, and app-based reminders.
   • Integrated with NHS App and GP systems.
   • Metric: uptake change following digital invites.
2. Outreach where digital won’t land
   • Pop-up clinics in schools, community hubs, and faith settings.
   • VCSE partnerships to build trust and reduce stigma.
   • Metric: uptake change in lowest quintiles.
3. Equity guardrails
   • Monitor uptake by deprivation, ethnicity, and geography.
   • Commission interventions where gaps persist.
   • Metric: gap reduction between least and most deprived.
4. Learning from pilots
   • FIT@80 bowel pilots show targeted methods can shift behaviour (+35% uptake).
   • Adapt playbooks for cervical and MMR.

Inequalities lens

• Screening and immunisation gaps map directly onto deprivation and ethnicity.
• Culturally competent communication, flexible clinic hours, and co-production with communities are critical.

How ProMedical would align

• Community Outreach Capacity: Provide additional staffing for outreach clinics, helping extend access into under-served communities.
• Digital Recall Support: Back digital recall and follow-up programmes with the staffing cover needed to turn alerts into real appointments.
• Equity Reporting: Track and report uptake by deprivation quintile, giving commissioners visibility of equity impact and reach.

Final word — Altin Biba, MBA, AMBA

“Prevention is the point where the NHS either saves lives early or pays the price later. Breast screening shows that digital recall can work, but cervical and MMR remind us how far we still have to go. By pairing digital tools with local outreach, and by tracking equity as rigorously as coverage, we can finally bend the prevention curve in the right direction.”

References

• NHS England. Integrated Performance Report, September 2025 (Item 4.1)
• NHS England. NHS Oversight Framework metrics list, September 2025 (Item 4.1.1)
• NHS England. Healthcare Inequalities Improvement Programme & Race and Health Observatory report, September 2025 (Item 6)