Screening: Evidence and Practice

A comprehensive, practical, and accessible guide to screening programmes, for public health practitioners and anyone else involved in or with an interest in screening. It covers the concepts and evidence behind screening, how to make sound policy on screening, and how to plan and deliver high quality programmes at affordable cost.

Angela E. Raffle,Anne Mackie,J. A. Muir Gray

Dr Angela Raffle has practised as a Consultant in Public Health in Bristol since 1990. Her involvement in local programme delivery for cervical screening began in 1986 whilst she was still in training. Data since 1977 for her Bristol area programme revealed the extent of the barely recognised yet growing overdiagnosis issue within cervical screening. With the support of colleagues in Bristol and nationally, she successfully published on this issue, despite strong opposition from those who regarded this as 'too controversial'. An advocate for honesty and informed consent, Angela has worked part time for the UK National Screening Programmes since it began, combining this with her Bristol-based public health work. In 1997 she was awarded the Skrabanek Prize for contribution to medical ethics.

Professor Anne Mackie lives in London, and fulfilled senior public health roles in the NHS before taking over from Muir Gray in 2007 as Programmes Director for the UK National Screening Programmes. Under her leadership, UK screening has become known for its high quality and robust policy making processes, and the public health ethos of screening is now firmly embedded in NHS culture. Despite continual NHS upheaval she has ensured that within screening there has been continual strengthening of processes for transparent policy making and review, quality assurance and measures, information provision for participants, and universal training and education for screening staff. Anne has also played a role in fostering international collaboration within public health focused screening.

Sir Muir Gray lives in Oxford and has worked in the British National Health Service since 1972, holding many senior positions during his career. He was instrumental in leading the transformation of NHS screening from a disorganised mess in the 1980s, into high quality, evidence based, nationally managed programmes based on informed choice. He was Programmes Director from 1996 when the UK National Screening Programmes were established, through to 2007. Muir also created the National Library of Health, was a key supporter of the Cochrane Collaboration when it was in its infancy, and he continues to influence the NHS through his work with Better Value Healthcare.