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

Overview

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 access, communication and convenience have evolved. Bowel Screening Wales is therefore seeking innovative approaches that can support service modernisation, improve participant experience, improve the timeliness of pre-colonoscopy assessments and strengthen the ability of NHS Wales to meet future demand. ________________________________________ The Challenge Current pre-colonoscopy assessment processes remain heavily reliant on manual and telephone-based activity during routine office hours (Mon-Fri. 9-4pm). This can limit access for screening participants (especially those of working age), create pressure on specialist nursing teams, contribute to variation in waiting times and participant experience, and limit opportunities to make better use of participant information resources (i.e. current inability to signpost participants to digital resources and video content). We are seeking innovative solutions that can improve access to timely assessments, provide increased flexibility for participants to undertake an assessment, enables participants to have more control over their engagement with the service, including the possibility of them booking their own appointment slots following assessment. In addition, the innovation should have the ability to enable the screening programme to triage participants for appropriate investigations and stratify individuals for timely interventions based on clinical need following a positive FIT result. The challenge is outcome focused and does not prescribe a specific technology, product type or delivery model. Applicants are encouraged to propose the approach they believe will best address the challenge and demonstrate how their solution could be adapted, developed or enhanced to meet the needs of Bowel Screening Wales. We are not seeking to specify a single solution in advance. The purpose of this challenge is to support the development and demonstration of solutions that can address the underlying service need as described above whi