For Breast Cancer Awareness Month, we’re spotlighting a healthcare professional from Barnet who has had great success in improving breast screening uptake in North Central London.
As part of North Central London Cancer Alliance’s work to improve breast screening participation, the Did Not Attend (DNA) project was launched, aimed at tackling the reasons why people missed their cancer screening appointments. This included creation and funding of a Health Promotion Administration Officer post, dedicated to identifying reasons people don’t turn up for scheduled breast screening and making adjustments to overcome the barriers.
Between December 2022 and July 2025, Trudy reached out to 14,223 individuals who did not attend their scheduled breast screening. Of those she contacted, 3,737 then booked their screening appointment, and 1,259 people were successfully screened. Nine patients were diagnosed with breast cancer that would not have been picked up otherwise and four identified as at high risk. Early intervention greatly increases the likelihood of treatment being successful.
Trudy spoke to us about her role and what key insights she had to share.
“I’d already been working for the breast screening Hub in another position, so when the Health Promotion role came up, I saw it as an opportunity to take on new projects in breast screening.
Most of my time is spent on DNAs: running reports, preparing data, mapping deprivation levels. A lot of ringing clients to hear about their reasons, then logging them.
My previous experience at the Hub came in handy, as I was used to speaking on the phone. I’ll explain I’m calling because they were due to attend screening but hadn’t turned up, and that I just want to find out the reason for their DNA. I always approach it in a non-judgemental way and am sensitive to any reasons people give. I find most people are friendly.
The most common reasons people give are either that they have other health concerns to think about right now, or work commitments getting in the way. For the first one, I say I’ll follow up again after they’ve had some time to deal with their other health issues (and make sure I do follow up!). For work commitments, I try to find a convenient time for them, such as weekend slots, if they’re available.
Of course, we want to increase uptake in the whole eligible population, but certain groups typically have lower engagement with screening. This can lead to significant differences in life expectancy and health outcomes depending on your circumstances, so I work to reduce these health inequalities as much as possible. We target the most deprived areas to try and improve uptake. I also identify clients that require special adjustments for their appointments and facilitate their needs accordingly.
One factor that helps the most is being very familiar with all aspects of breast screening, all the logistics, especially how to get there from various places in north London. I do a lot of helping to book people’s transport!
We make sure people know that they can bring a friend or family member, which is especially helpful for people with learning disabilities.
We offer people with learning disabilities a pre-visit. People can be intimidated by the process. Some people turn up to the screening, then get so scared of the machine they turn around and leave. To overcome this, at the pre-visit they can get familiar with the space, the machine, and they don’t have to commit to getting screened. But also, if they decide ‘actually, it’s not so bad’ they can go ahead and get it done there and then. They’re already here so it’s way more convenient and saves them having to come back.
I think my role is important because it shows us what’s working and what isn’t. We can make adjustments to help people based on what they actually tell us they need, rather than us just guessing.
It’s so interesting speaking to people and finding out what’s going on with their thought processes – I’ve heard so many random reasons for not attending. It’s helped with my awareness of the challenges people face. One thing I’ve learned: Everyone struggles.”