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Timed appointments increase attendance in the NHS Breast Screening Programme

Sending timed appointment invitations increases attendance at breast screening, with a larger impact on attendance rates for those living in the most deprived areas, according to an NHS England-commissioned study led by WIPH researchers. Findings from the study are already being implemented in the NHS Breast Screening Programme.

Published:
In the foreground, a mammographer views a breast screening image on a computer monitor, while in the background, a woman is having a breast screening in a mammogram machine.

The study evaluated the effect of different combinations of open invitations and timed appointments on attendance in the NHS Breast Screening Programme among 17,965 women invited for screening in seven screening services in England. Services used one of four open/timed appointment combinations. Women who did not attend following their first screening offer received a second invitation.

The results, published in the British Journal of Cancer, show that sending timed appointment invitations increases attendance at breast screening. Attendance was 49.1% for Open/Open invitations, 60% for open/timed, 64.7% for timed/open, and 67.9% for timed/timed invitations.

Timed appointments had a larger impact on attendance rates for those living in the most deprived areas, suggesting that this screening strategy may also help improve health equity. Attendance amongst the most deprived increased from 41.1%  (open/open) to 63.3% (timed/timed), compared with 61.4% to 78.0% for the least deprived quintile.

Senior author Dr Judith Offman said: “When we sent women invitation letters with a place, time and date for their appointment, rather than invitations asking them to call to make a screening appointment, attendance increased by nearly 20%. Even if this only resulted in a 5% increase in attendance, it could lead to an additional 84 lives saved across England every year.” 

Pre-publication findings from this study were used to inform NHS England on the most effective invitation methodologies, and timed appointments have been offered in the NHS Breast Screening Programme since April 2025.

Shuping J Li, Adam R Brentnall, Jacqui Cookson, Sue Hudson, Samantha L Quaife, Sharon Webb, Emma O’Sullivan, Jacquie Jenkins, Jo Waller, Stephen W Duffy, Judith Offman. The Effect of Different Combinations of Open Invitations and Timed Appointments on Breast Screening Attendance: Service Evaluation of Invitation Strategies in the NHS Breast Screening Programme. British Journal of Cancer 14 May 2026.

https://www.nature.com/articles/s41416-026-03436-8

 

 

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