Bowel cancer awareness month - April 2024
12 April 2024
Interview with Mark Donnelly, BCSA Chair
As part of Bowel Cancer Awareness Month, we asked Mark Donnelly, Bowel Cancer Screening Accreditation (BCSA) chair, about how the Bowel Cancer Screening Programme (BCSP) has impacted patient care.
Can you introduce yourself, your role in BCSA, and how long you’ve been involved in the Bowel Cancer Screening Programme?
I’ve been a consultant gastroenterologist in Sheffield for 25 years, a screener for more than 15 of those years, and clinical director of the South Yorkshire and Bassetlaw Bowel Cancer Screening Centre for the past 4 years. My other main professional interest is in endoscopy training and I’m the director of the newly established Yorkshire Endoscopy Training Academy.
What motivated you to take on the role as BCSA chair?
Richard Robinson, my predecessor, suggested it to me! But seriously, the BCSP has been a major positive part of my career for many years, I am passionate about the programme and very keen to see it maintain the reputation for excellence that it has established over the last 18 years. I believe a central part of developing and maintaining that excellence is the very rigorous accreditation process that we have had in place since the very beginning. I have been a BCSA examiner for more than 12 years and that enthusiasm for the BCSP, and for the accreditation process, made it a very natural thing for me to take on.
How have you seen the Bowel Cancer Screening Programme improve patient care and impact on individuals?
Without a doubt, the BCSP has impacted hugely on the care of individuals with bowel cancer and/or colonic polyps in the UK. One example is that patients diagnosed through screening have much earlier cancers as a rule and are generally have a much better chance of cure compared to those diagnosed outside of the screening programme. The effect on patient survival or outcomes from all the polyps we are diagnosing and resecting is still filtering through but will likely have a similarly positive impact.
How have you seen the BCSP impact bowel cancer screening practice in the UK?
Simply put, patients are diagnosed earlier, pathways are more streamlined, and there is faster diagnosis and treatment.
How has the BCSA programme helped to drive improvement?
If we recall the state of UK colonoscopy before 2000, practice was very patchy, standards were demonstrably poor, and the service was in no way prepared for the introduction of screening. The imminent start of the BCSP made us radically address these problems. JAG was given real authority to lead the training and quality agenda, hands-on courses were established in accredited training centres, the whole idea of competency and the establishment of key performance indicators (KPIs) as a fundamental part of endoscopy practice were adopted. What we have now is a colonoscopy service in the UK that is the envy of much of the world. One could argue that the catalyst for all of this was the BCSP. BCSA is seen as an aspirational gold standard for many colonoscopists, to be ‘the best of the best’.
Do you have a stand-out moment from working in the BCSP?
There are too many to mention. I, and I think all of those involved in the BCSP, are immensely proud of the difference it has made and is making every day to the lives of patients with bowel cancer.
What current and future projects in the BCSA programme can you tell us about?
The BCSP is ever expanding. We have recently taken on Lynch syndrome surveillance and the age range will soon encompass 50–75-year-olds in England (catching up with Scotland, for example). The next step will be reducing the faecal immunochemical test (FIT) positive level. It has been said that most colonoscopy performed in the UK 10 years from now will be, in one way or another, screening colonoscopy. Hence the work of the BCSA will increase to encompass more accreditation of increasing numbers of screening colonoscopists. To this end we are training a first new tranche of examiners. The other project we are currently working on is the comprehensive rewrite of the multiple-choice questionnaire (MCQ) stage of the accreditation process, as certain questions had become outdated. So, lots of current and future work for us!