HealthTech NHS Bowel Cancer Screening Digital Platform — NHS CSP

NHS Bowel Cancer Screening

FIT (Faecal Immunochemical Test) kit posted to eligible people.

FIT kit workflow

• 1invitation letter posted (GOV.UK Notify — or digital if NHS App registered),
• 2FIT kit posted by NHS Logistics,
• 3kit returned and analysed by BCSP hub laboratory,
• 4result received from laboratory (HL7 v2 ORU message from hub lab LIMS — Laboratory Information Management System),
• 5result interpreted (

FIT threshold

• &gt
• = 10 microg Hb/g — positive result, refer for colonoscopy), (6) result letter posted (GOV.UK Notify).
• Non-responders: people who do not return kit after 16 weeks receive a second invitation.

Colonoscopy Pathway and BCSP Hub Integration

• Positive FIT result → colonoscopy referral.
• BCSP Hub (specialist bowel cancer screening units): NHS eRS referral (FHIR R4 ServiceRequest).

Colonoscopy appointment

patient contacts BCSP Hub directly (phone or NHS App booking).

Colonoscopy results

• adenoma grade (low, intermediate, high risk), cancer suspected, normal.
• Follow-up: high-risk adenoma → surveillance colonoscopy at defined intervals.
• Cancer suspected → 2-week wait urgent referral (NICE NG12).

BCSP Hub FHIR R4

colonoscopy procedure and result sent back to call-recall platform (FHIR R4 Procedure resource).

Clinical safety hazard

FIT positive result not acted upon (patient not referred for colonoscopy) — delay in cancer diagnosis.

Mitigation

• 1positive FIT results trigger immediate BCSP Hub referral (automated — no manual step between positive FIT and eRS referral creation),
• 2eRS referral acknowledgement required within 5 working days (alert to coordinator if not acknowledged),
• 3colonoscopy scheduling audit (all positive FIT → colonoscopy within

BCSP target

6 weeks).

Safety metric

100% of positive FIT results result in a colonoscopy referral — zero tolerance.

Second hazard

wrong person receives wrong result.

Mitigation

NHS number verified against PDS on every result dispatch.

NHS App bowel screening integration

people registered on NHS App receive digital FIT result notification (push notification).

NHS App

view your bowel screening result, book colonoscopy appointment (if positive), and bowel health information.

NHS App adoption for bowel screening

42% of 60–74 age group have NHS App (growing) — digital notifications supplement (not replace) postal letters for this demographic.

Accessibility

bowel screening affects older population — platform designed with accessibility as primary consideration (large text, simple language, phone support prominently displayed alongside digital).