Experience of quality assurance across BUPA screening centres

BUPA's mammography quality assurance programme comprises an annual audit visit to 31 hospital-based screening centres by one of a team of three quality assurance mammographers. Clinical competence and mammographic film quality are assessed and technical quality control data are also collected. Monitoring of overall image quality is also addressed by a 'quarterly' test object film. A patient dose survey has been undertaken with exposure and breast thickness data collected from all sites.

The standard of mammography across screening centres is good and well within NHSBSP standards. Reject rates are less than 3% and are personalised to each radiographer, enabling feedback and learning. Continuing professional development is in place and sites have evidence of a system of peer review. Quality control checks are undertaken according to recommended standards and records are kept. The mean glandular dose for a lateral oblique film across all centres was 1.7 mGy, well below the recommended national reference dose level. Mean doses at individual hospitals ranged from approximately 1.1 mGy to 2.3 mGy. Image quality scores using the Leeds TORMAM are generally satisfactory and typical of elsewhere, with only a few films having scores less than optimum and driving a move to higher contrast film/screens at these sites.