Over the previous 3 years, we have launched several Freedom of Information Requests (FOI) to monitor the availability of mpMRI pre-biopsy across the UK. Overall, the data shows that progress has been made and more men are able to access it. Our latest FOI conducted in 2019 has found that 72% of areas across the UK are now offering these types of scans to PROMIS trial standard.
Implementation in England
In England, we worked with NHS England to develop an optimal timed diagnostic pathway for prostate cancer. It outlined how Hospital Trusts can introduce pre-biopsy mpMRI to rapidly and more accurately diagnose prostate cancer. Alongside this, there was an expectation from NHS England, that Hospital Trusts would implement pre-biopsy prostate mpMRI by March 2020. Since the document’s publication in April 2018 we have been offering support to Trusts to ensure that pre-biopsy mpMRI is widely available including radiologist training and implementation events.
Implementation in Wales
In Wales, adoption of pre-biopsy MRI began at a slower pace due to the complexity of the technique and lack of resources to achieve widespread adoption.
At Prostate Cancer UK, we worked closely with the Welsh Government, the Welsh Planned Care Programme team and the Welsh Urology Board to provide solutions to the barriers to adoption of high-quality mpMRI across the Health Boards.
Over the last 18 months we have seen substantial progress in Wales as Health Boards across the country have transformed their diagnostic pathways to provide mpMRI before biopsy.
Prostate Cancer UK will continue to work with the National Imaging Academy of Wales and groups such as the Prostate Cancer Diagnostic Pathway Group in order to support Health Boards to provide high-quality mpMRI.
Making progress in Scotland
Clinical transformation in Scotland requires agreement among relevant clinicians (urologists and radiologists) that the evidence for change is strong enough. We brought clinicians together from across Scotland’s Health Boards to get their backing for the widespread adoption of mpMRI before biopsy.
Prostate Cancer UK was fully engaged in the process to update NHS Scotland’s prostate cancer Quality Performance Indicators (QPI) and helped to secure the first ever QPI covering prostate MRI before biopsy. The latest QPIs were agreed in early 2020.
We will continue to work with the Scottish Government, via our mpMRI Roundtable to reach agreement on how best to take forward high-quality mpMRI services across the nation.
Some Health Boards have already put mpMRI before biopsy into the prostate cancer diagnostic pathway. Use our map (last updated 2019) to see which ones.
Availability in Northern Ireland
Pre-biopsy MRI scans are widely available across Northern Ireland. However, they are not to PROMIS standard. While the PROMIS standard is more accurate, if there is any uncertainty around the result of the MRI scan in Northern Ireland then clinicians will keep a close eye on patients to ensure they do not require further scans or require treatment.