Dudley Metropolitan Borough Council: Targeted promotion and convenient mobile unit location helped boost breast screening uptake

The public health team at Dudley Council has worked with the local breast cancer screening service to help boost uptake in one of the West Midlands’ most deprived communities. A new central location was found for the mobile screening unit and a targeted promotional campaign was organised involving social media, pharmacies and hairdressers and beauty salons. Following the project, uptake at the local GP surgeries increased by up to 6 percentage points.

“This initiative showed that getting the right location for breast screening services significantly influences uptake, particularly for women from ethnic minority groups” – Dr David Pitches, Public Health Consultant

Dudley has high rates of breast screening coverage with the exception of one area - the central district covered by the Dudley and Netherton Primary Care Network (PCN).

While the other five PCNs in Dudley all have better coverage levels than the national average, Dudley and Netherton PCN was well below, with 61.6 per cent of women having attended screening in the three years up to 2023-24.

Alongside this, the area has high levels of deprivation so the council’s public health team started working with the Dudley, Wolverhampton and South Staffordshire Breast Screening Service to see what could be done to address the issue. The two services already had a close working relationship with a public health consultant Dr David Pitches chairing the local cancer screening and prevention group.

Public Health Registrar Dr Oliver Topping said: “The service uses a mobile breast screening unit to increase access, but historically Dudley and Netherton has not had a suitable location for the vehicle. So we began to look for sites that could work for this area.

“There are strict criteria for where a mobile screening unit can be located – it’s a big articulated lorry so you need a power supply, flat ground, water and toilet facilities. It narrows the suitable sites. Supermarket car parks are commonly used, but those in central Dudley are too small or too hilly so we had to look for other solutions. In the end we identified a council car park, but as it had no power supply, we had to use the generator in the mobile unit.”

the project did not just rely on having a new site for the mobile clinic. Alongside the traditional GP letter invites, a bespoke marketing and promotional campaign was also launched. The initial focus was to work with three local GP surgeries to invite their eligible patients for screening – women aged 50 to 70.

The surgeries had high rates of women from minority ethnic communities so the public health team and breast screening service worked with Dudley’s community development workers and local women to develop a target campaign on social media as well as producing posters to display in shops. Local pharmacies were also given branded dispensing bags promoting the mobile service.

“We had a really good response,” said Dr Topping. “Some businesses did not always have space for the posters, but shared materials on social media, which really helped extend our reach in the target populations, especially as we focussed on hairdressers and beauty salons.

“We also took our time to get the messaging right. We came up with four different designs, but the one we thought was best was not the one the panel of local women preferred. It shows why it is so important to consult with the local population first.”

The promotional campaign ran ahead of the mobile service being stationed at its new location from March to May of last year. It had a positive impact with uptake increasing by between 2 and 6 percentage points across the three GP surgeries.

To further evaluate the project, a survey of 231 women who had been screened was undertaken. Three-quarters used the mobile screening unit in its new location, though a few who lived further away requested appointments at another venue. Two thirds said they preferred the new location for its convenience. Over half could still recall seeing the promotional campaign several months later.

One women said the location was “vital.” “It needs to be safe for women, free to park, private and secluded. All to encourage women to have their breasts screened. Another said: “I was more inclined to go because of the convenience of getting to it.”

Following on from the success of the project, the mobile unit will return to the same location this year with women from other nearby GP surgeries invited to take part.

Dr Pitches said: “Accessible and convenient healthcare services are essential to reduce inequalities and improve health outcomes. This initiative showed that getting the right location for breast screening services can influence uptake, particularly for women from ethnic minority groups. 

“Moreover, it shows that health promotion requires diverse strategies that combine traditional and digital outreach methods to maximise reach. Collaborating with local businesses provided further opportunities to reach diverse audiences, whilst community involvement played a crucial role in developing relevant and effective health promotion campaigns that resonated with the target audience.”