Screening: It’s Complicated
Another Successful Centre for Evidence and Values in Healthcare Meeting
The second meeting of the Centre for Evidence and Values in healthcare (CEVH) was held on 5th February 2026 in St Andrews. It may have been a miserably cold and damp day outside – but inside, the sold-out event was buzzing. With delegates from near and far, from healthcare professionals, patients and lay people, academics, policymakers, students, philosophers, people working in the charity sector and government advisors – all made the event rich with perspectives, passion, knowledge and experiences.
From the University of St Andrews, Dr Margaret McCartney, Director of CEVH, together with Professor Frank Sullivan, Professor of Primary Care Medicine, opened the day by introducing what screening is and is not, and summarising why screening is ‘complicated’ by sharing the many and varied issues in the screening arena – that delegates had highlighted prior to the event.
The keynote presentation “Stories from 30 years of screening: creating order out of chaos” was delivered by Dr Angela Raffle, the leading international expert in screening who has shaped UK policy. Angela’s presentation set the scene for two major themes of the day: first, that an effective screening was not just about doing a test. Instead, good quality screening is about giving people good quality information, effective choice, high quality tests, delivery of results and actions as needed. In other words, it should be a programme, and one that is evidenced, organised and managed properly; and second, the UK National Screening Committee is essential to effective and rational screening.
Angela went on to host a ‘mini-masterclass’. This was usefully preceded by a precis of all the essential statistics delivered by Robin Alexander, a medical statistician. Robin explained the sometimes confusing terminology – perfect preparation for the ‘masterclass’. Angela asked the audience to put themselves in the position of being public health officials, charged with making decisions about whether to introduce a new screening programme. They were given data and questions to answer, resulting in great debate at each table, and a lively feedback session.
Underpinning the ethos of the CEVH is engaging with a variety of disciplines ensuring different viewpoints and perspectives – rather than just viewing challenging issues through a medical lens. As such, there were presentations from: Professor Kevin Orr, Professor of Leadership and Governance in the Business School, University of St Andrews; Dr Emily Postan, Reader and Chancellors’ Fellow in Bioethics, University of Edinburgh; and from the sharp-end of the policymaking arena, Dr Tasmin Sommerfield, Consultant in Public Health Medicine and National Clinical Advisor for Screening in Scotland, and Richard Foggo, Co-Director of Population Health with the Scottish government.
Professor Kevin Orr spoke about narratives of screening and how this is effectively a ‘contested space’ where scientific legitimacy is not always clear. It was a brilliant insight into how we have to think of the best ways to helpfully inform people about the science of screening – using examples from the US, he suggested ‘story telling’ may be more effective.
Dr Emily Postan, asked the audience to consider a philosophical approach considering the different meanings that people can ascribe to test results – may not just be about knowledge but also crucially about the impact on their ‘identity’.
Dr Tasmin Somerfield explained the way that policy is made in the UK and Scotland. This was a very helpful explanation of the checks and balances that go into the system in order to ensure that it moves with the evidence. Richard Foggo shared key challenges in screening in policymaking and reflected how this event was so useful in offering a forum for people to discuss and debate together. They both acknowledged, we all want the same thing – better healthcare – and there is much to learn from understanding different perspectives.
Overall, the day demonstrated that ‘Screening – really is complicated’.
To get a flavour of the day, watch the video.
Testimonials from attendees included:
“Superb day. Talks both inspirational and informative. Really useful networking opportunities”
“Very wide-ranging talks with absolute experts”
“Greater understanding of the subject and the limits of it so will be more informed in my activity”
“Empowerment to address these issues with friends, family, colleagues and policy makers”
With grateful thanks to The Della Fish Foundation for supporting this event and the Centre for Evidence and Values in Healthcare.
The next event on June 19th in Edinburgh is entitled “The business of healthcare – ethical issues for doctors, vets and dentists”. Registration is now open for this event. Find more information on the CEVH website.