All population screening programmes have national standards which ensure stakeholders and the public have access to:
- data at local, regional and national level
- reliable and timely information about the quality of a programme
- quality measures across the screening pathway without gaps or duplications
Standards ensure a consistent approach across screening programmes and that data collection is beneficial.
Standards and quality measures for cervical screening are in our professional guidance documents, section 7a service specifications and our quality assurance operating model.
Following consultation, we have just published consolidated screening standards for the NHS Cervical Screening Programme.
The consolidated standards set out some of the important targets providers have to meet to make sure local screening services are safe and effective.
Data gathered and reported against these standards will feed into reports to support commissioners and health professionals in providing a high-quality programme.
We will review the consolidated standards based on outcomes and feedback every year which will allow for continuous improvement.
Please note that structural standards are not included in the new consolidated standards. These can be found in the Section 7a service specifications and will be separately monitored through the screening quality assurance service and commissioning.
Seeking views from the front line
We are very grateful for all the support we had during this piece of work. In particular, we'd like to thank our colposcopy and laboratory clinical professional groups and colleagues in screening quality assurance.
Lots of other health professionals generously gave their time to comment during our consultation and this valuable feedback has been fed in.
Further change to come
The programme is about to undergo one of its biggest ever changes with the move to HPV primary screening and we are aware that these current standards will soon need updating.
We have been working closely with the team who led on the HPV primary screening pilot as part of this future piece of work. In addition, PHE screening has begun collecting preliminary data in areas already using HPV primary screening to inform future standards.
By continually reviewing and updating cervical screening standards in England we will continue to ensure the delivery of a high quality programme.
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6 comments
Comment by Dr Douglas Russell posted on
So called “inadequate”smear samples lead to increased workload, through repeat sampling, delay and also to patient anxiety and inconvenience with possible negative impact on uptake. A 63 year old patient called by the programme was told by her local practice that at her age “90% of samples are inadequate, and therefore she must use oestrogen hormone cream for 2 weeks prior to a sample being taken, to reduce the rate of inadequate smear samples”
Is this correct advice? What is the evidence for this? Are the costs of providing such creams allowed for in the ongoing assessment of the quality and efficacy of the service? This happened in North Norfolk. If true, why does the invitation letter from PHE not make this clear?
Comment by Andrew Anderson posted on
Dear Dr Russell
Thank you for your query.
Please be assured evidence shows that inadequate tests only relate to 2.8% of the samples taken in the cervical screening programme.
Kind regards,
Ruth Stubbs, cervical screening programme manager, Public Health England
Comment by Laurence Carter posted on
I'm not sure if this is the right place to ask this question; please re-direct me elsewhere if necessary. Is there a protocol whereby if a woman visits an NHS facility (perhaps for gynaecological reasons), the doctor or nurse who sees her receives a flag on their computer record if the patient falls outside the correct cervical screening standard (eg has not been screened in the last 3.5 years for patients aged 25-49), which thus creates an opportunity for the medical health provider to provide a reminder to the patient - all within the framework of informed consent of course.
Comment by Andrew Anderson posted on
Dear Laurence
Thanks for your enquiry.
We expect that when a GP refers a patient to an appropriate service (for example a gynaecology clinic) they would advise if the lady is due or overdue for cervical screening.
There is a national IT system which informs all GP practices and contraceptive and sexual health services that a woman is due for her smear. There are plans to update the national system but we do not have any details when the new system will be available yet.
Best wishes
Ruth Stubbs, cervical screening programme manager, Public Health England
Comment by Nick Wood posted on
Based on the experience of the HPV primary screening pilot sites but also the advancing cohort of HPV vaccinated women, what is the predicted impact on colposcopy clinics of introducing primary HPV screening nationwide? Do we have enough resource allocated to colposcopy services to meet these requirtements?
Comment by Andrew Anderson posted on
Dear Nick
Thank you for your comment.
The human papilloma virus (HPV) primary screening pilots did show an increase in workload for colposcopy services, particularly in year three of the pilot, but this was not sustained. We’re expecting the findings from the pilot to be published shortly.
A study (see link at bottom) contains data from Public Health England’s HPV infection surveillance which clearly shows the benefits of the vaccination programme.
Further modelling work will inform the full impact of the vaccination on the future workloads and we will continue to work closely with NHS England to plan future requirements.
Best wishes
Ruth Stubbs, Public Health England’s cervical screening programme manager
https://www.ncbi.nlm.nih.gov/pubmed/29917082