Cervical Screening

Cervical screening is available to women and people with a cervix aged 25 to 64 in England.

The first invitation is sent to eligible people at the age of 24.5 years. People aged 25 to 49 receive invitations every 3 years. People aged 50 to 64 receive invitations every 5 years.
Cervical screening looks for the human papillomavirus (HPV) which can cause abnormal cells on the cervix. If no HPV is found (HPV negative) the person is recalled every 3 or 5 years, dependent on their age until the age of 65.
If HPV is found (HPV positive) a cytology test is used as triage, to check for any abnormal cells.
If no abnormal cells are found, a follow up screen is arranged for 12 months’ time. This will check to see if the immune system has cleared the virus. Most HPV infections are transient, and slightly abnormal cells often go away on their own when the virus clears. If HPV persists, abnormal cells can, if left untreated, turn into cancer over time.
If abnormal cells are found, the individual will be referred to colposcopy.
Around 50–79% of sexually active women have a lifetime risk of being infected with human papillomavirus (HPV).  Almost 40% of women are infected with HPV within two years of first sexual activity.
The prevalence of high-risk HPV (that lead to cell changes that could develop into cancer, if left untreated) is 16%.

https://www.gov.uk/guidance/cervical-screening-programme-overview

Call Recall
The Cervical Screening Administration Service (CSAS) is responsible for the call/recall for cervical screening and their role in supporting cervical screening includes:   

  • Sending Prior Notification Lists (PNLs) of patients eligible for screening to GP practices
  • Ceasing and deferring patients
  • Sending out call and recall letters to patients
  • Notifying patients of test results once received form the laboratory

Further information is available on their website:  https://www.csas.nhs.uk/support/
General enquiries: CSAS.Enquiries@nhs.net
Online forms: www.csas.nhs.uk   
Support: https://www.csas.nhs.uk/support/

Call recall: https://www.gov.uk/government/publications/cervical-screening-call-and-recall-administration-best-practice

Further Resources
Programme overview: https://www.gov.uk/guidance/cervical-screening-programme-overview

Sample acceptance: https://www.gov.uk/government/publications/cervical-screening-accepting-samples-in-laboratories/guidance-for-acceptance-of-cervical-screening-samples-in-laboratories-and-pathways-roles-and-responsibilities

Programme and colposcopy management: https://www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management

Management of screening safety incidents: https://www.gov.uk/government/publications/managing-safety-incidents-in-nhs-screening-programmes

Ceasing and deferring women   https://www.gov.uk/government/publications/cervical-screening-removing-women-from-routine-invitations/ceasing-and-deferring-women-from-the-nhs-cervical-screening-programme

Sample taker training – national requirements: 
The national guidance for sample taker training was updated in February 2020. Registered Nurses, Nursing Associates, Midwives and Physician Associates must complete a recognised theoretical course followed by a period of supervised training as described in this guidance and is available here
https://www.gov.uk/government/publications/cervical-screening-cervical-sample-taker-training

Initial Training:
The training period for trainee sample takers is approximately 9 months from enrolment through to completion.
Any training provider can be used as long as training meets the criteria within the national guidance and is accredited.  The links below are the training providers used across Surrey to date.

Training Course Calendar – NEPSEC – North of England Pathology and Screening Education Centre

http://www.clinicaltrainingltd.co.uk/training-courses/

Kingston and St Georges– University of London:   Kingston University and St.George's University of London - Faculty of Health, Social Care and Education - Greater Together (healthcare.ac.uk)

We are aware that current availability of training places is challenging due to COVID-19. Some theoretical teaching is being offered virtually. Surrey Training Hub are working with all training providers to offer dates across Surrey, please see Eventbrite here for upcoming courses.

Sample taker numbers 

It is now possible for practice managers to register someone working at their practice on the sample taker database and allocate a sample taker number cervicalsampletaker.scwcsu@nhs.net. In doing so the individual health professional is confirming that they have taken or are undertaking training which meets the criteria within the national guidance. 

Cervical screening mentor

The cervical screening mentor supports the trainee through their practical sample taker training and confirms their achievement for progression to the final evaluation and clinical assessment.
Mentors must be practising sample takers with at least 12 months continuous experience, having taken at least 50 cervical samples following completion of their own initial training. Mentors must have effective communication skills and ideally hold a relevant mentoring and, or teaching qualification. Further information about the role of the mentor is detailed in the national sample taker training guidance.

Cervical screening assessor
The assessor is external to the trainee’s place of work. The assessor is responsible for conducting the trainee’s final clinical assessment. The training provider is responsible for recruiting and inducting individuals to the role of assessor making sure they understand the role, are sufficiently prepared to carry it out and are consistent in their practice. Further information about the role of the assessor is detailed in the national sample taker training guidance.

There will be opportunity for experienced practitioners to undertake this course fully funded due to the challenges due to COVID-19. Please contact the Training Hub is you are interested in this opportunity.

Required update training for cervical sample takers

Sample takers must undertake a minimum of 3 hours update training every 3 years. The national eLearning resource for sample takers meets the programme requirements for update training.
This is a free resource suitable for update training only. Sample takers will need to register, via the web-site, for an e-LFH account at the link below:
https://www.e-lfh.org.uk/programmes/nhs-screening-programmes/
https://www.surreyi.gov.uk/jsna/screening-and-immunisations/

https://www.gov.uk/government/publications/cervical-screening-cervical-sample-taker-training/training-for-cervical-sample-takers-education-pathway

Want to know how your practice ranks within the CCG or how many people you need to screen to meet 80% coverage? A national tool has been developed to help practices review their screening coverage for the most recent quarter and year to date.  https://app.powerbi.com/view?r=eyJrIjoiOGIzODcxY2YtZDQwYS00NDRlLWFhMjctNjlkZWJjMzQzODg2IiwidCI6IjUwZjYwNzFmLWJiZmUtNDAxYS04ODAzLTY3Mzc0OGU2MjllMiIsImMiOjh9

Resources and initiative Improving access to cervical screening | Jo's Cervical Cancer Trust (jostrust.org.uk)

For any queries relating to Immunisation and Screening please email your local the team: phe.screening-immsssat@nhs.net.  The team produce quarterly updates so please watch out for the communications.

Information for the public about cervical screening is available on the NHS website and Jo’s Cervical Cancer Trust. In addition, Public Health England (PHE) and Jo’s Cervical Cancer Trust produce tailored resources to support specific groups of people participate in cervical screening.
Anxiety and mental health

Resources for people who feel anxious about attending due to mental health or trauma

Ethnic communities
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Learning disabilities

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Resources for healthcare workers and carers of people with learning disabilities

Physical disabilities
Resources for people with a physical disability

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Sexual abuse

Resources for people who have experienced sexual abuse

Resources for healthcare workers and sample takers

Transgender men

Resources for transgender men

Resources for healthcare workers

Other resources

Cervical screening saves lives – evaluating the national campaign (PHE)e deaf