HMR101 Request/Report Form

The HMR101 form is used for cervical screening tests. Most of the boxes 01 to 20 of the form are completed by the sample taker. The form is then sent with the cell sample to the laboratory. Sample takers should ensure that all information provided on the HMR101 form is complete and legible to support the laboratory in assessing the adequacy of the test, producing an accurate report, making appropriate recommendations for future management of the woman and notifying the correct organisations of the test result and next actions.

The laboratory completes the form and makes a report to the sample taker, the woman's GP (if different) and the administrator of the call/recall system for the cervical screening programme. If multi-part forms are used, the laboratory may send each colour-coded part to the appropriate organisation. If single-part forms are used, the laboratory will send printed or electronic reports directly from the laboratory computer system to each organisation.

Changes to the HMR101 Request/Report Form

In June 2011 the Advisory Committee on Cervical Screening agreed that questions relating to sampling adequacy in HMR101 Box 20 (Cervix visualised - Yes or No? and 360° sweep - Yes or No?) were no longer a national requirement. The fields may be removed from locally-designed forms, or disregarded according to local policies and protocols.

In October 2011 the three standard versions of the forms available through the Open Exeter system were updated to remove the sampling adequacy questions. The forms were also enhanced to support accurate patient identification, promote patient choice, improve consistency between versions of the form, and incorporate HPV test results.

Detailed instructions on each element of the form are given below. Note that these instructions refer to the updated 2003 version of the HMR101 form as produced by the Open Exeter system, and not to locally-designed variations which may be numbered or arranged differently or include alternative data fields and/or options.

Open Exeter HMR101 Form Completion Guidance [PDF 34Kb]

Follow link for more information on Open Exeter (requires an N3 connection).

Open Exeter HMR101 Forms - Frequently Asked Questions

Q1. Why have the sampling adequacy questions ('cervix visualised' and '360° sweep') been removed from box 20 and how can sampling difficulties be communicated now?

A1. The technical adequacy of the sampling process depends on many factors and it is unnecessary to highlight two in particular. Sample takers are expected to indicate on the form, using box 20 if necessary, any problems experienced including inability to see the cervix or complete the series of five full sweeps. If no comments are made, the laboratory will assume that the sampling was satisfactory and therefore unlikely to yield a false negative result.

Q2. Is it necessary to specify a "Colp. clinic for direct referral…...." before we know that referral is required?

A2. In some areas there are multiple colposcopy services available and this field allows the woman to specify her preference if a referral is needed. It may also save time at the laboratory if it would otherwise be necessary to work out which was the appropriate colposcopy service for a direct referral for a given postcode or GP practice. If no preference is given, any referral will be directed to the colposcopy service that has been agreed as the default for the patient's area.

Q3. What are HPV infection codes used for?

A3. HPV triage is a new protocol for cervical screening which is being introduced across England. Women whose screening tests show borderline or mild dyskaryosis are managed differently according to the presence or absence of infection with a high-risk subtype of Human Papillomavirus (HPV).

More information on HPV triage is available.

Q4. Will the laboratory report other infections as well as HPV?

A4. Reporting of incidental infections is not part of the NHS Cervical Screening Programme. Where laboratories wish to report an infection, this should be done directly to the woman's GP or sample taker for further management on a case by case basis. Laboratories have been advised not to send infection codes with cervical screening results to PCO screening departments.

Q5. Do we have to update our local HMR101 forms and/or ICE paperless systems to match the Open Exeter forms?

A5. Local forms and electronic requesting systems may be developed to suit local requirements and no elements of the OE forms are mandatory, although it will be important to ensure that HPV result and infection codes can be accommodated for national roll-out of HPV triage beginning in 2011/12.

Q6. Are there any more changes to the HMR101 forms in the pipeline?

A6. Primary screening by HPV test will begin at a number of sites in 2011/12 and the HMR101 forms will be reviewed next year to ensure that they can accommodate the new screening protocol. The review will also consider the format and content of the existing forms and may result in further changes. In addition to national requirements, requests for changes to Open Exeter processes and forms are considered regularly by the Open Exeter Project Board. Any user can request a change to OE using the online form available at:
http://nww.connectingforhealth.nhs.uk/nhais/prodservs/cr_form (requires an N3 connection).

Q7. Which version of the HMR101 form should we use?

A7. Every area has one of the OE forms set as its default version. When a patient is selected in OE and an HMR101 form is requested, the default version will be offered first. A different version can be selected if required. It is good practice to agree with the receiving laboratory which version of the form is preferred, and to review this agreement at regular intervals.

Q8. What is the 'reason for smear' for smears taken at colposcopy?

A8. This will depend upon the reason for referral:
If an abnormal sample (any degree of abnormality) - use code 4 (previous abnormal sample)
If an inadequate sample - use code 5 (previous inadequate sample)
If a negative sample or no sample - use code 3 (other)

Q9. What is the 'reason for smear' if the woman had a mild or borderline smear several years ago but her most recent test result was negative?

A9. This will depend upon the woman's status:
If the woman is still under surveillance (last test coded 'R' for action) - use code 4 (previous abnormal sample)
If the woman has been returned to routine recall - use code 2 (routine recall)

Please send all queries to