Who does what in the NHS Cervical Screening Programme?

The national office of the NHS Cancer Screening Programmes, based in Sheffield, is responsible for improving the overall performance of the programme. Set up in 1994, its priorities are to:

  • develop systems and guidelines which will assure a high quality of cervical screening throughout the country
  • identify important policy issues and help resolve them, and improve communications within the programme and to women

Every Primary Care Trust (PCT) has a nominated person responsible for its cervical screening programme and implementing the national guidelines.

Regional directors of public health are responsible for the quality assurance network in their region.

The NHS Call and Recall System

Holds a list of all patients registered with a GP in the area it covers.

Sends the list of women due for screening to each GP to check the records (for correct name and address and in case it is not appropriate for them to be invited).

Sends the invitation letters and reminder letters.

Sends the result letter.

The sample takers

Take the samples, using the most up-to-date methods and in line with quality standards.

A woman can choose to have her test taken at her GP surgery by the GP or practice nurse or at a community clinic, such as a family planning or well-woman clinic.

Check that the results are returned to the GP surgery and to the woman.

Arrange for repeat tests if necessary.

The laboratory

Interprets the samples. All slides are screened by a bio-medical scientist or a cytology screener. Samples which are thought to be abnormal are screened again by senior laboratory staff and are given a result code which depends on the degree of abnormality seen.

Follows strict quality assurance procedures, including rapid review by a senior member of staff of all samples originally classed as negative.

Sends the results to the Primary Care Trust, the GP and the sample taker (if not the GP).

Runs a failsafe system for checking that all abnormal samples are followed up.

Reports on biopsies (samples of tissue taken at colposcopy) and provides a histological diagnosis.

Samples are screened in the hospital's pathology department. A consultant pathologist has overall responsibility.

The colposcopy service

Accepts referrals from GPs.

Diagnoses conditions from colposcopy examination.

Treats the condition.

Takes samples from the cervix (a biopsy) to obtain a histological diagnosis.

Follows up treatment with further investigation if necessary.

Discharges the patient back to the call-recall system.

Runs a failsafe system for checking the follow-up of all patients treated.

This service is provided in the gynaecology and genitourinary medicine departments of the general hospital.

The primary care team

Includes the woman's GP and all practice staff.

Encourages women to have cervical screening when it is due and keeps women informed about the different stages of the screening programme.

Answers questions and concerns that women may have regarding test results, follow-up and treatment.

The GP refers women for further treatment if necessary, regardless of whether he or she was the sample taker.

Incidental findings of infections are not part of the NHS Cervical Screening Programme but may be reported and acted upon according to local protocols.