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As you are aware, invitations for the Cervical Screening Programme were paused by the Department of Health (DOH) in March 2020 in response to the COVID-19 pandemic. The PHA has been advised to plan for the restoration of programmes, including cervical screening.

Given that there is a cohort of women who did not receive their invitation, but may be considered at higher risk of significant cervical disease, I am writing to advise that we plan to recommence invites to this group of women in the first instance from mid-June.

This phased, prioritised approach will ensure that the service is not overwhelmed and restarts in a controlled manner.

The first group to be invited (mid-June) will be those who were due an invite during the pause and are currently coded as suspended or where their last screening test was reported as inadequate. We are sending these invitations as a failsafe, because the woman either has not attended colposcopy, is having colposcopy treatment, or treatment is completed but call/recall have not yet been informed. The numbers of invitations in June will be relatively small (approximately 5,000 in total) which should allow primary care and laboratory services, in particular, adequate time and capacity to restart screening services.

Pending DOH approval, it is anticipated that the next group to be invited (mid-July) will be women for whom either colposcopy services or laboratories have requested a repeat screening test. It is proposed that women on routine recall (i.e. 3 or 5 yearly recall) will begin to be invited by mid-August.

During the restoration of screening programmes, it is recommended that those at greatest clinical risk are prioritised and seen earlier. As cervical sample taking is usually undertaken in primary care I would request that these women be facilitated as soon as possible.

Some older women may have had limited opportunity to make an appointment for their final routine screen due to COVID-19. Women who were eligible prior to the pause but became ineligible during or because of the pause (eg. had their 65th birthday since March) will still be invited and I would ask that these women are also facilitated. 

It would be helpful if Primary Care providers would review their local records or use final nonresponder lists to identify individuals whose screening may have been affected by COVID-19 (eg. their appointment has been cancelled and not been rebooked, they have been refused an appointment during the pandemic response, or they have not responded to a reminder letter) and be proactive in contacting them about their screening and giving them opportunity
to attend.

Women with symptoms of cervical cancer should be managed and referred as appropriate.

In terms of sample takers and personal protective equipment (PPE), please follow local arrangements which will be in line with guidance for primary, outpatient and community care: https://www.publichealth.hscni.net/covid-19-coronavirus/guidance-hsc-staff-healthcareworkers-and-care-providers/guidance-hsc-staff https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/877599/T2_Recommended_PPE_for_primary_outpatient_and_community_care_by_setting_poster.pdf 

In relation to women attending for their cervical screening test, local arrangements should again be followed in line with guidance (see below). All patients should be triaged remotely before any face-to-face appointment is booked. Patients without symptoms of COVID-19 who are booked for a face-to-face appointment should be advised to inform staff if they develop symptoms, and asked again before consultation.

https://www.england.nhs.uk/coronavirus/publication/managing-coronavirus-covid-19-ingeneral-practice-sop/

If you have any queries regarding the cervical screening programme please contact the Young Person and Adult Screening Team (YPAST) team at [email protected]