Cervical screening is failing women, because the number of women tested does not even meet the lower target set by the NHS – less than 72 per cent of women eligible for tests were screened in 2017-18, against a lower target of 75 per cent. (The standard target is 80 per cent)
At least 98% of women should receive their results within 14 days of their cervical screening appointment, but this target has not been met since November 2015. The NAO found that in March 2018 a third of women received their results on time. This did improve in December to just over half of women receiving results on time, but laboratories across England still hold more than 150,000 untested cervical screening samples (as at March 2018)
The NAO’s report has highlighted the failures of all the screening programmes it investigated, with all failing to meet their standard targets. The breast screening programme screened just over 72 per cent of eligible women against a target of 80 per cent, while the bowel screening programme just missed its 60 per cent target, testing 59.6 per cent of people.
These failings have been flagged up before – in May last year the Secretary of State for Health and Social Care advised of the serious failures in the breast screening programme with approximately 450,000 women aged between 68 and 71 not being invited for final breast screening.
In addition, in November 2018 it was revealed that between January 2018 and June 2018, 43,220 eligible women had not been invited for cervical screening. 4,508 women were not sent their result, even though 182 required follow up treatment.
The NAO claims changes to testing led to hundreds of thousands of women having to wait to find out if they required treatment. NHS England has now advised the NAO that it is working to reduce the backlog by moving the analysis of samples across the country. This should in turn reduce the load on those laboratories under most significant pressure.
The UK National Screening Committee recommended the introduction of primary human papillomavirus (HPV) testing in 2016. – HPV is said to be present in almost all cervical cancers.
At the moment, smear tests collect a sample of cells which is then analysed to detect abnormalities. The new process would effectively act as a triage service, reducing the number of samples which need to be tested within laboratories because it will test for HPV first, identifying those women most at risk. Those samples will then be sent for analysis, reducing laboratories’ workload. This type of testing is expected to begin in England by December.
Is a lack of funding the problem?
In 2017-18 the NHS spent £423 million on health screening programmes in total, but more than twice as much was spent on both breast and bowel screening than on cervical screening. That year, £66.6m was spent nationally on cervical screening, compared to £179m for breast screening and £187m for bowel screening. Bowel screening spending has risen by more than £56m in the last five years, but spending on cervical smears has stayed roughly the same.
Ally Taft, partner and specialist in clinical negligence said:
“This report raises key concerns surrounding screening programmes across the NHS. Turnaround times are extremely poor for cervical screening, in particular. It’s clear that someone who’s had a cervical test and requires further treatment should be notified of this within 14 days.”
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