Cervical screening offers will start being sent out to women across England again from this month after the invitation system was paused due to the Covid-19 pandemic.
Women stopped being sent invitations from 9 April but the NHS will begin issuing them again ‘from around 6 June’, according to a document drawn up by Public Health England outlining how to restore cervical screening services.
Nursing in Practice’s sister publication Pulse understands the first set of invitation letters will be prioritised for women at high risk of cervical cancer and also those who were invited to book a screening appointment before invitations were paused, but never made contact with their GP practice.
The PHE document, seen by Pulse and which was drawn up on 14 May, said it is now ‘vital’ for plans to be made to ensure NHS cervical screening programme services can ‘operate fully as soon as it is safe to do so’.
The document said services should be restored ‘in a consistent way to minimise risk to individual patients’.
The guidance, aimed at NHS regional public health commissioning teams, follows NHS England’s letter on 29 April advising the health service to ‘step up’ non-Covid19 urgent services as soon as possible, which included screening.
It said: ‘To support the [cervical screening] restoration process and to give time for services to recover, invitation and reminder letters for cervical screening have been delayed for eight weeks from 9 April 2020 and will begin being posted to women again from around 6 June 2020.’
Some GPs have told Pulse their practices have continued to offer screening where possible during the Covid-19 outbreak, though others have encountered problems with collection services picking up samples.
There has been no national instruction from NHS England to stop screening altogether, but in some regions local NHS advice was to halt the service due to the risk of transmission.
In London, the NHS director of primary care and public health commissioning, Liz Wise, wrote to GPs on 1 April advising that no cervical samples should be taken until further notice. Services have only resumed in the past week.
The letter said: ‘Given the threat posed by Covid-19 infection and the national delay strategy of social distancing, social isolation and shielding, the benefits from maintaining screening through the programme are outweighed by the risk posed to the NHS and the population by Covid-19.
‘This pause in local screening programmes will free up valuable resource to assist with the NHS Covid-19 response.
‘We are requesting that until further notice, no cervical samples are taken in primary care, CASH services or hospital gyane clinics.’
However, the NHS London team says GPs in the capital are now ‘working hard to ensure screening is available to all women who need it’.
Some women in London – those who displayed symptoms of cervical cancer – have been able to access assessment and procedural services throughout the past couple of months, such as colposcopy services.
In a statement to Pulse, Dr Kathie Binysh, head of screening for the NHS in London, said: ‘GP practices are currently working hard to ensure screening is available to all women who need it.’
Dr Binysh added: ‘Services for women with symptoms of cervical cancer continued throughout the pandemic in London, ensuring that they were assessed and treated as necessary.
‘On 21 May, GP practices, sexual health and other clinics in London began to resume taking cervical samples, starting with women at highest risk.’
Commenting on the reintroduction of cervical screening invitations in England from next month, Dr Chandra Kanneganti, the BMA GP Committee’s lead for NHS England policy, said GPs should seek help from their local primary care network or federation if they are overwhelmed by the backlog of appointments.
He said: ‘In my area, we had problems with the availablity of transportation for samples but now that has started again we are proactively encouraging patients to contact us.
‘Because of the backlog of patients from the past two months our local federation are providing some practice nurses to carry out the screening.
‘I don’t believe this will be overwhelming, but if it does become that way practices should ask for help and support, such as from their network or federation.’
A spokesperson for the NHS said: ‘Where local screening providers have decided to reschedule screening appointments due to coronavirus, we are working with them to ensure plans are in place to resume appointments as soon as possible.
‘Cervical cancer takes a long time to develop so the risk of any clinical harm is very low and patients are strongly encouraged to seek help from their GP if they have symptoms.’