Cervical Screening Guidance for users of the WYCSA system - Bradford

Who is eligible? / Women aged 25 – 64 are eligible for cervical screening. Women aged 25 – 49 are routinely screened every 3 years. Women aged 50 – 64 are routinely screened every 5 years. This applies to tests taken 1.1.05 onwards.
Note to sample takers. / When a woman attends for her cervical sample, remember to check her details. The address on the form is where we send the result letter. If the result letter is to go to a different address, which isn’t hers, please mark clearly that this is a care of address otherwise the computer system will be updated and this address will be noted as her permanent address.
Sample takers should be using pre populated HMR101 (sample request forms) from Open Exeter –see Open Exeter.
Ceasing at age 60 and over / Women are automatically ceased when they reach age 65 even if they have never attended for a cervical sample. Women who attend for cervical screening age 60–65 will be automatically ceased providing their result is negative (This means a woman age 60 may be automatically ceased from recall as her next test would be due after the age of 65). Women with previous abnormalities will be ceased from recall providing they have had the relevant follow up. Those who have not had relevant follow up will continue to be invited for cervical screening.
PNL’s - Prior notification lists.
What do I do with them? / These are produced by WYCSA on a monthly basis. PNL’s are A3 listings that detail women who are due a cervical sample within a future month. These listings are sent approx 3 month in advance. PNL’s are available electronically – see Open Exeter.
All women on the PNL will be sent an invitation unless otherwise indicated. If an invitation is appropriate, do nothing! If a recent test has been taken attach a photocopy as evidence, if you are awaiting the result, indicate this on the PNL, a letter will not be sent to the woman but will be checked at a later date to ensure a result has been received. If a woman is pregnant write her expected delivery date on the PNL and WYCSA will postpone until 3 month after delivery. Reasons for ceasing on a PNL see below.
Ceasing / Valid reasons for ceasing - no cervix, radiotherapy to the cervix and if a woman has signed an “official” disclaimer letter issued from WYCSA.
Gender Reassignment: –
Male to female – cease as no cervix (no follow-up required)
Female to male (total hysterectomy/no cervix) – Removed from the Cervical Screening Programme (no follow-up required)
Female to male (cervix intact) – Removed from the Cervical Screening Programme and GP will assume responsibility for offering screening.
Absence of cervix is the only valid exclusion from the National Screening Programme
Ceasing a woman for physical/mental disabilities – new guidance is available. Please contact the Screening Department for info.
Open Exeter / Open Exeter enables practices to view their patients screening history, recall status and notes held on the WYCSA system. PNLs and eCards (non-responder cards and ceased notifications)can be actioned on line. Also, pre populated HMR101 (sample request forms) can be printed to save time during an appointment. Please contact me for an application form. Open Exeter access is free of charge.
When do WYCSA issue invitations? / WYCSA issue invitation letters approximately 6 weeks before the test is due. Invitations are run on a weekly basis. If a cervical sample isn’t received within 12 weeks a reminder is sent to the woman.
FNR – Final Non ResponderCeased Notifications
What do I do with them? / If you receive a FNR card/Open Exeter Electronic Card Notification this indicates that a sample has not been received and the woman is overdue. FNR cards are issued approx 16 week after the reminder letter. When a patient reaches FNR her call/recall is moved on depending on her age and previous results.
●1 Year for repeat advised and previous abnormal results ●3 years for 1st calls or routine recalls (aged 25 – 49)
●5 years for 1st calls or routine recalls (aged 50 – 64)
Checkfor a valid reason for non attendance, for example: - recent test, no cervix or pregnancy. If a valid reason is found update the card using the same criteria as the PNLs. If the woman is a genuine non attender use the FNR as a prompt to send a “personalised’ letter from the practice asking her to attend for atest as soon as possible, you could also include an ‘in-house’ disclaimer form (it is advisable to send her a covering letter explaining the benefits of cervical samples and the implications of not having one).If she signs and returns the disclaimer to the surgery you may set a Read code on your computer system. Do not inform WYCSA as we will invite her again according to the bullet points above.
Ceased notifications – when a woman is ceased we send a notification to the practice. Please check that ceasing is appropriate.
Women who TEMPORARILY refuse cervical samples. / Do not postponea woman’s recall, let her know that she will still receive her invitations but to ignore them. WYCSA will send 2 letters, an invitation and a reminder then her recall will be moved on for 1, 3 or 5years depending on her age and previous history. The process will start again at PNL stage. A woman will never be lost to follow up and by managing it this way, if any problems were to arise in the future there will be an audit available (on the WYCSA system) to confirm that letters have been sent appropriately.
Women who PERMANENTLY refuse cervical samples.
How do I do this? / If a woman refuses tests and becomes upset and angry when she receives invitations of this nature, she may be removed permanently from the WYCSA/National Screening Programme. She MUST be given one to one counselling explaining the benefits of cervical samples and the implications of not having them.
Inform WYCSA in writing,(practice “in-house” disclaimer forms will not be accepted) confirming that one to one counselling has been given & clearly instruct WYCSA to send the “official” disclaimer letter.WYCSA will send the woman the letter which if signed and returned allows her to be permanently removed from the Programme. WYCSA will send a copy of the signed disclaimer to the practice to be entered in her medical records. We will also send the woman a letter confirming that she has been permanently removed from the screening programme but it also informs her that she can return to the programme if she changes her mind. Once a woman is ceased from recall she will never be called for again by WYCSA.
*** THESE WOMEN ARE NOT EXCLUDED FROM YOUR ELIGIBLE POPULATION! ***
When do WYCSA issue result letters? / Result letters are posted 1st class Monday to Friday with the exception of Bank Holidays.
Direct Referral for abnormal results. / Abnormal results are sent direct to the colposcopy department from the laboratory. The colposcopy dept issue appointments to patients. We have a protocol in place to ensure that sample takers are aware of the result before the woman, and the woman receives her result letter before her colposcopy appointment arrives.
Do I need to inform WYCSA of cervical samples taken privately and/or abroad? / Yes. The majority of private clinics are very good at informing WYCSA of cervical samples they have taken. But as best practice I advise you to photocopy any forms and forward them to this department. Also photocopy results from abroad and forward to WYCSA.
All private samples and samples taken abroadcan be recorded on the system and count towards targets but for negative results the recall date is not moved on,the woman is still eligible for NHSCervical screening and must be sent an invitation.
Do I need to inform WYCSA of patients with NO CERVIX? / Yes. You are our only source of information. Please ensure that WYCSA is sent this information on a regular basis, for women whose recall is to be permanently ceased. **Only inform WYCSA once all follow up has been completed – this way we can continue to recall and send result letters on your behalf** If a woman is ceased as no cervix, and a sample is taken, this sample cannot be entered onto the system and we cannot send a result letter on your behalf. This also means that we cannot generate any future invites if she requires follow up. Please also remember to state“no cervix” (not hysterectomy) on all correspondence.

Karen Taylor Screening Manager WYCSA (West Yorkshire)

Direct Line: 0113 2952561. Email ptember 2012

Screening Lines: 0113 2952529, 2952558, 2952559, 2952531, 2952583 Screening Fax: 0113 2952539