Cervical Screening Programme, England - 2019-20 [NS]

The National screening Committee recommended that the NHS Cervical Screening Programme replaces cytology with Human Papilloma Virus (HPV) testing as the primary screen within the NHS Cervical Screening Programme.

Replacing cytology with HPV testing as the primary screen within the NHS Cervical Screening Programme, aims to increase efficiency and prevent more cases of cervical cancer as it has an increased sensitivity for underlying disease.

Evidence from the 6 HPV primary screening pilot sites and international studies suggest that the need for cytology tests may reduce by around 80 to 85%.

Due to the reduction in future cytology requirements combined with HPV primary screening implementation and procurement plans, laboratory providers experienced difficulty retaining and recruiting staff to continue the existing cytology screening services.

This has severely impacted on the turnaround times of cervical screening samples since 2016-17, leading to increases in time to receipt of results.

To reduce the backlog and stabilise service delivery, a national mitigation plan was put in place during 2018-19. HPV primary screening pilot sites increased the amount of HPV primary screening to release cytology capacity to help other laboratories and non-pilot laboratories become early adopters of HPV primary screening¹.

Following a national procurement process by NHS England during 2019, 8 laboratories were chosen to carry out HPV primary screening. The 45 laboratories providing cervical screening at the start of 2019-20 consolidated onto these 8 sites over the course of the financial year.  

HPV primary screening was fully implemented by December 2019 with all laboratory sites consolidated by 31 March 2020.

The increase in the HPV primary screening population can impact on the data as this has the ability to increase the amount of invitations or recalls in the programme as the screening follows a different follow up pathway.

Further information on HPV Primary screening can be found here.
 

See table on the next page for summary of the changes to cervical screening laboratories during 2019-20.

As part of the implementation of HPV primary screening a new laboratory structure was established. A number of laboratories stopped processing cervical samples during 2019-20. Of the 48 initial laboratories, 3 laboratories closed prior to 2019-20. During 2019-20, the work of the remaining 45 was consolidated into 8 laboratories at the time of full implementation. This table summarises where work has been transferred.

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