Practice nurses key to reversing cervical screening downturn

New guidance from Public Health England says practice nurses and GPs can help improve attendance by educating women about cervical cancer and screening and offering varied appointment times

Practice nurses and GPs have a key role to play in educating women about cervical screening and tackling falling attendances, according to new Public Health England (PHE) guidance.

GPs and practice nurses are urged to offer appointment times in the day and evening to encourage attendance. Picture: iStock

Despite the success of the NHS cervical screening programme, screening coverage has fallen over the past ten years. Attendance is now at a 19-year low and dropping across all age groups.

Attendance down

Screening figures collected by NHS Digital show that coverage among women aged 25-49 was 70.2% at 31 March 2016, compared to 71.2% in 2015 and 73.7% in 2011.

For women aged 50-64, coverage at 31 March 2016 was 78%, down from 78.4% in 2015 and 80.1% in 2011.

The latest edition of Health Matters, a resource for local authorities and health professionals, was launched today and says practice nurses and GPs are well placed to answer questions women may have if they are unsure about cervical screening.

Non-attendance for cervical screening is one of the biggest risk factors for developing cervical cancer. Many women have said that appointment times are often inconvenient, according to PHE.

Practice nurses and GPs should be aware that providing appointment times throughout the day and in the evening will help women to find a time when they can attend for screening, and limiting access to screening appointments can affect coverage. Evidence shows that GP endorsement also has a positive effect on cervical screening uptake.


The cervical screening programme sends a standard invitation letter and a reminder letter 18 weeks later to women who are eligible for cervical screening. Standard letters sent by the programme can include an additional paragraph of free text specific to a GP practice.

The registered GP sends out a second reminder letter to non-attenders. This provides an opportunity to tailor the practice invitation according to the services the practice provides and the practice population.

Helpful content includes:

  • Surgery opening times.
  • Reassurance that the sample taker will be female.
  • Offering opportunities for a conversation about any screening concerns.

PHE director of screening Anne Mackie said: ‘The last decade has seen a decline in cervical screening attendance across all age groups, and GPs and practice nurses can play a key role in increasing coverage by supporting eligible women who want to attend. 

‘Screening is not for all women and they must make an informed choice on whether it’s right for them. GPs in their everyday consultations with patients can inform them about what cervical screening involves, which can help reduce any anxieties about taking the test.’

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