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FOI release

FOI – 2024-000350 Cervical Screening (HTML)

Published on 06 November 2024

Date received – 09 October 2024 | Date responded – 06 November 2024

Request

  1. How many screeners are working across the two cervical screening Laboratories in Lanarkshire and Greater Glasgow?
  2. What is the detection rate screeners are expected to hit for detecting any abnormality in a smear test?
  3. Over the past 6 years (August 2018-August 2024), breakdown of whether screeners are meeting their targets?
  4. How often are quality assurance visits carried out at the laboratories? Are those results available?
  5. What is the protocol for re-checking smear tests, following a patient's diagnosis of cervical cancer that wasn't discovered through routine screening?
  6. Over the past 6 years, how many audits on cervical cancer patients' historical smears have thrown up misreading's?
  7. Are there any litigation cases over the past 6 years related to the misreading of a cervical smear test? If so, how many?

Response

I refer to your freedom of information request that we received on 09 October 2024. We have now completed the search of our records and can provide you with the following information:

1. How many screeners are working across the two cervical screening Laboratories in Lanarkshire and Greater Glasgow?

The staffing structure (head count) for the two laboratories is summarised below. This does not include consultant staff.

Primary screeners

  • NHS GG&C - 8
  • NHS Lanarkshire - 6

Checkers

  • NHS GG&C - 4
  • NHS Lanarkshire - 6

2. What is the detection rate screeners are expected to hit for detecting any abnormality in a smear test?

All staff performing primary screening are required to screen 3000 slides per annum. All staff performing checking (review of difficult cases referred by primary screeners), and reporting of abnormal samples are required to screen/report 750 slides per year. These targets are currently under review.

The minimum workload standards were introduced by the NHS Cervical Screening Programme (NHSCSP) and have been adopted by laboratories across the UK and endorsed by the British Association for Cytopathology. The standard is in place to ensure staff are exposed to enough abnormal slides to maintain competence.

The nationally agreed target for overall sensitivity is 90%. This is the target that individual screeners and the laboratory are assessed against.

3. Over the past 6 years (August 2018-August 2024), breakdown of whether screeners are meeting their targets?

The individual performance of all staff is assessed quarterly. There are local management of persistent poor performance procedures, and national procedures for staff returning after extended periods of absence. Laboratory performance is assessed at quarterly Quality Assurance Group (QAG) meetings. No major concerns have been noted to date.

4. How often are quality assurance visits carried out at the laboratories? Are those results available?

NHS Lanarkshire & NHS Greater Glasgow & Clyde (GG&C) laboratories are registered with both Quality Control for Molecular Diagnostics (QCMD) and National External Quality Assessment Scheme (NEQAS) schemes for HPV testing. QCMD distributes material once a year and the NEQAS scheme distributes three times a year. The laboratories have successfully completed all rounds of the schemes with no substandard performance.

All staff in both laboratories also participate in the UK Gynaecological cytopathology External Quality Assessment (EQA) scheme and the national technical EQA scheme run by NHS England.

Both laboratories have an annual United Kingdom Accreditation Service (UKAS) surveillance visit and are accredited by UKAS to the ISO 15189 standard.

5. What is the protocol for re-checking smear tests, following a patient's diagnosis of cervical cancer that wasn't discovered through routine screening?

All patients who have a diagnosis of cervical cancer have their records reviewed as part of the invasive cervical cancer audit. During this process any cervical cytology slides from within Scotland in the 10 years preceding the diagnosis are reviewed. If on review, there is a major discrepancy between the review opinion and the way the slide was originally reported the case is sent to the other Scottish laboratory for an external opinion.

6. Over the past 6 years, how many audits on cervical cancer patients' historical smears have thrown up misreading's?

Under Section 17 of the Freedom of Information (Scotland) Act 2002 (FOISA), NHS National Services Scotland (NSS) does not hold the information you have requested. Screening oversight and Assurance do not hold this level of detail. You may wish to contact the individual health boards who could provide this level of detail, addresses are as follows:

7. Are there any litigation cases over the past 6 years related to the misreading of a cervical smear test? If so, how many?

Under Section 17 of FOISA, NSS does not hold the information you requested. Screening oversight and Assurance do not hold this level of detail. This information is held by the health boards legal team’s, you may wish to contact their FOI team at the addresses above.

I trust you will find the information of assistance and if you require any further information, please do not hesitate to contact us.

If you are unhappy with any aspect of how we have dealt with your request, you can make representations to us asking us to review the handling of your request.

If you require any further information, please contact the Associate Director Governance and Board Services (Board Secretary) within 40 working days of the date of this correspondence.

Contact

Email: nss.foi@nhs.scot

Address

NHS National Services Scotland
Headquarters
Gyle Square
1 South Gyle Crescent
Edinburgh
EH12 9EB

If after a review you are still unhappy, you also have the right to apply to the Scottish Information Commissioner, who can be contacted at Kinburn Castle, St Andrews, Fife, KY16 9DS, or via their application form.

National Services Scotland (NSS) is committed to publishing all information released in response to Freedom of Information requests. You can view all FOI responses within our FOI Publications repository.

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