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GPs told not to exclude women from cervical screening during review

cervical screening

GPs in Scotland ‘can no longer add exclusions’ to the cervical cancer screening programme amid a national review of exclusion records.

This will ‘remain the case until we can be absolutely assured that a robust process is in place to verify GP exclusions’, said Scottish public health minister Maree Todd in a Parliament debate.

Some temporary exclusions, including for pregnancy, can still be applied by GPs.

And until a way to confirm GP-added exclusions is set up, women can still make the decision to formally opt-out of the screening programme by signing a disclaimer.

It comes as the Scottish Government announced last week that the records of just under 200,000 people who have been permanently excluded from the programme would need to be individually checked to ensure the exclusions were correct.

This follows the Government admitting in June that a ‘small number’ of women wrongly excluded from screening had subsequently developed cervical cancer, three of whom died.

Some 434 women who had partial hysterectomies, where part or all of the cervix remains, were incorrectly told they did not need to be screened.

The Government told Pulse it is developing an audit process to carry out the 199,000 record reviews that will involve GP practices, which is not anticipated to require clinical input from GPs themselves.

The process is due to be tested in pilot soon and the findings will inform the wider audit process.

The Government said that although the ‘overwhelming majority of these exclusions will be correct’, they expect that ‘more people will be discovered to have been wrongly excluded’. 

They added that the review will probably take ‘at least 12 months’ due to the ‘complexity and numbers involved’.

In all, 199,000 individuals have been excluded from the programme over decades, although around 45,500 are now deceased or no longer registered with a GP.

A Scottish Government spokesperson said: ‘We recognise the pressure healthcare services are under and we are working to find a solution that will allow a thorough review to be conducted as quickly as possible while minimising the impact on services. We will do this by drawing on the strengths of primary care and with clinical input from secondary care.

‘We are engaging with the BMA and health boards to develop a process that is workable in general practice, as well as at board level. The Scottish Government has also committed to providing additional funding to support the effort.

‘The NHS will also be working extremely hard to ensure that the methodology developed makes it as straightforward as it can be to review records consistently.’

In July, Public Health England revealed that the first-ever national cervical screening campaign in 2019 led to a 25% increase in the number of women aged 50-64 attending a smear test at their GP practice.

Click to complete relevant cancer CPD modules on Pulse Learning.


Patrufini Duffy 24 September, 2021 4:01 pm

Never the patient’s fault is it NHSE? __ never does exist in medicine. The amount of energy and nannying you plough into cervical screening is disproportionate to other conditions that affect the population.

Paul Attwood 27 September, 2021 11:43 am

I have an idea. GPs are overworked, that is agreed. GPs are looking for ways to reduce this workload. Might it not be a moment to offload cervical screening to national level? The result would be no more local database searching and excluding and no more GP screening clinics. This might leave some time to do actual GP.

Too simplistic? Beware the law of unintended consequences. The scottish public health minister feigns outrage as to GP exclusions. Just wait until the monumental FU that will occur when the civil servants get their mits on the database. Docker Doris (Soton 1970s cross dresser and performer) for a smear anyone?