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BMA criticises ‘appalling’ failure to send cervical screening letters to up to 48,000 women

The British Medical Association has written to the chief executive of NHS England expressing its extreme concern after being made aware that up to 48,500 women have not received information regarding cervical cancer screening after a system error1.

The BMA understands that the majority of the correspondence relates to appointment invitations or reminder letters, but that some are screening results. This incident is the latest in a series of failings by Capita, the organisation contracted to provide GP back office services2

In its letter to Simon Stevens, the BMA has urged NHS England to strip Capita of the contract and take Primary Care Support England (PCSE) services back in-house. NHS England has assured the BMA that it has written to those affected and informed GP practices. The BMA, is now informing its GP members, alerting them to the situation and preparing practices for the very understandable concerns and queries that patients are going to have. GPs will do all they can to provide these women with support but there must be no suggestion that GPs and their teams bear the brunt of rectifying this unacceptable failing by a private company – something GPs have experienced in the past.

Dr Richard Vautrey, BMA GP committee chair, said:

“This is an incredibly serious situation, and it is frankly appalling that patients may now be at risk because of this gross error on the part of Capita.  Some women will now be left extremely anxious because they have not received important correspondence, particularly letters about abnormal smear test results that need urgent follow up. This has been caused solely by Capita’s incompetence.

“We know that, because of the nature of this procedure, many patients are already reluctant to attend these appointments, and therefore reminder letters are crucial to provide encouragement and reinforce the importance of having a cervical smear test done. Incidents like this, therefore, will hardly inspire confidence in the system and risk even fewer women getting checked.

“Since it took responsibility for GP back room functions three years ago, Capita‘s running of these services has been nothing short of shambolic and after repeated warnings from the BMA and government, this is now clear evidence that its failings have put patient safety – and possibly lives – at risk.  It is ultimately NHS England that bears overall responsibility and it must now take this service back in-house. As the body which commissioned Capita to take on this work, despite clear warning signs that it was not up to the job, NHS England must shoulder the blame for this dreadful situation; you cannot outsource responsibility.”

Ends

Notes to editors

The BMA is a trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.

  1. For further details please contact NHS England.
  2. For more information on the BMA’s work around Capita and PCSE see this page.

Background

A cervical screening test (previously known as a smear test) is a method of detecting abnormal cells on the cervix. The cervix is the entrance to the womb from the vagina.

Detecting and removing abnormal cervical cells can prevent cervical cancer.

Testing for abnormal cells

Cervical screening isn't a test for cancer, it's a test to check the health of the cells of the cervix. 

Most women's test results show that everything is normal, but for around 1 in 20 women the test shows some abnormal changes in the cells of the cervix.

Most of these changes won't lead to cervical cancer and the cells may go back to normal on their own. But in some cases, the abnormal cells need to be removed so they can't become cancerous.

About 3,000 cases of cervical cancer are diagnosed each year in the UK. It's possible for sexually active women of all ages to develop cervical cancer, although the condition is most common in women aged 30 to 45. The condition is very rare in women under 25.

The cervical screening programme

The aim of the NHS Cervical Screening Programme is to reduce the number of women who develop cervical cancer and reduce the number who die from it. 

Since the screening programme was introduced in the 1980s, the number of cervical cancer cases has decreased by about 7 per cent each year.

All women who are registered with a GP are invited for cervical screening:
•aged 25 to 49 – every 3 years 
•aged 50 to 64 – every 5 years 
•over 65 – only women who have recently had abnormal tests

Some trans men should also be invited for screening. More information is available on the NHS's website.

Being screened regularly means any abnormal changes in the cells of the cervix can be identified at an early stage and, if necessary, treated to stop cancer developing.

Cervical screening isn't 100 per cent accurate and doesn't prevent all cases of cervical cancer, but it's the best way to pick up any abnormal cells that could later turn into cancer.

The process should be that women receive a first letter inviting them to be screened (tested) at their GP practice. If this is ignored, a follow-up letter is sent reminding them that it’s in their best interests to have a test.

Assuming they then take that initiative, they are then tested and under the national screening guidelines, 98 per cent of women should get their results in writing within 14 days of being tested. 

For women who then require a colposcopy, the proportion of women to receive biopsy results within 4 weeks from date of test is 90% and the screening programme strives to achieve 100 per cent within eight weeks.

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