Key Information about CervicalCheck for Non-Medical Staff in Primary Care

Presentation Objectives

• To give an overview of how the Programme works

• To outline the role of receptionist/practice administration staff in relation to CervicalCheck

• To deliver key Programme messages including the call, re-call process

‘Receptionists' work is complex, demanding and intense, involving a

high level of commitment to patients, colleagues, and the practice’ Br J Gen Pract. 1999 February; 49(439): 103–106.

• The receptionist is often the first point of contact people have with an organisation i.e. surgery/CervicalCheck. She/he is responsible for promoting a positive image for the practice

• First impressions count!• Women return to have repeat smear tests when they have had

a positive experience• That really does start from the moment a woman picks up the

phone to the practice to make her appointment … through to the woman getting her results

Responsibilities of Receptionist in CervicalCheck

• Need to be able to accurately/correctly answer queries from clients/patients in relation to the CervicalCheck programme

• Ensure accurate information i.e. patient’s demographics –contact numbers & PPS No. are maintained and up to date (computer/notes)

• May include managing administration in office i.e. making appointments, posting smear tests, data entry, payment issues etc.

CervicalCheck

• About CervicalCheck and who is eligible• About a smear test• The call, re-call process in practice• The best time to have a smear test• Screening intervals• What to tell women when making an appointment• Cervical Cytology Form• Results• Key messages

About CervicalCheck

• CervicalCheck – The National Cervical Screening Programme provides free smear tests through primary care settings to 1.1 million eligible women aged 25-60

• CervicalCheck operates an organised call, re-call system of invitation in line with best international practice

About CervicalCheck Contd.

• From 1 September 2009, a woman needs a letter of invitation from CervicalCheck to avail of a free smear test

• Over the next three years, CervicalCheck will send every eligible woman on the register who has not yet had a free CervicalCheck smear test a letter of invitation by post

• CervicalCheck holds a register (list) of women aged 25-60

• This register is a secure electronic database that contains the name, address, date of birth & PPS No. of women aged 25-60

About a Smear Test

• A sample of cells taken from the surface of the cervix (neck of the womb) which are sent to the laboratory for examination

• It is a test to detect early cell changes

• It is not a test for cancer

• It may detect possible abnormalities, or changes in the cell which may develop into cancer if not found or treated

Taking a Smear Test

Cervical CheckOffice

Invitationletter

Smear test

Resultletter

No abnormally detected

result

Inadequate / unsatisfactory

resultNot normal result

3 ConsecutiveInadequate

ASC-US ASC-H LowGradeLSIL

HighGradeHSIL

AGUS/AGC

AGH QueryGlandularNeoplasia

Invasioncervix

Normalrecall

Repeatsmear

Repeat in6 months

Repeat in6 months

3ASC-US

2 LSIL or 3LSIL (10yr)(Conseq)

Colposcopy

2 repeat smears in 1yr thenannual

Histology

Normal recall

A woman phones you to make an appointment for a CervicalCheck smear test.

Ask her if she received a CervicalCheck invitation or re-call letter

Yes

Woman is eligible for a free CervicalCheck smear test

The Call, Re-call Process in Practice

A woman phones you to make an appointment for a CervicalCheck smear test.Ask her if she has received a CervicalCheck invitation or re-call letter

No

The Call, Re-call Process in Practice

She may be eligible without a letter in the following circumstances:• Women aged 60 and over who have never had a smear test• Women of any age post colposcopy• Women post hysterectomy in certain circumstances• Women aged 20 and over on renal dialysis• Women ages 20 and over with HIV infection• Women aged 20 and over with post organ transplant

Ask the woman if she has had a smear test in the last 3 yearsAny woman who has not had a smear test in the last three years can opt-in and request an invitation letter from CervicalCheck by registering online at www.cervicalcheck.ie, completing andreturning a Freepost form, or by calling CervicalCheck on Freephone 1800 45 45 55.

The Best Time to Have a Smear Test

• The best time to have a smear test is between day 10 and day 20 of a woman’s cycle (counting 1st day of period as day 1)

• If the woman has stopped having periods (therefore has no periods) any time suitable to both smeartaker and client

• The smear test takes approximately 15-20 minutes

Screening Intervals

• Women aged 25 – 44 every 3 years

• Women aged 45 – 60 every 5 years

• However, all women, regardless of age should have a second Programme smear test after 3 years before going on to age appropriate interval

What to Tell Women When Making an Appointment

• Bring their invitation letter or re-call letter– Bring PPS No. or advise them where they can access it

• All clinical queries e.g. woman after hysterectomy, abnormal bleeding, etc. should be referred to the Doctor or Practice Nurse

Cervical Cytology Form

• May be hand written or computer generated (Healthone, Helix, Socrates)

• Ensure correct demographics i.e. most recent name, address, DOB, contact numbers, PPS no.

• Very important to ensure correct result is tagged to the correct woman

• Ensure all samples are posted minimum once a week (vial and form in box)

• Ensure correct number of forms to vials in box and that forms match vials

• Smeartaker must get consent (not appropriate for receptionist to do so)

Information Which Has to be Present for Smear Test to be Processed

• PPS No.• Woman’s demographics (name, address, DOB, phone number)• Consent must be signed• Smeartaker name & ID number (An Bord Altranais or IMC

number)• Clinically responsible Doctor’s IMC & GMS numbers

Results

• Results should be seen by the Doctor or/and Practice Nurse• Appropriate re-call date entered on computer/notes• Results can be scanned and then shredded appropriately• Results may be given by letter or phone depending on each

individual practice protocol

• NOT ACCEPTABLE to send laboratory reports to women under any circumstance

Additional Information

• All smeartakers should be registered with the Programme including locum GPs and nurses

• Registration form available to download from website

www.cervicalcheck.ie

Final Key Messages

• CervicalCheck offers free smears test to eligible women 25 – 60 in primary care

• The procedure takes approximately 15-20 minutes• The best time to have a smear test is between day 10-20• Refer any queries re bleeding patterns or menstrual cycle

issues to the Doctor or Practice Nurse • Ensure correct information is on file• Record keeping: Result should be scanned and shredded or if

manually entered smear test result filed in patient’s notes (legal requirement)

Remember

• If you are unsure of a woman’s eligibility call CervicalCheck on Freephone 1800 45 45 55

• Receptionist plays a very important role in ensuring a quality delivered Cervical Screening Programme from the front line

Thank you