Ardens has recently sought the advice of the NHS England Screening Authority with regard to Cervical Screening invitations and they have clarified the process for us. Also outlined in this link, the process should be as follows:


  • Practice receives a list of those patients due to be invited (previously the ‘Prior Notification List’ (PNL)) and practices process these to ensure patients are appropriately recalled;
  • The Cervical Screening Administration Service invites all eligible patients, sending 2 invites;
  • If the patient has not been screened after those 2 invites, the CSAS sends a list of ‘non-responders’ to the practice;
  • The practice then undertakes (and optionally codes) a third invitation.


The Screening Authority has explained to us why it is important that the first 2 invitations are sent centrally, as this ensures that the correct information is sent to patients at the time they are eligible.


The risk of inviting based on local searches is: 

  • Risk of inappropriate invitations  (i.e. to patients who have opted out)
  • Risk of inappropriately worded letters
  • Lack of appropriate information to give a balanced view of benefits and harms of screening
  • Risk of incorrectly timed invitations (e.g. shorter intervals for patients under surveillance or longer as they age)
  • Risk of early tests being rejected by the labs


As such, we have amended our searches for Cervical Screening to enable you to identify any non-responders, and potentially send a 3rd invite to these patients.


These searches can be found in Clinical Reporting > Ardens Ltd > Conditions | Cancer


Screening | 1a For advice


This folder includes searches that identify patients of the relevant age who have not had screening in the time frame and have not received advice about the cancer screening programme in the last year. You can choose between All patients who fall under these searches, or you can exclude any that have a Learning Disability or Reasonable Adjustment. (These particular patients are covered in the searches in the Screening | 1b Consider Advice folder) As well as Cervical screening advice, these searches also include bowel screening and breast screening patients should you wish to identify them as well.



Screening | 1b Consider advice


This folder includes searches that identify patients who are the same as in Screening | 1a Consider advice but also have a Learning Disability or Reasonable Adjustment. This way you can send separate and more appropriate advice to them depending on their needs.



Screening | 2a For non responder invite


The Non-responder Invite folder contains searches identifying patients who have a Cervical smear non-responder code recorded 'Cervical smear non-responder - XM1ym (Snomed: 275982002)'.  The non-responder code should be added to patients records who have been invited twice by the screening authority but have not yet had a smear. We advise practices to check each patient's record to ensure no response or screening has taken place, and if appropriate send the patient a third invite. These searches are broken down by the different ages/timeframes, and further broken down by those without accessibility requirements or reasonable adjustments recorded.



Screening | 2b Consider non responder invite


This folder contains patients that you might want to consider to invite as they have accessibility requirements for reasonable adjustments recorded in their record.


Screening | 3 For Review


This folder contains searches that look for patients who might get missed off invites as there are various codes that might exclude them, or searches for patients who have never had a smear recorded in their notes but are in the age range. It is advised practices review the patients in these searches to see if any further codes should be added or removed on a patient-by-patient basis.


Screening | 4 Activity


These searches show you which patients have had their screening done in the time frames specified.



Screening | 5a Cohorts


These searches are for reference only and display all patients within the age ranges for the specified screening programmes.


 

Screening | 5b PNL Cohorts


The PNL (Prior Notification List) cohorts contain 48 reports covering all screening areas including Cervical Cancer and breaks down the cohorts into useful cohort lists.