Key Information About CervicalCheck for Non-medical Staff in Primary Care

1. Key Information About CervicalCheck for Non-medical Staff in Primary Care

2. 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

3. ‘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

4. 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.

5. 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

6. 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

7. 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

8. 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

9. Taking a Smear Test

10. Cervical CheckOffice Invitationletter Smear test Resultletter No abnormally detected result Inadequate / unsatisfactory result Not normal result 3 Consecutive Inadequate ASC-US ASC-H Low Grade LSIL High Grade HSIL AGUS/ AGC AGH Query Glandular Neoplasia Invasion cervix Repeat in 6 months Repeat in 6 months Normalrecall Repeatsmear 3 ASC-US 2 LSIL or 3 LSIL (10yr) (Conseq) Colposcopy 2 repeat smears in 1yr then annual Histology Normal recall

11. The Call, Re-call Process in Practice 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

12. 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 The Call, Re-call Process in Practice No Ask the woman if she has had a smear test in the last 3 years Any 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 and returning a Freepost form, or by calling CervicalCheck on Freephone 1800 45 45 55. • 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

13. Is the women due for practice or clinic re-call? Integrating Practice and Clinic Re-call Systems with CervicalCheck Yes • Advise those women to: • Check they are on the CervicalCheck Register. A woman may register or update • her details by: • Completing the online registration form at www.cervicalcheck.ie • Completing the printed Self-registration form and returning by Freepost. Practices • may order forms from Inform Systems – T: 061 33858 • Telephoning CervicalCheck (Freephone 1800 45 45 55) • 2.Answer ‘No’ to the registration question ‘Have you had a smear test • within the last three years?’, so they will be issued with an early letter of invitation • 3. Make a cervical screening appointment upon receipt of their letter of invitation

14. 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

15. 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

16. 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

17. 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)

19. 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

20. 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

21. 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

22. Information Leaflets & Self-registration Forms for WomenInform Display Systems Ltd. • Tel:061 33 85 80 • Fax: 061 33 85 84 • Email: cervicalcheck@informireland.info • Website:  www.informireland.info

23. 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)

24. 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