By Gráinne Gleeson, CervicalCheck Programme Manager, National Screening Service
Did you know there are over 4,500 people involved in delivering our CervicalCheck programme?
CervicalCheck is Ireland’s national cervical screening programme. It’s a free service available to 1.3 million women and people with a cervix aged 25 to 65. The aim of the programme is to prevent cervical cancer or find it at an early stage before there are any symptoms so that rapid access to treatment can be offered.
While cervical screening is a simple test for HPV, delivering this national programme is a complex service of processes and clinical pathways that involves a large, experienced and dedicated team across a range of disciplines.
National Programme Office
This team of around 40 people is based in Limerick and led by the clinical director and programme manager. The team manages vital systems, services and supports to ensure the efficient delivery of the programme.
- The register is the beating heart of the programme and tells us when to send invitations for screening, who attended for screening, what the tests results are and who provided the clinical care. Once women are registered for the programme, we are responsible to make sure invitations are issued and test results are provided in a timely manner. This is one of the main challenges for the team. The register is compiled from a data transfer from the Department of Social Protection and self-registration by women. Once registered with the CervicalCheck programme, we rely on women to keep their address and contact details up to date so that invitations and results letters are delivered promptly and to the right place. This is an important part of our communications with screening participants – to check the register and update contact details.
- Our programme management and administrative teams are responsible for the daily operations of the programme and ensure contracts are in place with all service providers. The team liaise daily with sample takers (GPs and practice nurses), laboratories and colposcopy units. They also liaise with external contractors including services that provide medical equipment for screening tests, printers who provide over 1 million invitation and results letters every year, delivery agents who deliver the samples to the laboratories and letters to the doors of thousands of women, and a dedicated call centre answering queries from members of the public and healthcare professionals.
- Our Screening Training Unit provides high-quality education and training for all healthcare professionals involved in delivering a cervical screening service. Cervical screening education is critical for the provision of a quality-assured programme. The training unit is a clinical team of 13 registered nurses supported by administration staff. The team are located in different regions around the country. This ensures that a wide community of medical and nursing professionals have access to the educational support and expertise they need to provide quality care to those attending for cervical screening. It’s important that women have access to the same high-quality information and service regardless of their geographical location in Ireland.
- Our IT Team provides core support to the operations of the programme on a daily basis. The programme is reliant on this support to ensure vital systems are operational for the efficient processing of information and effective delivery of the programme.
Primary Care
There are over 4,000 sample takers around the country registered with CervicalCheck to provide a cervical screening service in their practice or clinic. These GPs and practice nurses take samples from women attending for screening and are the first point of contact for women accessing screening. In Ireland, women can choose where they get their screening test done, which provides flexibility to those who work away from their local GP practice or who choose to have their test done in another practice.
Laboratories
We commission the services of two screening laboratories - one based in Clifton, New Jersey in the US and the second in the Coombe Hospital, Dublin. Both labs are commissioned to provide the same quality service and involve staff with expertise in the areas of sample handling and data entry, HPV analysis, cytology analysis and reporting. There are around 90 people employed between the two laboratories - medical scientists, consultant virologists, consultant cytopathologists, administrative staff, laboratory aides, laboratory managers, quality managers and ICT managers.
Colposcopy units
Fifteen colposcopy units in acute hospitals around the country are commissioned to provide colposcopy services for women who receive abnormal screening test results that need further investigation. Sample takers refer women to their nearest colposcopy unit. There are 180 staff employed to work in colposcopy units made up of expert medical, nursing and administrative teams. Consultant colposcopists and nurse colposcopists are trained and accredited to practice by the British Society for Colposcopy and Cervical Pathology.
Histology units
This is a diagnostic service supporting colposcopy services. Histology units look at tissue samples if a biopsy is taken in colposcopy. This sample is then transferred to the local histology laboratory for analysis and reporting. These teams are not designated solely for CervicalCheck programme work as they provide many other services to their host hospitals. Histology teams consist of medical doctors, specialist medical scientists, laboratory aides and administration support.
Quality assurance
Quality assurance in screening is carried out to check the quality of our programme, ensure compliance with the standards and support the service to improve quality. Specific quality standards and requirements are set out and must be met for each part of the cervical screening programme. Standards are monitored by a Cervical Screening Quality Assurance Committee.
CervicalCheck is also supported by our corporate business functions in Dublin including our public health, client services and communications teams, our programme evaluation unit, our quality, safety and risk team, human resources and finance teams, and our strategy, business and projects team.
There are a lot of moving parts to delivering the cervical screening programme which need to be working in the same direction, at the right time, to provide a high-quality caring and compassionate service to thousands of women annually. Every year, we estimate the number of women who will attend cervical screening. This helps us to ensure we have the clinical capacity to provide the services across the screening pathway. We encourage women to book their cervical screening when they receive their invitation letters so that clinical services can be delivered a timely manner. Women can also check the register to find out when their next screening is due.