By Dr Rachael Comer, Education and Training Manager, CervicalCheck
For some women, attending cervical screening can be difficult. Access issues, previous negative experiences, anxiety, trauma, or believing screening is no longer needed after menopause can all become barriers to taking part.
To help reach more women, particularly those who may never have been screened before or who attend screening less often, we’ve been working with ambulatory gynaecology services across Ireland to make cervical screening part of routine care in these settings.
This work is led by the CervicalCheck Screening Training Unit (STU), in collaboration with the National Women and Infants Health Programme (NWIHP) and ambulatory gynaecology teams nationwide. Together, we are helping to create more opportunities for women to access screening in a familiar, supportive healthcare setting.
Why this work matters
We provide free HPV cervical screening for women and people with a cervix aged 25 to 65 who do not have symptoms of cervical cancer.
While participation in cervical screening is high among younger women, attendance drops with age. Around 1 in 4 women over 50 do not attend screening, and more than half of cervical cancers occur in this age group.
There are many reasons why women may not attend screening regularly.
Some women:
- find it difficult to get a GP appointment
- experience discomfort during screening
- have had previous trauma or negative healthcare experiences
- believe screening is no longer necessary after menopause.
Ambulatory gynaecology clinics provide assessment and treatment for women with gynaecological symptoms, where speculum examinations are already a routine part of care. This makes them an important opportunity to offer cervical screening to women who are overdue for screening or who may never have been screened before.
By integrating screening into these services, we’re helping to make screening more accessible and improving opportunities for earlier detection and prevention of cervical cancer.
Making screening part of routine care
Our aim was to integrate opportunistic cervical screening into ambulatory gynaecology services in a safe, consistent way, supported by clear clinical governance.
To do this, we worked closely with ambulatory gynaecology teams across the country to understand existing practices, identify barriers, and support services to introduce or strengthen cervical screening within their clinics.
Key actions included:
- mapping all 20 ambulatory gynaecology services to understand current screening practices
- engaging with Registered Advanced Nurse Practitioners (RANPs), Consultants and Clinical Nurse Managers to assess readiness and training needs
- supporting access to the Cervical Screening Education Programme and Clinical Update training
- providing tailored educational resources and support to services moving to nurse-led models of care
- introducing unique ambulatory gynaecology clinic codes to support traceability, quality monitoring and evaluation.
This collaborative approach helped ensure that women attending ambulatory gynaecology services could be offered cervical screening as part of their care journey, rather than needing a separate appointment elsewhere.
Improving equity and access
At the centre of this work is a focus on equity and accessibility.
For women who may not regularly engage with screening services, offering screening during an ambulatory gynaecology appointment can remove practical and emotional barriers. It can help women feel more supported and comfortable, particularly when they are already receiving care from a trusted healthcare team.
It also helps ensure that cervical screening remains part of conversations across multiple points within the health service, strengthening links between women’s health services and CervicalCheck.
The impact so far
The work has already had an impact across Ireland.
In 2025:
- 18 ambulatory gynaecology services actively offered cervical screening to women overdue for screening
- 2,242 screening tests were carried out across ambulatory gynaecology and gynaecology outpatient services
- 355 sample takers were registered across ambulatory gynaecology and gynaecology outpatient services
- 108 women were referred to colposcopy following screening.
These figures reflect growing integration of cervical screening into secondary care settings and increased opportunities for women to access screening.
Looking ahead
Integrating cervical screening into ambulatory gynaecology services is an important step towards making screening more accessible, equitable and person-centred.
By embedding screening into routine care pathways, CervicalCheck and its partners are helping ensure that every contact counts - creating more opportunities for women to access potentially life-saving screening in settings where they already receive care.
This work supports Ireland’s vision to eliminate cervical cancer by 2040, by helping to reach more women with safe, compassionate and accessible care.