Cervical Screening


Bristol North Somerset and South Gloucestershire CCG Research Capability Funding (Local development).

What is the research question?

What is the impact of a lateral approach testing procedure on improving engagement with cervical screening?

What is the problem?

Cervical cancer screening programs are effective at identifying the presence and increased risk of cervical cancer. However UK screening rates are falling. The NHS Long Term Plan and Quality Outcomes Framework both target increased screening rates, to >75% of those eligible. Locally BNSSG achieve 71.9% of the age group most at risk and are ranked 101st out of 209 CCGs in England.

Women do not attend screening for various reasons, but many cite the discomfort and indignity of procedures as reasons for non-attendance. Traditional testing is undertaken with the patient in a supine position. An alternative, used in some parts of the world is to undertake the procedures with the patient lying on their left side.

In the UK, the supine procedure remains the primary approach, but as of this year Public Health England suggest that women should be given both options.

What is the aim of the research?

The aim of the research is firstly to carry out further investigation, leading to the development of an NIHR application for a research study. However, ultimately to determine whether it is worthwhile to offer patients a choice of alternative screening techniques and whether this may increase attendance rates, resulting in earlier identification, enhanced survival rates and reduction of healthcare treatment costs and in health inequalities.

How will this be achieved?

Initially, a scoping review will be undertaken to help formulate the background information for the subsequent NIHR application. In addition, a survey of Practice Nurses will seek to gain a better understanding of current practice; competency in alternative positioning; clinical reasoning regarding positioning; and learning needs for practice change. A consultation meeting with Staffordshire Practice Nurses forum will discuss the project

Consultation with patients (ideally from a range of ethnicities) regarding the need for this research will also be undertaken and the study team will be further developed to prepare and undertake the NIHR application.

The eventual research study is anticipated to comprise of 3 workpackages covering qualitative interviews with Practice Nurses, a co-designed training package and pilot implementation and evaluation.

Who is leading the research?

Professor Nicola Walsh, Professor of Knowledge Mobilisation and Musculoskeletal Health

Further information:

About Professor Nicola Walsh

For more information or to get involved in this project, please contact bnssg.research@nhs.net