IBMS Response: NI Smear Test Review
In July 2022, senior laboratory staff from the Southern Health and Social Care Trust notified their management team that they had concerns about performance in some steps of their laboratory’s screening system.
To fully investigate these concerns, the Trust commissioned RCPath Consulting to undertake an independent assessment of its cervical screening services from January 2008 to October 2021. RCPath Consulting offers a service to commissioners and managers of pathology services who need an expert, independent view on how pathology and laboratory medicine services should be organised to provide safe patient care. RCPath Consulting is a part of RCPath Trading Limited (a wholly owned subsidiary of The Royal College of Pathologists).
As part of their major review of the cervical screening programme, around 17,500 women in Northern Ireland are to have their smear tests re-checked.
Although the IBMS is still reading the full report in detail, the lapses that have been made public highlight the importance of maintaining a highly trained and qualified workforce in sufficient numbers. It also highlights the importance of delivering diagnostic services within a quality assured framework with good governance.
Work is ongoing to finalise the full introduction of primary HPV testing into the cervical screening pathway in Northern Ireland, bringing the service into line with the other UK nations. This will be a major improvement to the screening pathway and is a key recommendation of the RCPath report.
IBMS Vice President Allan Wilson said:
"A key aim of every cervical screening programme is to minimise the small number of unavoidable false negative and false positive outcomes. Intensive training, regular competency assessment and strict adherence to programme wide procedures and quality control are vital steps to ensure patient safety and reduce incidence and mortality from cervical cancer.
It is vital that screening laboratories work to deliver and maintain the highest possible quality standards. Implementation of new and emerging technologies such as HPV testing and early escalation of issues coupled with robust management action will reduce the risk of incidents that negatively affect patients."
Training a sustainable workforce with the skills necessary to meet current demands is the key to high quality and safe services.
The UK governments must recognise this and meet the key objectives of the IBMS’ Long Term Biomedical Scientist Workforce Plan. This will enable our laboratory professionals to provide the best possible services for our healthcare system and patients.