Implementation of Primary HPV cervical screening in England

The announcement by NHS England (NHSE) that Primary HPV testing within the NHS Cervical Screening Programme will be implemented fully across England by the end of December 2019, and that to support this, the agreement of a strategy to commission up to a maximum of 13 laboratory services, was made in late 2017.

NHSE called a stakeholder meeting in early February that was attended by the BAC, IBMS and other stakeholders, where further information and detail on the timescales and processes for this was shared:

• A national service specification is currently being drawn up by NHS England which will include the laboratory aspects of the new service.
• NHS England indicated that the procurement process for the new service will be a two stage process; the first stage being a National Framework of providers, from which regional NHS England teams will draw down from and run the second stage of the process via regional mini-procurement exercises.  NHS England local commissioning teams are currently defining the ‘lots’ to be procured which may involve the retention of existing boundaries, or may require some variation to allow for viable laboratory services.
• A series of regional market engagement events are planned for early in the 2018/2019 financial year, at which NHS England will outline the procurement process and seek engagement with potential providers of services about what is to be procured.  The intention is to ensure contracts can be awarded by the end of 2018, with contracts commencing in the financial year 2019/20 ensuring that full national coverage of HPV Primary Screening across England is achieved by the end of December 2019.
• The tendering process will involve the familiar OJEU approach, and NHSE encourage trust contracting departments and laboratory managers to look out for this when it is formally advertised. The first step of the procurement process will be for potential providers to bid to get onto the National Framework, and only those providers on the National Framework will then be able to bid for the tenders once the regionally-led second stage of the process begins.
• Tenders at both the national and regional stages of the procurement will be evaluated against a set of criteria.

NHS England has established an internal HPV Procurement Board to oversee this work and workstreams covering elements such as IT systems, transport and logistics, laboratory footprints and finance are already in place.

During this whole process laboratories will need to deliver the Cervical Screening Programme to existing standards, and whilst existing mitigation plans may already have aided this to a degree, both the mitigation process and monitoring of laboratory performance remain under review.

NHSE acknowledged that laboratory staff will naturally have many concerns about their uncertain future during this implementation period.  NHS England confirmed that national TUPE regulations will apply to any procurement undertaken to support the delivery of the HPV primary testing within the Cervical Screening Programme. Laboratory staff who may be affected by this process should seek advice from their internal HR departments and/or their unions as appropriate.

NHSE has also indicated their intention to provide reliable communications to professional groups, cancer charities, laboratories and local commissioners during this process. This will be primarily via the PHE screening blog and existing communication channels between local commissioners and providers. Face to face meetings between organisations may also take place at key stages in the process.  

Both the IBMS and BAC have offered to provide advice and expertise to the procurement process where appropriate, with the aim of ensuring a well-managed, safe and robust implementation process for all involved including staff and service users.   

Allan Wilson,  IBMS Council member and lead for cytology said:  

“This is obviously a very worrying time for all staff working in cervical cytology labs across the UK. The Institute is committed to working with PHE and other professional bodies to offer support to staff who are concerned about future roles. It is vital that we support all staff through this difficult period as the programme depends on the current staff to deliver the cytology service before the introduction of primary HPV screening. 

The Institute will continue to engage with PHE to minimise the impact on both the screening programme and on the staff who work in cytology labs across the UK”