Good practice for cervical screening

This page is aimed at primary care staff, including sample takers and reception staff. It may also be useful for other healthcare professionals.

Although cervical screening is often described as a quick and simple test, at Jo’s Cervical Cancer Trust we know that many women and people with a cervix don’t find it easy. In fact, some can find it painful, invasive or traumatising.

The role of the sample taker and other primary care staff that patients will meet cannot be overstated. You can create an environment that is welcoming, supportive and where the patient feels in control.

On this page:

• Before the appointment >
• During the appointment >
• After the appointment >
• Useful resources >

Before the appointment

If the patient calls to book an appointment, you should:

• check whether this is their first cervical screening or if they have been before
• ask whether they have any questions about the appointment
• ask whether they would benefit from a longer appointment (if your surgery can offer it)
• ask whether they want to bring or have the surgery provide a chaperone
• ask whether they would benefit from an interpreter
• suggest that some patients find it more comfortable to wear a skirt or bring something such as an extra shirt to cover up
• tell them anything they need to know – for example, the COVID-19 safety measures that are in place are your surgery
• remind them that they can call back if they think of more questions.

If they book an appointment online, it is good practice to email them with any essential information and to check whether they have questions. 

When the patient checks in

Some patients will be uncomfortable with the idea that they are coming in for cervical screening. When they check in, don’t push them to disclose which appointment they are there for.

Remember that some patients may also disclose, verbally or non-verbally via a written note, something that makes cervical screening difficult for them. If this happens, pass it on confidentially to the sample taker in order to ensure the right person has this conversation with the patient.

During the appointment

COVID-19 safety measures may mean your usual routine for patients arriving at the surgery looks different. While this may make creating a welcoming environment more challenging, you can still make sure the patient feels at ease once they are invited into the examination room. 

Get the room ready

Before the patient arrives, make sure:

• the room is set up and ready
• you have the equipment to hand.

Welcome the patient

Once you have greeted the patient:

• remind them that the appointment is confidential 
• check Open Exeter or SCCRS to establish their identity and check they are due for cervical screening.

Establish rapport

It can be tempting to launch into the test straight away, but remember that cervical screening isn’t a regular thing for patients. Here are our tips for putting patients at ease:

• thank them for coming to the appointment
• ask them how they are or how their day has been
• be friendly, both verbally and visually – a smile can go a long way
• tell them how long you’ve been a sample taker for – this can subtly reassure patients who feel embarrassed or worried about a gynaecological test
• be mindful of the language you use  – don’t make assumptions (for example, use ‘partner’) and try not to use medical words.

Read about communicating with patients >

Check knowledge and understanding

The patient needs to make an informed decision to have cervical screening. As part of that, you need to make sure they understand the test. You can ask questions and use their answers to adapt how you support them.

Check preferences

• ‘Do you want a chaperone?’ It’s good practice to check, even if reception have already asked. If the surgery usually provides a chaperone for intimate examinations, you will need consent from the patient for this. 
• ‘Do you want the door locked or unlocked?’ Patients may feel safer or more at ease with one option over another.  
• ‘Do you want to see the speculum and brush?’ Seeing or touching the equipment can help patients feel more in control and prepared.
• ‘Would you prefer a different size speculum?’ If the patient wants to see the equipment, check which speculum size is best for them.
• ‘Do you want to put the speculum in yourself?’ This will not affect the test result and can give the patient more control over the test.
• ‘Which position would you like to be in?’ Patients may prefer to be on their back or in the left lateral position.

Taking the test

Give the patient privacy to change and cover themselves with a paper or plastic sheet, or something they have brought from home.

It is good practice to explain every step of the test and get consent before you do it. Here are our other tips:

• Remind the patient that if they are uncomfortable or in pain, you can stop. The patient may not feel able to say this, so look for visual or verbal cues too.
• Don’t react to the patient’s genitals. This may sound obvious, but it is possible you could meet someone who has experienced female genital mutilation (FGM) or has a condition.
• Remove speculum as soon as the test is done – don’t leave it in while you sort the sample or start post-test admin.

Make time after the test

After the test, give the patient privacy to change again. Once the patient is ready:

• invite them to come and sit with you at the desk
• ask if they are okay – some patients may benefit from a glass of water or boiled sweet if they are feeling shaken
• ask whether they have any immediate questions.

Everyone reacts to cervical screening differently. Be prepared for some patients to need more time or space to process what has just happened.

Explain possible results

Patients will receive results via letter to their home address, so need to understand the possible results beforehand. You should use this time to explain the different results and what they mean.

At the moment, patients may be particularly worried if they get an HPV result. You should explain the switch to HPV primary screening and tell them more about HPV. 

Read Jo’s Cervical Cancer Trust's CPD-accredited article about how to discuss HPV with patients in primary care >

Tell patients when they can expect to receive their results. If there are delays in your area, let them know.

Download cervical screening pathways for:

• England and Wales >
• Scotland >
• Northern Ireland >

Signpost to information and support

Jo’s Cervical Cancer Trust and the NHS in England, Scotland, Wales and Northern Ireland have reliable, patient-centred information about cervical screening and results.

Visit our patient-facing cervical screening information >

After the appointment

Make sure the sample pot is labelled correctly, to avoid patients having to come back for a repeat test. You may need to be more specific in your labelling for some patients, including trans men and/or non-binary people.

Follow up with patients

Research suggests that patients who are less educated are more likely to miss follow up appointments, such as colposcopy. You play an important part in educating patients about HPV and abnormal results, which may lead to increased attendance at follow up.

We recommend following up with patients who have any kind of abnormal result – HPV, cell changes or both. After you receive the results at your surgery, it is best to wait 3 working days to contact the patient.

You could ask:

• Have you had your results yet?
• [If yes] Do you have any questions or worries about your results?
• Do you understand what the next steps will be?

We know that patients may initially react with worry at being called about results. However, your purpose is to reassure them, help them understand the results, and be a presence that can offer support.

Useful resources

• Our good practice guidance – 10 top tips (pdf) >
• Our cervical screening checklist (pdf) >
• Public Health England – Cervical screening: cervical sample taker training >
• Public Health Scotland – Cervical Screening Toolkit (pdf) >
• Cervical Screening Wales – Sample Taker Reference Guide (pdf) >
• Public Health Agency – Northern Ireland Standards for Nurse and Midwife Education Providers: Cervical Screening Sample Taking (pdf) >

August 2023 - Please be aware that this information for health professionals is currently undergoing regular review in line with our editorial policy. However the information remains valid.