COVID-19 and cervical screening

This information is for primary care professionals, including sample takers and reception staff.

The current COVID-19 pandemic has had an impact on routine cervical screening appointments and how patients feel about going to their GP surgery or clinic.

How has cervical screening been impacted?

Scotland, Wales and Northern Ireland all officially paused routine cervical screening appointments when COVID-19 first hit in March 2020. Cervical screening wasn’t officially paused in England, but invites did stop for a period and appointments were delayed.

Even though cervical screening has now started again, there may still be delays in patients being able to access appointments. Some patients due for cervical screening may be waiting for an invitation or be expected to rearrange themselves. In some areas, non-routine cervical screening appointments are being prioritised.

How has this affected patients?

Understandably, some patients are worried that postponed appointments may have an impact on their health. You may be dealing with patients who have had a previous HPV or cell changes (abnormal cells) and are waiting for follow-up appointments. Some patients are also worried about getting COVID-19 or putting too much pressure on the NHS.

If a patient has made a decision not to attend cervical screening during the COVID-19 pandemic, as always this is their choice and must be respected. However, if they want to attend but feel scared or paralysed because of everything that is going on, you can take several steps to support them.

What you can do

Make sure patients know they can book in for cervical screening

Patients may have heard that cervical screening was paused, or had appointment cancelled, so there may be some confusion about what is happening now. If you’re offering appointments, let your patients know.

You could think about communicating with patients via text messages, emails, letters and notices on websites. Make sure to tell patients if and how to book an appointment – for example, if a previous appointment was cancelled, do they need to reschedule or will you rebook them in?

If your practice is offering limited appointments, make sure you know about alternative clinics and practices where patients could go for cervical screening, if they wish to. It’s especially important reception staff have this information to hand, as you may be getting more calls than usual.

Make sure patients know they should book appointments for symptoms

Whether or not you are able to consistently offer cervical screening, it is important that your patients understand they can and should contact you about symptoms.

You could consider sending out our symptoms of cervical cancer video to patients by email or text, or even host it on your website.

Remind patients about COVID-19 safety measures

You can reassure patients you’re taking COVID-19 seriously by:

• outlining the safety measures your surgery is following
• reminding patients what they will need to do at the appointment.

Remember that cervical screening can bring up a lot of anxiety and part of that can be the unknown. It can be very reassuring for patients to know what might be different during the pandemic – for example, they may have to wait outside before their appointment, and staff will be wearing PPE. You can also explain that what happens in their appointment will be the same as usual.

Read our good practice guidance for cervical screening >

Train all staff on possible barriers to cervical screening

The usual barriers to cervical screening haven’t gone away – they will still affect patients. But COVID-19 may have made some of them worse – for example, if someone is anxious anyway, the pandemic could make them more anxious than usual. Ensuring staff understand the fears and concerns around screening can help them support patients who want to attend appointments.

Read about barriers to cervical screening >

Help patients who need a chaperone or extra support

COVID-19 guidelines may mean a patient can’t have a friend or family member with them. But you could offer alternatives – for example, a member of staff could act as a chaperone.

Consider communication issues

Face coverings and PPE can make it more difficult to build a relationship with patients. Patients won’t be able to see your facial expressions as well and may not be able to understand what you’re saying clearly, particularly if they are hearing-impaired or don’t have English as a first language.

If a patient needs a translator, make sure they know this is still available both in person and over the phone.

Think about how you can make communication and establishing a relationship easier. Some professionals wear a lanyard with a photo of their face, so patients can see what they look like under the PPE. Or you might consider creating and using flash cards, as well as speaking.

Look after vulnerable patients

If a patient is in the extremely clinically vulnerable category – and at higher risk of becoming seriously ill with COVID-19 – they may be especially concerned about coming in for cervical screening.

Make sure you understand their individual circumstances, so you can help them weigh up the benefits and the risks. It may be appropriate for them to take advice from their dedicated healthcare team, depending on why they are classed as extremely clinically vulnerable.

If it is not appropriate for them to come for an appointment at the moment, you can reassure them by explaining that HPV and cervical cell changes (abnormal cells) usually take between 5 and 20 years to develop into cervical cancer – and, in the majority of cases, won’t develop at all.

Let patients know about results

Some cervical screening labs are also being used for COVID-19 tests. As testing increases, cervical screening results may be delayed. Find out what is happening in your area and let your patients know – it’s one less thing for them to worry about.

Encourage patients to seek support and information

Patients may want to get information or support from a source outside of the GP surgery or clinic – it can sometimes be easier to talk to a stranger. You can give them our free Helpline number on 0808 802 8000 or signpost them to our website.

Read our 10 tips for communicating with patients during COVID-19 >