1. Key Information About CervicalCheck for Non-medical Staff in Primary Care

2. Presentation Objectives To give an overview of how the Programme works To outline the role of receptionist/practice administration staff in relation to CervicalCheck To deliver key Programme messages including the call, re-call process

3. ‘Receptionists' work is complex, demanding and intense, involving a high level of commitment to patients, colleagues, and the practice’ Br J Gen Pract. 1999 February; 49(439): 103–106. The receptionist is often the first point of contact people have with an organisation i.e. surgery/CervicalCheck. She/he is responsible for promoting a positive image for the practice First impressions count! Women return to have repeat smear tests when they have had a positive experience That really does start from the moment a woman picks up the phone to the practice to make her appointment … through to the woman getting her results

4. Responsibilities of Receptionist in CervicalCheck Need to be able to accurately/correctly answer queries from clients/patients in relation to the CervicalCheck programme Ensure accurate information i.e. patient’s demographics – contact numbers & PPS No. are maintained and up to date (computer/notes) May include managing administration in office i.e. making appointments, posting smear tests, data entry, payment issues etc.

5. CervicalCheck About CervicalCheck and who is eligible About a smear test The call, re-call process in practice The best time to have a smear test Screening intervals What to tell women when making an appointment Cervical Cytology Form Results Key messages

6. About CervicalCheck CervicalCheck – The National Cervical Screening Programme provides free smear tests through primary care settings to 1.1 million eligible women aged 25-60 CervicalCheck operates an organised call, re-call system of invitation in line with best international practice

7. About CervicalCheck Contd. From 1 September 2009, a woman needs a letter of invitation from CervicalCheck to avail of a free smear test Over the next three years, CervicalCheck will send every eligible woman on the register who has not yet had a free CervicalCheck smear test a letter of invitation by post CervicalCheck holds a register (list) of women aged 25-60 This register is a secure electronic database that contains the name, address, date of birth & PPS No. of women aged 25-60

8. About a Smear Test A sample of cells taken from the surface of the cervix (neck of the womb) which are sent to the laboratory for examination It is a test to detect early cell changes It is not a test for cancer It may detect possible abnormalities, or changes in the cell which may develop into cancer if not found or treated

9. Taking a Smear Test

10. Cervical Check Office Invitation letter Smear test Result letter No abnormally detected result Inadequate / unsatisfactory result Not normal result 3 Consecutive Inadequate ASC-USASC-HLow Grade LSIL High Grade HSIL AGUS/ AGC AGHQuery Glandular Neoplasia Invasion cervix Normal recall Repeat smear Repeat in 6 months Repeat in 6 months 3 ASC-US 2 LSIL or 3 LSIL (10yr) (Conseq) Colposcopy 2 repeat smears in 1yr then annual Histology Normal recall

11. A woman phones you to make an appointment for a CervicalCheck smear test. Ask her if she received a CervicalCheck invitation or re-call letter Yes Woman is eligible for a free CervicalCheck smear test The Call, Re-call Process in Practice

12. A woman phones you to make an appointment for a CervicalCheck smear test. Ask her if she has received a CervicalCheck invitation or re-call letter No The Call, Re-call Process in Practice She may be eligible without a letter in the following circumstances: Women aged 60 and over who have never had a smear test Women of any age post colposcopy Women post hysterectomy in certain circumstances Women aged 20 and over on renal dialysis Women ages 20 and over with HIV infection Women aged 20 and over with post organ transplant Ask the woman if she has had a smear test in the last 3 years Any woman who has not had a smear test in the last three years can opt-in and request an invitation letter from CervicalCheck by registering online at www.cervicalcheck.ie, completing andwww.cervicalcheck.ie returning a Freepost form, or by calling CervicalCheck on Freephone 1800 45 45 55.

13. Is the women due for practice or clinic re-call? Yes Advise those women to: 1.Check they are on the CervicalCheck Register. A woman may register or update her details by: Completing the online registration form at www.cervicalcheck.iewww.cervicalcheck.ie Completing the printed Self-registration form and returning by Freepost. Practices may order forms from Inform Systems – T: 061 33858 Telephoning CervicalCheck (Freephone 1800 45 45 55) 2. Answer ‘No’ to the registration question ‘Have you had a smear test within the last three years?’, so they will be issued with an early letter of invitation 3. Make a cervical screening appointment upon receipt of their letter of invitation Integrating Practice and Clinic Re-call Systems with CervicalCheck

14. The Best Time to Have a Smear Test The best time to have a smear test is between day 10 and day 20 of a woman’s cycle (counting 1 st day of period as day 1) If the woman has stopped having periods (therefore has no periods) any time suitable to both smeartaker and client The smear test takes approximately 15-20 minutes

15. Screening Intervals Women aged 25 – 44 every 3 years Women aged 45 – 60 every 5 years However, all women, regardless of age should have a second Programme smear test after 3 years before going on to age appropriate interval

16. What to Tell Women When Making an Appointment Bring their invitation letter or re-call letter –Bring PPS No. or advise them where they can access it All clinical queries e.g. woman after hysterectomy, abnormal bleeding, etc. should be referred to the Doctor or Practice Nurse

17. Cervical Cytology Form May be hand written or computer generated (Healthone, Helix, Socrates) Ensure correct demographics i.e. most recent name, address, DOB, contact numbers, PPS no. Very important to ensure correct result is tagged to the correct woman Ensure all samples are posted minimum once a week (vial and form in box) Ensure correct number of forms to vials in box and that forms match vials Smeartaker must get consent (not appropriate for receptionist to do so)

19. Information Which Has to be Present for Smear Test to be Processed PPS No. Woman’s demographics (name, address, DOB, phone number) Consent must be signed Smeartaker name & ID number (An Bord Altranais or IMC number) Clinically responsible Doctor’s IMC & GMS numbers

20. Results Results should be seen by the Doctor or/and Practice Nurse Appropriate re-call date entered on computer/notes Results can be scanned and then shredded appropriately Results may be given by letter or phone depending on each individual practice protocol NOT ACCEPTABLE to send laboratory reports to women under any circumstance

21. Additional Information All smeartakers should be registered with the Programme including locum GPs and nurses Registration form available to download from website www.cervicalcheck.ie www.cervicalcheck.ie

22. Information Leaflets & Self-registration Forms for Women Inform Display Systems Ltd. Tel:061 33 85 80 Fax: 061 33 85 84 Email: cervicalcheck@informireland.infocervicalcheck@informireland.info Website: www.informireland.infowww.informireland.info

23. Final Key Messages CervicalCheck offers free smears test to eligible women 25 – 60 in primary care The procedure takes approximately 15-20 minutes The best time to have a smear test is between day 10-20 Refer any queries re bleeding patterns or menstrual cycle issues to the Doctor or Practice Nurse Ensure correct information is on file Record keeping: Result should be scanned and shredded or if manually entered smear test result filed in patient’s notes (legal requirement)

24. Remember If you are unsure of a woman’s eligibility call CervicalCheck on Freephone 1800 45 45 55 Receptionist plays a very important role in ensuring a quality delivered Cervical Screening Programme from the front line Thank you