Cervical Screening: National and Local Perspectives
The first stage of this project has focused on expanding our research into local women's experiences of cervical screening to produce a comprehensive view of the Redbridge perspective.
The National Perspective
In 2023, NHS England set a target to eliminate cervical cancer by 2040. It's an admirable but challenging goal, set against declining levels of uptake by women of cervical screening over the past 20 years.
In response, we launched research to investigate why some women are hesitant to go for screening, to make recommendations to policymakers on how to improve uptake and to help meet the elimination goal.
Healthwatch Redbridge supported the Healthwatch England national review by interviewing seldom-heard women about the barriers they faced when accessing, or seeking to access, cervical screening locally.
Key findings
- The top reasons for hesitancy among respondents were worries about physical discomfort, embarrassment at undressing in front of healthcare professionals and a belief they didn't have to go because they weren't currently sexually active.
- Women felt NHS information describing the purpose of cervical screening was good/clear (78%), but fewer (58%) said it explained Human Papillomavirus (HPV), the leading cause of cervical cancer.
- Some women didn't receive accessible or translated information to enable them to understand the invitations and make an informed decision about attending screening.
- Most women (81%) who'd attended screening previously said staff treated them with respect. However, only a third (33%) felt they'd been able to ask staff for practical changes that could make them feel comfortable in appointments.
- There was strong support (73%) for home testing – currently being considered as an option by screening experts - if it was offered free on the NHS.
- There are major gaps in national data on the diversity of women who attend cervical screening.
- In-depth interviews with women provide examples of innovative practices that improve uptake among diverse women.
The Redbridge Perspective
Healthwatch Redbridge supported the Healthwatch England national review by interviewing seldom-heard women about the barriers they faced when accessing, or seeking to access, cervical screening locally.
The insight we gained from these local experiences motivated us to undertake an extended Women's Health Project. By connecting with women through local community organisations and groups, we increased our interview pool from 3 to 47.
Key findings
- Invitation to screenings via GPs - Many women told us they were invited for cervical screening; African/African Caribbean (63%), Romanian (66%), Somali (75%). Other women reported lower responses, Bengali (44%), Learning Disabled (LD) (25%) and wheelchair users (40%). However, Bengali women (22%) reported they were only invited after giving birth.
- Translated Information - African/African Caribbean (36%), Bengali (22%), Romanian (66%), and Somali (41%) women stated they would want information in their own languages so they were more informed about the procedure and could make informed choices.
- Improvement to the provision of information - Over half of women (55%) from the LD community and wheelchair users reported a lack of accessible information.
- Speculum Sizes - A third of all women interviewed (34%) reported that they had no idea about the range of speculum sizes available which could improve their overall screening experience.
- Accessibility - Many wheelchair users reported a lack of reasonable access within practices and a lack of understanding of their conditions when communicating with health professionals. One woman reported that due to the lack of an accessible venue with an appropriate examination table, she was misreported as refusing screening on several occasions, although she had consistently requested an appointment.
- Health Literacy - Most (91%) participants reported that health literacy was an issue, such as not knowing what HPV was or what the screening would look for.
- Patient experience - Some individuals reported services having a poor approach to culturally sensitive beliefs and practices, and trauma informed care/FGM.
- Home Testing Kits - Many participants (39%) reported they are willing to use home testing kits when they are rolled out by the NHS.
Downloads
Our full report detailing our findings and recommendations will be available over the coming months.
To find out more about our ongoing Women's Health Project contact Rafat Kiani.
