Calls have been made for a rapid overhaul of the system which manages cervical cancer screenings in Scotland.
A review of screening services, commissioned by the Scottish Government, has identified weaknesses in the way the system manages exclusions from regular tests.
It comes after an audit identified two women were mistakenly excluded from the national screening programme and subsequently developed cervical cancer.
Both women had undergone a subtotal hysterectomy and had been excluded from further tests in error.
Cervical screening looks for the presence of the HPV virus in the cervix, which causes 99% of all cervical cancers, and women aged between 25 and 64 are supposed to be routinely offered screening every five years.
However, following the review the charity Jo’s Cervical Cancer Trust has now called for an overhaul of the current system in which women can be legitimately excluded from screening for a number of reasons.
The focus of the review, carried out by Healthcare Improvement Scotland, was on how the system inviting women to be screened manages exclusions to identify where improvements can be made.
The team looked at more than 2,000 documents and held focus group meetings with a range of people involved in all aspects of the cervical screening programme.
The review observed a “very committed workforce” but also identified “longstanding weaknesses” in the management of exclusions and what was termed as “a failure to fully recognise the risks” relating to exclusions.
It made 18 recommendations on how to improve the system, including a review and revision of the nationally agreed procedures for cervical screening and putting in place “a clearly documented process” for the management and application of exclusions.
The review also recommended a review of national governance arrangements for cervical screening “as a matter of urgency to ensure they are robust, responsive and person-centred”.
It further recommended the implementation of a formalised quality management system to support “a consistent and co-ordinated approach to delivering high-quality cervical screening services”.
Iona Stoddart, deputy head of information and engagement with Jo’s Cervical Cancer Trust, said: “This report is very welcome and the recommendations will ensure the programme is more suited to individual patient needs, and is as effective and safe as possible.
“We urge for them to be swiftly implemented. Cervical screening can stop cervical cancer before it starts so it is an incredibly important test.”
Dr Karin Denton, the independent chair of the review, said: “It’s important that confidence in the system for calling women to be screened remains high.
“Our review identified a hard-working and committed workforce, but also long-standing weaknesses in the system that need to be addressed to ensure that everyone eligible for a cervical screening test is called.
“We are confident that the recommendations in this report, if implemented, will help to ensure that the system meets the needs of women in Scotland.”