Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the NHS Digital's publication, Cervical screening programme England 2017-18, published on 27 November 2018, what assessment he has made of the reasons for the change in the number of eligible women taking up such screening in the last 21 years.

NHS England has reviewed the data from 2013 showing the continuing gradual national and international decline in the five-year coverage. Assessments for the decline were done in partnership with key stakeholders Public Health England (PHE) and Jo’s Cervical Cancer Trust.

NHS England hosted a spotlight session in April 2016 which focussed on gaining insight into the reasons why women do or do not attend for screening. This suggested that ease of access together with attitudinal changes to informed choice, may contribute to this widespread reduction in uptake.

Jo’s Cervical Cancer Trust published a report in January 2018 suggesting that some young women did not attend cervical screening appointments because they were embarrassed about their body, while others did not think the test was important and were not at risk because they led healthy lifestyles.

NHS England and PHE have therefore modified the commissioning levers and communication processes, for example through supporting Jo’s Trust in the Time to Screen campaign and the development of a new ‘Be Clear on Cancer’ campaign for early 2019 promoting uptake of cervical screening.

NHS England has supported the Cancer Alliances who bring together local senior clinical and managerial leaders representing the whole cancer patient pathway across a specific geography, and have a general role in improving early diagnosis. In turn they have developed specific plans to improve uptake rates in screening programmes as part of that agenda with cervical screening considered a priority area.

Cancer Research UK and Macmillan general practitioners (GPs) are also being utilised to provide awareness and training, with work and focus groups to target reducing inequalities among women over 50 and women from Eastern European countries a specific focus in one region. The role that sexual health clinics can play in providing access to screening among vulnerable women via an opportunistic offer of screening is being considered.

Training of GP receptionists is underway to improve ease of access to a screening appointment, while a toolkit has been developed to reduce the inequality in uptake among women with a learning disability.

In addition, NHS England recently announced that Professor Sir Mike Richards has been asked to lead a review of cancer screening programmes which will consider ways to increase uptake of cervical screening.