NHS Calderdale and Kirklees Cervical Screening GP Registrars Training Information.
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Transcript of NHS Calderdale and Kirklees Cervical Screening GP Registrars Training Information.
NHS Calderdale and Kirklees
Cervical Screening GP Registrars Training Information
Topics to be covered:• Cervical screening programme basics• Training guidance and further resources• Responsibilities as sample takers• Responsibilities as employers• Quality/safety – Incidents• Local Pathway• Cervical Sample Taker Database (CSTD)• Monitoring Performance
Cervical Screening Programme Basics
• The programme covers women age 25-64
– 25-49 every 3 years– 50-64 every 5 years– 65+ only if not screened since 50 or had recent
abnormal tests
The majority of cervical screening samples are taken in primary care
Useful Websites
• Quality Assurance Reference Centre (QARC)http://www.neyhqarc.nhs.uk/
CervicalScreening/RegionalProtocolsandGuidance.aspx
• NHS Cervical Screening Programme:http://www.cancerscreening.nhs.uk/cervical/index.html
Update training
Components• E-learning – accredited package• Localisation training
Specific event Optional visits to the care pathway
• Annual review of audit data Inadequacy; abnormality; TZ rates
NHSCSP publication 23: Taking Samples for Cervical Screening (April 2006):Training requirements for medical and nursing professionals are equivalent. “Sample takers should undertake a minimum of one half day’s update training every three years.”
NEYH Sample Taker Training Guidance (July 2012):“All sample takers in in the NEYHQARC region irrespective of their place of work and job description are required to adhere to the requirements of this training guidance”
E - learningThis course covers theoretical information - but it doesn't guarantee clinical competence.
http://www.nwyhelearning.nhs.uk/elearning/yorksandhumber/shared/cervical_sample_taker/Preview/index.html
HPV e-learning module
• An e-learning course has been developed, which takes approximately 30-45 mins to complete:
http://www.nwyhelearning.nhs.uk/elearning/Shared/HPV/HTML/Published/WEB/COURSE/SHA-HPV.html
• Following completion of the course sample takers can take an assessment by following this link:
http://www.nwyhelearning.nhs.uk/elearning/Shared/HPV/HTML/Published/WEB/ASSESSMENT/assessment.html
Responsibilities of Sample Takers, Employers and Sample Taking Co-ordinators
http://www.neyhqarc.nhs.uk/LinkClick.aspx?fileticket=jLc8oXXJ1o8%3d&tabid=93&portalid=0&mid=923
“All screening programmes do harm: the challenge is to ensure that
programmes are implemented in such a way that they do more good than
harm at reasonable cost”
Raffle, A. & Gray, M. (2007) Screening: evidence and practice. Oxford University press
Quality/Safety and Incidents
Essentials
• High coverage of the population (80% or more) • Well trained professionals • High quality cervical sample taking • High quality cervical sample analysis • Evidence-based, high quality treatment and
clinical management • Efficient failsafe systems for all elements of the
pathway
Err on the side of caution…
• Inform / discuss with the Screening Manager / Co-ordinator
• The QARC should be notified within 24 hours of any problem which may be a suspected Serious Incident
• The responsible person in the provider/PCT should complete the template form
Incidents in primary care
• Incorrect method (e.g. not including the brush head in the pot due to being trained in a different technique)
• Incorrect use of screening e.g. sample-taking when visible cancer on the cervix
• Using out of date vials• Taking samples without training or a code• Employing an untrained sample taker• Incorrect labelling of samples / not matching with
forms• Code-sharing• Poor technique e.g. not visualising cervix
Local pathway
Overview
Pathway & players
Call/recallGeneral
practice, hospital or community
clinic
CytologyColposcopy
Treatment
WYCSA
Laboratory / WYCSA
Colposcopy clinic
Woman receives invitation
Woman registers with GP
Woman has cervical sample
taken
Sample sent to laboratory
Result sent to woman & sample takerWoman invited for
colposcopy
Woman invited for treatment
CERVICAL SAMPLE TAKER DATABASE
www.cstd.neyhqarc.nhs.uk
Cervical Sample Taker Database• Web based database - register of all the sample takers in the North East,
Yorkshire and the Humber• Performance management tool (results of samples, reports on
performance)• Cervical sample taker training record tool• Local training days and events in your area advertisement• National, regional and local cervical screening guidelines and protocols
held• All sample takers need to obtain a new cervical sample (smear) taker code
to replace their existing code• A NEW CODE WILL NOT AUTOMATICALLY BE SENT TO YOU!• The new code will begin with a letter followed by four numbers e.g. A0001• Access will be given to the Cervical Sample Taker Database
• QARC REQUIRE ALL SAMPLE TAKERS TO BE REGISTERED BY END SEPT 2012
How to get a new sample taker code
CSTD Links
For the sample taking coordinators to register and to add sample takers:
www.cstd.neyhqarc.nhs.uk/admin
For sample takers:
www.cstd.neyhqarc.nhs.uk
Sample Taker Performance
Sample Taker Performance• Audit of inadequates, TZ rate (women under 50) and
abnormals by QARC
• Monthly download
• Use lab data toProduce funnel plot
• RAG rated (how nearto lab average)
Sample Taker Performance contSample Taker Code Sample Taker Inadequate % RAG Rating
Example 1 1.25% Green
Example 2 7.50% Red
Sample Taker Code TZ % RAG Rating
Example 1 80.00% Amber
Example 2 90.00% Green
Sample Taker Performance cont• ‘A Guide for Practices and Sample Takers to UnderstandingSample Taking Performance Data’ http://www.neyhqarc.nhs.uk/LinkClick.aspx?
fileticket=FCelRX1QH3A%3d&tabid=289
• If RED – recommend looking at data in more depth. QARC/PCT can support this. They may recommend an internal WASP assessment should take place.
http://www.neyhqarc.nhs.uk/LinkClick.aspx?fileticket=sLuhQAYqREg%3d&tabid=93&mid=923
• Practice responsibility to ensure staff are competent
TZ Rates
• Good technique:
– Get a good view of the cervix– Anchor the brush in the os– 5 clockwise turns with firm pencil pressure
For further informationCalderdale & Kirklees Cervical
Screening Programme & NHS Calderdale
Dr Jill FarringtonDistrict Coordinator / Consultant in Public Health Medicine01422 [email protected]
Sharron McMahonPublic Health Screening Manager01422 [email protected]
Sarah JanuszczykPublic Health Secretary01422 28 [email protected]
NHS Kirklees
Dr Mercy VergisConsultant in Public Health01484-464236 (PA)07904-194321 [email protected]
Finally...
Any Questions?