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STATEMENT FROM THE NATIONAL CANCER SCREENING SERVICE REGARDING COLPOSCOPY SERVICES

The National Cancer Screening Service (NCSS) is responsible for the implementation of CervicalCheck - the National Cervical Screening Programme. Colposcopy services are an integral part of a population based screening programme.

A colposcopy service is not a cancer service. Colposcopy services are provided as a dedicated number of hours / sessions within the wider gynaecology clinic.

The NCSS has not removed the colposcopy service at Letterkenny General Hospital (LGH). The LGH service has not been identified as a service to initially support the CervicalCheck programme. The NCSS is in dialogue with LGH regarding this.

Of the expected 300,000 women to be screened annually, approximately 2-5% will require access to colposcopy services. Women that have precancerous cell changes detected by their smear test are referred for colposcopy.

One of the reasons for establishing a national, population based, cervical screening programme is to end opportunistic and excessive screening and ensure women are screened at the appropriate intervals. To date, much screening has been carried out on an ad hoc basis and women have been subject to unnecessary investigation (including colposcopy) and treatment.

The NCSS is making a significant investment in colposcopy services to enhance the service delivered to women and ensure timely access to a quality assured, standardised colposcopy service for those women that require further investigation.

The roll out of CervicalCheck has provided an opportunity to focus on the development and organisation of colposcopy services in Ireland. To date, women have been offered varying structures and processes of care in addition to sometimes lengthy waiting times. The purpose of identifying and investing in these colposcopy services to initially work with CervicalCheck is to guarantee that any woman that needs a colposcopy can access a quality assured, standardised service of care that ensures structured follow-up treatment and access within an agreed timeframe, regardless of which location she is referred to.

In preparation for the launch of the National Cervical Screening Programme, the NCSS, in cooperation with the National Hospitals Office (NHO) of the HSE, completed a baseline analysis of existing colposcopy services in Ireland. This service by service analysis examined facilities, staffing, systems management, information management, information technology and governance. Key to colposcopy service provision is to ensure that as part of the Programme women can access colposcopy services within international best practice timeframes; the adherence to quality assured clinical practice and the achievement of best clinical outcomes for women.

Existing services are at different stages of operational development and accordingly on the basis of this analysis, 11 services have been initially identified as most prepared to receive referrals from CervicalCheck - The National Cervical Screening Programme.

The colposcopy service at Letterkenny General has not been identified for initial referrals of women, however in the interim the service will continue to provide colposcopy services to women already attending or awaiting colposcopy.

The feasibility and provision of additional colposcopy services to women in the North West is also being examined. The colposcopy service at LGH requires a number of enhancements to meet the quality assurance standards defined by the NCSS. Accordingly, the NCSS is currently working with Letterkenny General Hospital to examine the issues together.

The NCSS will be responsible for the monitoring and audit of colposcopy services to ensure the quality assured standards (based on those defined by the Royal College of Obstetricians and Gynaecologists) are adhered to.

It is not considered appropriate for the NCSS to enter into public debate or dialogue  with outside parties at this time.

 

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