National Cervical Screening Programme Sector Update - July 2022
Kia ora koutou
Around 80% of people who develop cervical cancer in New Zealand have either never been screened or have been screened infrequently.
That powerful statement is contained in the new Draft NCSP Clinical Practice Guidelines for Cervical Screening in New Zealand that are being circulated among health professionals for feedback from sector groups.
It is a timely reminder of why cervical screening is so important, if New Zealand is to achieve the World Health Organisation’s global strategy to accelerate the elimination of cervical cancer as a public health problem by 2030.
We can only do this by improving access and opportunities that support getting more participants into our cervical screening programme, and by reinforcing the key message that HPV vaccination combined with screening provides the best protection from cervical cancer.
The first line of defence against cervical cancer is prevention by safe, effective and proven HPV immunisation which is free for all people from ages 9 to 26 years old. The second line is maintaining regular cervical screening.
With the transition to HPV Primary Screening, we are aiming to bring more participants into the screening programme. Until then, please reinforce these key messages, and encourage participants to continue their regular screens.
What’s happening in the NCSP
Cervical Screening Media Campaigns
The NCSP’s two Māori and Pacific social marketing campaigns to promote a safe return to cervical screening after the disruptions caused by COVID-19, are getting closer to going live.
Content is being developed in partnership with Māori and Pacific Campaign Advisory Groups (CAGs) to encourage and empower wāhine Māori and Pacific people to get their cervical screen.
These have been designed with Māori and Pacific creative agencies and separated out into distinct campaigns.
The Māori-focused campaign will be launched this month, followed by the Pacific-focused campaign later in the year.
We will look to share these videos with the sector soon, before they go live for the public. The CAG members are keen to take part in sharing the story of how the campaign came together and tell of the partnership approach and collaborative effort that made this possible.
This will be a wonderful opportunity for the CAGs to speak on this kaupapa and the journey we have taken to get the sector’s support and enthusiasm.
COVID-19 Recovery Planning
COVID’s impact on screening services has attracted the interest of the national media, with a Stuff article and a TVNZ News item focusing on waiting lists.
We are well aware of this impact as the effects of lockdowns and isolations, people “staying home to stay safe”, plus the flu season and general winter illnesses take their toll. We have recognised in previous editions of Sector Update that thousands of cervical screens are needed to reach pre-pandemic coverage levels.
In particular, there has been significant impact on access to cervical screening for wāhine Māori and Pacific people and we are asking all services to focus resources and additional support to enable their return to cervical screening.
We are urging people to resume screening as soon as possible and took the opportunity in the TVNZ interview to get this message across.
A capacity survey is underway with the sector (Regional Coordinator teams, Register teams and Support to Screening teams) to get a better picture of the current capacity in each rohe.
We will work with regions to best support a safe return to screening, and these survey results will help inform this.
NCSP Parliamentary Review Committee
The three-yearly NCSP Parliamentary Review has progressed its work after conducting interviews with providers and stakeholders to inform the review.
The panel members are now in the collation and writing phase prior to submitting their report. We are looking forward to hearing their recommendations in areas such as accessibility to primary health care and equity.
A date has not yet been announced for the release of the report. We will update you when we know more.
Please refer to NCSP Review for background to the review.
NCSP Advisory and Action Group
A refreshed NCSP Advisory and Action Group will provide strategic advice and guidance to the cervical screening programme, in particular for the implementation of HPV Primary Screening. The Group includes members with experience in all stages of the screening pathway and is focused on equity. The NCSP will work alongside this group in a partnership model.
Tira Albert, kaiwhakahaere of Mana Wāhine, and member of the Māori Monitoring and Equity Group, chairs the group alongside Jane O’Hallahan, Clinical Director of the National Screening Unit.
The group met on 22-23 June. During this time, TV1 interviewed Jane O’Hallahan and Tira Albert about the COVID-19 related backlog in screening. This was an opportunity to get key messages out about returning to screening. The advisory group also appeared briefly as part of the news item.
We will be sharing information on the members of the group in the next Sector Update.
More information, including minutes from each hui, brief bios of the members and points of contact, will be available on the NCSP website.
We will bring you updates on this group’s work in future.
What’s happening with the HPV Primary Screening Project
July 2023 remains the target date for the move to HPV Primary Screening.
As we engage more closely with health professionals, we learn more about what the sector wants to know, and what information you require.
We have been attending different hui over the last month to share information about the change to HPV Primary Screening and talk through what this means for you. This has included discussing the HPV virus and the new clinical pathway.
The NCSP Regional Coordinator hui and the Screening Support Services Kaimahi hui are particularly useful groups to give us insights about what is really important to you, so we know how best to support your needs, and ensure a clinically-safe transition for participants and their whānau to the new screening pathway.
The recent Screening Support Services Kaimahi hui chaired by Senior Portfolio Manager Nadine Riwai revealed that many sample takers want to know more about training opportunities.
We have have compiled the information below to better inform you of what is available.
Cervical Sample Taker Training
In response to questions raised by the sector, we are pleased to share details of training courses currently on offer around the country.
New Zealand Family Planning provides clinical training for nurses, midwives and doctors. Online and in-person courses cover cervical screening, contraception, STIs and general sexual and reproductive health.
Information about their courses can be found at Courses - Family Planning
The Eastern Institute of Technology’s (EIT) next course at the EIT campus in Hawke’s Bay is on 1-3 August. The contact is programme secretary Catherine Mason – [email protected]
Hamilton-based WINTEC offer two intakes a year in February and July. Information can be found at Cervical Smear Taking (Level 7).
Well Women and Family (WONS) run a Cervical Sample Taker Training course every second month in Auckland, and every alternate month in the regions. You can enrol with Well Women and Family online.
If the course is full and an organisation urgently needs to get a nurse trained earlier, contact [email protected] and WONS will try and accommodate these situations. Kaimahi training is free.
Reimbursement for successful completion of cervical screen taker training is available through the NSU. You can find further details at smear takers.
New HPV Primary Screening resources
We have been seeking sector input to support the development of public-facing resources for participants and their whānau. We need your expertise to ensure these resources work for the communities they are trying to inform and engage.
Thanks to all those who took the time to complete the survey last month and share your views on the collateral that is available now (pamphlets, websites etc.). We had a great response. It was helpful to understand what works, what doesn’t and what we need for the future.
We will discuss the survey results with the Māori and Pacific Campaign Advisory Groups and then consult further with the HPV Primary Screening Working Groups.
This collaborative effort will inform the requirements to update and develop the public-facing resources so that they resonate with participants and their whānau in preparation for the new HPV Primary Screening programme.
We will keep the sector updated as this work progresses.
Sector Working Groups
We are making good progress on the formation of the Working Groups that will be needed in the implementation phase of the Project, as we prepare for the transition to HPV Primary Screening in July 2023.
The input of the health professionals on these restructured groups will be critical. They will inform the development of, and provide feedback on, the Register functionality, resources, and what training is needed and how it should be delivered.
Either individually or as a group the members will be involved in testing communications and training material. They will help us identify challenges and opportunities the sector might have to the proposed changes, using their connections to professional and advocacy groups on behalf of the Project.
The Working Groups will help us ensure that change impacts are understood and will act as champions for the HPV Primary Screening Project to build awareness, understanding and adoption of the required changes within Health New Zealand and primary care.
We are now working on the specific purpose statement for each group and will be selecting members based on several factors, including clinical expertise, the area of the health sector they represent, and geographic representation for as many regions as can be achieved.
We will come back to you with more information as we settle on the structure and membership of each group.
The request for proposals (RFP) for laboratory work required under HPV Primary Screening has now closed and the bids are being evaluated.
An announcement will be made soon.
Members of the Colposcopy Working Group held a hui on 21 June which gave group members an opportunity to view the Draft Clinical Practice Guidelines for Cervical Screening in NZ and also the Draft NCSP Policies & Standards Section 6: Providing a Colposcopy Service.
The group will meet in July to kick off their work for the implementation phase of the Project including agreeing on an independent chairperson and terms of reference for this phase.
The new Register will be accessed by many more health professionals than the current version. It will be population-based, giving us the opportunity to look for new functions that will benefit the sector to support wāhine and whānau.
Our focus is on ensuring the design of the new Register effectively supports the new clinical pathway and enables health providers to have direct look-up access to screening histories to support participants on their screening journey. It will enable improved reporting and monitoring.
Two major functions we are working on are centralised notification (covering the first notification for someone starting on the screening programme) and recall (when someone already in the screening programme is notified about their next screen being due). The focus of this is to support administrative tasks to be managed centrally.
It is important to know that we are at the start of a developing journey and that we will give the sector an opportunity to shape the decisions we will make on the Register.
Over the coming months we will be working through the detailed requirements for access rights for different groups (e.g. who can read-only, who can edit, etc.). We will be reaching out to the sector for feedback as we design these improvements.
Answers to Your Questions
Our new email address is proving a big success in giving health professionals a direct channel to contact the HPV Primary Screening Project Team and ask questions.
One query we have received is whether participants could access their health data through the Register. At this stage, the Register is purely for healthcare professionals that are needing access for cervical screening purposes and it would not be within the Project’s scope to expand that beyond professionals.
The Hira project is entirely separate from the HPV Primary Screening Project and will enable information to be pulled from different systems to create a single view. Organisations who would like to be involved in creating Hira can contact the Hira programme: [email protected]
Four key messages to share about the HPV Virus:
- Human papillomavirus (HPV) is a virus that infects the skin and mucous membranes.
- There are many types of HPV
- 14 oncogenic HPV types can cause cervical cancer
- Persistent infection with an oncogenic type is a risk factor for developing cervical cancer
And two further key messages to share about the need for HPV Primary Screening
- Around 80% of participants who develop cervical cancer in New Zealand have either never been screened or have been screened infrequently
- HPV vaccination combined with regular screening provides the best protection from cervical cancer
More key information to give wāhine/whānau is provided at Frequently asked questions | National Screening Unit
Staying in Touch
Lots of people are passing on our Sector Update and our distribution list has quadrupled over the last couple of months. If you know of anyone who wants to have their name added to the Sector Update distribution list, please let us know by dropping us a line.
Your thoughts and queries are what we want to hear as we engage with you and communicate more in the coming months.
Please use our new email address [email protected]. Your feedback is important to us.
Noho ora mai