National Cervical Screening Programme Sector Update - June 2022
One of the key messages stressed by the National Cervical Screening Programme (NCSP) is that HPV vaccination combined with screening provides the best protection from cervical cancer.
The importance of that message was underlined by a recent television news item which suggested some school children are missing out on immunisation. The first line of defence against cervical cancer is prevention by safe, effective and proven HPV immunisation.
This is a major part of the World Health Organisation’s global strategy to accelerate the elimination of cervical cancer as a public health problem by 2035. WHO launched that strategy in 2020 with a target for a 90% vaccination rate by the age of 15.
New Zealand fully supports the WHO strategy and it is important to see schools and colleges encourage children to be immunised. HPV immunisation is free for everyone aged 9–26 years (inclusive), including boys and young men. It is offered to boys and girls in year 7 or 8 at school and can also be given by a doctor.
Health professionals can help by spreading the word.
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 roll-out.
Content is being developed in partnership with Māori and Pacific Campaign Advisory Groups 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 campaign will be first to roll out once Aotearoa is through the peak of Omicron, followed by the Pacific-focused campaign later in the year. We will look to share these videos with the sector before they go live for the public.
COVID-19 Recovery Planning
We are reviewing the COVID-19 situation regularly, monitoring the impact and initiating planning for the subsequent recovery in screening. We know that COVID-19 continues to have a major impact across cervical screening services.
The overall decrease in screening coverage during the pandemic is consistent with most countries who continue to face substantial difficulties catching up on screening backlogs. As of 31 December 2021, approximately 34,000 cervical screens were needed to reach pre-pandemic coverage levels.
There has been significant impact on access to cervical screening for wāhine Māori and Pacific people. Therefore, these groups are more at risk and will require additional support to return to cervical screening.
While we know the response is ongoing, we are focusing attention on approaches that will support recovery. We are progressing work on sharing data at DHB level to assist recovery planning and will be working with providers to identify further opportunities. This also includes assessing opportunities to re-prioritise funding to support recovery efforts.
NCSP Parliamentary Review Committee
The three-yearly NCSP Parliamentary Review is continuing its work, which is taking place over the first half of this year.
The committee has been reaching out to the sector to arrange interviews with providers and stakeholders to inform the review. These interviews started in mid-May and will run until mid-June 2022, so some of you may already have been contacted.
Updates and background to the Review
What’s happening with the HPV Primary Screening Project
July 2023 remains the target date for the switch to HPV Primary Screening.
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.
Questions and feedback shared in these hui give us valuable insights into 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.
New HPV Primary Screening resources
In the next few months, we will be seeking sector input to support the development of public-facing resources for participants and their whānau. We need your expertise to ensure these resources resonate and work for the communities they are trying to inform and engage.
We are kicking this off this month, with a survey seeking your views on the collateral that is available now (pamphlets, web sites etc) -- what works, what doesn’t, and what we need for the future.
The link to the survey will go out via email to Screening Support Services and Regional Coordinators, but they are welcome to circulate it to their networks because we want to hear the views of as many people as possible who use these resources.
The email will be going out in the next week or so and the survey will be open until 22 June. It’s short and sweet and takes about two minutes to complete – so please do take the time to give us your feedback.
This will provide important context for the Māori and Pacific Advisory groups that will partner with us and for the agency that will be undertaking focus groups with wāhine and whanau to develop these resources and tools.
Sector Working Groups
As the Project is now moving out of the design phase and into the implementation phase (where we start getting everything ready for July 2023), we are looking at what’s needed from the sector working groups who have made such a valuable contribution to date.
We want to reassure you that the working groups will continue from now until July 2023, with some small changes where necessary. This next phase is where the more detailed work is done, and it’s really important we have sector voice and representation supporting the development and delivery of these changes.
The expertise, passion and commitment you bring will help to ensure the transition to HPV Primary Screening is implemented successfully.
Thank you to those of you who have supported this work so far. We are looking forward to your continued involvement.
The colposcopy working group is finalising the clinical guidelines and we will be sharing these across the groups for feedback on ease of use and readability in June. This will be important information and context for the feedback sessions that follow in July/August.
A schedule is being finalised for the proposed sessions planned in the next few months.
Team members from the National Coordination Centre – Cervical Screening (better known within the sector as regional call centre/ Whakarongorau) are now included in the Project team, as well as holding membership roles in several of the Project Working Groups.
We’d like to extend our thanks to the Whakarongorau team for their support and commitment to the Project, in helping to confirm future requirements, develop new business processes, test concepts, and identify resource requirements.
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.
Colposcopy Price Uplift Contract variations were sent out in mid-May.
Please note that these need to be signed and returned by 10 June 2022.
A hui is planned with the Colposcopy Working Group on 21 June. We will give feedback on the hui in the next Sector Update.
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 whanau.
This includes understanding the changes to existing workflows with the introduction of HPV Primary Screening and assessing opportunities for improvements.
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, to free up clinical time within primary care.
We are mindful that there are significant impacts that need to be considered and discussed as we develop this approach to ensure a smooth transition, appropriate reporting and feedback mechanisms and ability to match to local capacity. Appointments will still be managed by providers at a local level.
We will be reaching out to the sector for feedback as we design these improvements.
We are also focusing on the protection of people’s cervical screening data and will continue to work closely with the National Kaitiaki Group who have guardianship over the use of cervical screening data for Māori wāhine and will ensure appropriate processes are put in place as we progress.
Here are seven key messages to share about HPV Primary Screening:
- The National Cervical Screening Programme (NCSP) is changing the way cervical screening is undertaken in New Zealand
- From July 2023 the primary test for cervical screening will change to a human papillomavirus (HPV) test
- This new screening method will test for the presence of HPV, the cause for 99% of cervical cancers
- Self-testing with clinical oversight will be an option for all participants and their whānau
- The screening interval following a negative test will change to 5 years
- To enable HPV Primary Screening, a new NCSP Register will be implemented
- The new Register will be a population-based Register sourced from NHI and will include both enrolled and unenrolled populations, with an opt-off option and with direct lookup access for primary health care staff
More key information to give wāhine/whanau is provided on the website Frequently asked questions | National Screening Unit (nsu.govt.nz)
Staying in Touch
We are aware that you are being asked many questions about HPV Primary Screening. We will be engaging with you and communicating more in the coming months.
You will have many questions to ask us, or comments which we’d like to hear.
Please use our new email address [email protected] Your feedback is important to us.
Noho ora mai