National Cervical Screening Programme Sector Update - March 2022
Sector Update March 2022
We would like to start by acknowledging you and your teams and all the work you are doing to keep everyone safe, and to keep delivering our cervical screening programme across Aotearoa in these challenging times.
We know that COVID-19 continues having a major impact across cancer screening services, and none more so than cervical screening. The NCSP are reviewing the situation regularly and responding to the current situation, while planning for impact and subsequent recovery.
We also thank you for your support in reaching out with information through relationship managers and your assistance in filling out situation reports. If there are any capacity concerns in your DHB or service that could affect NCSP participants, please advise your relationship manager within the NCSP.
With COVID-19 having a major impact across cervical screening services, particularly for our Māori and Pacific communities, our collective focus needs to be on ensuring we are actively reaching out to those who are most at risk of developing cervical cancer. This includes our wāhine on annual screens or who have never been screened.
We are asking all screening providers, where possible, to please use any available appointments to book appointments for patients with a higher clinical risk, preferencing Māori and Pasifika, in line with the NCSP prioritisation guidance
The table below shows just how important that prioritisation is for Māori and Pacific peoples.
Our focus is on moving towards a more equitable screening programme. This update provides information on the move to a new HPV Primary Screening and the steps we are taking to lay the foundations for a change in service delivery models.
What’s happening in the NCSP
Cervical Screening Media Campaigns
The NCSP is working in partnership with Māori and Pacific Campaign Advisory Groups and Māori and Pacific creative agencies on the production of digital content for the roll out of the social media campaigns.
These are being developed to support increasing awareness of the importance of regular cervical screening and will grow and change as we move to implementing a new screening test.
The campaigns are planned to be rolled out prior to July 2022 and we will keep you informed on when they are due to be released.
NCSP Parliamentary Review Committee
The 3-yearly NCSP Parliamentary Review is taking place in the first half of 2022. As the NCSP is currently in transition to a new screening pathway, this review will have a limited scope with a focus on accessibility to Primary Healthcare and colposcopy workforce capacity, quality assurance improvements and accessibility in an HPV Primary Screening setting to support equitable outcomes. The committee is made up of the following wāhine:
Associate Professor Heather Came is a founding member and co-chair of STIR: Stop Institutional Racism, a fellow of the Health Promotion Forum, and chair of the local branch of the NZ Public Health Association. Her research focuses on critical policy analysis, Te Tiriti o Waitangi, anti-racism and institutional racism in the health sector
Ms Liane Penney (Ngāpuhi Te Ngare Hauata, Te Hikutu) is the Director of Kiwikiwi Services Limited, a research, evaluation, change and project management consultancy. Liane has expertise in Māori health planning and development, and has been a member of many governance groups, expert panels and research committees, including the 2018 Parliamentary Review Committee of the NCSP
Dr Georgina McPherson (Ngāti Kao, Ngāti Tane) is a subject matter expert and has extensive experience as a practising colposcopist. Dr McPherson is actively involved in the HPV self-testing research in the Auckland region, and is a member of the Australian Society for Colposcopy and Cervical Pathology executive committee.
What’s happening with the HPV Primary Screening changes
Clinical Pathway Consultation Summary
The new HPV Primary Screening clinical pathway, with the option of self-testing, was consulted on last year and a thematic analysis of the feedback received in that consultation has been compiled.
This has been published on the National Screening Unit (NSU) website at https://www.nsu.govt.nz/health-professionals/national-cervical-screening...
Work is underway to finalise clinical and transition pathways as part of updated guidelines for HPV Primary Screening.
Partnership and Te Tiriti as foundations for equity
Designing an equitable approach to the transition to HPV Primary Screening is a key focus on building the foundation for change.
We undertake the transition mindful of our obligations to Te Tiriti o Waitangi and with the aim of achieving equitable outcomes through Māori representation within project governance, Māori data governance and within the sector working groups.
Ensuring that Māori voice and perspective is in place from the start of our journey is critical to the success of this change.
The NCSP project team is taking a workstream approach to ensure delivery across all parts of the pathway are considered. Each workstream is led by staff within the NCSP supported by advice and input from sector working groups. This work will support the clinically safe transition to the new programme and ensure the change is designed to support equitable access, outcomes, and choices for wāhine.
These working groups provide sector representation from all aspects of the screening pathway, from access to screening through to diagnostics and treatment. These groups are supporting the programme to develop the planning for implementation.
The working group members represent people that deliver cervical screening and include wāhine, whānau, Kaimahi, Practice Nurses, Colposcopists, Pathologists, Register Coordinators, Support to Screening teams, GPs, Family Planning Laboratory Scientists, Programme Managers, and Primary Health Organisations.
Cervical Screening Services and Access Update
Initial workshops are underway with our sector working groups. These have been invaluable in gathering insights into what the transition to the new screening pathway will mean for participants and people working in the sector.
Replacement of the current NCSP Register with a population-based register in 2023 provides us with an opportunity to enhance notification and invitation to participants and those who are eligible for cervical screening. This direct notification could enable standardised messaging and the ability to notify and recall those people who are not enrolled with Primary Care.
As we progress this mahi we will widen the kōrero, to support a clear understanding on how this approach impacts current invitation and recall activity. We will keep you up to date with our work as it progresses.
Work is progressing finalising the NCSP Policies and Standards Section 6 for the provision of colposcopy services to reflect changes to the clinical pathway and the change to HPV Primary Screening.
Assessing the impact of the transition to HPV Primary Screening on colposcopy units is also underway that includes modelling referral volumes, assessing training and education needs and resource requirements.
Ensuring we have best practice in place and future proofing systems for whānau and the sector is a key focus of the workstream. We are also looking to simplify forms for triage and referral to and within colposcopy.
The real impact of COVID-19 on the capacity and readiness of colposcopy services is acknowledged, and this is also being assessed to inform discussions with DHBs on planning for the change.
We are currently working on the process laboratories can use to achieve validation of their HPV technology for processing and reporting self-collected swab samples for HPV testing, where their HPV test technology has not already achieved international validation for this.
This process will be part of NCSP Policies and Standards Section 5 and will be ready to use soon for any laboratories requiring it.
The Laboratory Procurement process is underway to support future laboratory services to support the new clinical pathway.
Monitoring and Reporting
The monitoring and reporting requirements needed to safeguard the ability for the NSU to measure the quality of the NCSP during the transition to the new HPV Primary Screening (and into the future) is critical for this change.
To do this we are reviewing and updating the monitoring indicators and identifying data elements required to produce these indicators and other quality monitoring reporting.
Additionally, we are mapping all current data inputs and outputs to ensure nothing is overlooked in the transition to the new system.
Engagement is underway with sector stakeholders to understand how they currently interact with the existing NCSP-R (National Cervical Screening Programme Register) and how this will potentially change once the new Register is implemented.
We continue to focus on the protection of cervical screening data, and value the partnership we have with the National Kaitiaki Group who have guardianship over the use of Māori cervical screening data.
We will be running more workshops with our working groups to build understanding and gain feedback on the changes to workflows to ensure the design of the new Register meets the needs of the new clinical pathway, and allows for better reporting, monitoring, notification, and recall.
We look forward to sharing updates with you as we progress these changes. Information specific to your organisations and communities will be provided through a range of different channels, and we will connect with you about these over the coming months.
In the meantime, please feel free to direct any questions to the NCSP inbox with the subject line HPV Primary Screening Project team if you have any questions.