Barriers to accessing cervical screening

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Summary of report content

In November 2019, it was reported to Healthwatch North Lincolnshire, by a local disabilities campaigner, that some women were facing barriers to accessing cervical screening. These barriers included women with physical disabilities being unable to be tested at GP surgeries due to them not having hoists available within practices.  Healthwatch undertook research into take up using a survey and a focus group.  Altogether they spoke to 285 people.

Most women felt that cervical screening was important to detect pre-cancerous cells, but there are barriers that prevent some women from accessing this.  Disabled women who use wheelchairs and can’t get onto the examination table found they couldn’t get screened except at hospitals. Women have expressed that GP practices are not wheelchair accessible which makes attending an appointment in the GP practice difficult and can be a barrier for accessing screening. GP practices do not appear to be making reasonable adjustments for these women to ensure that have the same access to screening as those who are able bodied.

Some GP practices are ceasing offering appointments to disabled women who they consider do not require screening due to either assumptions or disclosures of not being sexually active. There is an inconsistent approach to providing accessible information across GP practices for women with a learning disability or difficulty. Some practices are taking the time to support women to understand the importance and process of screening and are providing easy read information to reinforce this. Those women who felt supported reported a higher level of satisfaction in the process. However, some women with a learning disability are not accessing cervical screening appointments due to lack of understanding of, and importance of attending regular screening. This is contributing to fears over attending the appointments. Information provided to patients is not accessible enough, and GP practices are not supporting women with a learning disability to understand the process, despite a plethora of easy read and accessible information available.

Some women find the prospect of cervical screening daunting, due to range of issues such as beliefs around screening, fear, embarrassment and previous negative experiences, including abuse. This means that some women are avoiding attending screening and are ignoring reminders to have this important test undertaken. Some GP practices are making a concerted effort to engage with women who do not attend appointments.

Women are finding attending appointments difficult due to caring responsibilities, work commitments etc which indicates a general inflexibility of GP practices to accommodate these needs.

The report contains 13 recommendations about making cervical screening appointments accessible for all women

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General details

Report title 
Barriers to accessing cervical screening
Local Healthwatch 
Healthwatch North Lincolnshire
Date of publication 
Friday, 30 April, 2021
Date evidence capture began 
Monday, 20 January, 2020
Date evidence capture finished 
Friday, 28 February, 2020
Key themes 
Access
Building and facilities
Communication between staff and patients
Health promotion
Information providing
Quality of appointment
Staff attitudes

Methodology and approach

Was the work undertaken at the request of another organisation? 
No
Primary research method used 
Focus group
Survey
If an Enter and View methodology was applied, was the visit announced or unannounced? 
N/A

Details of health and care services included in the report

Primary care services 
GP practice

Details about conditions and diseases

Conditions or diseases 
Gynaecological conditions
What type of pregnancy or maternity themes are included in the report 
N/A

Details of people who shared their views

Number of people who shared their views 
285
Age group 
Not known
Gender 
Female
Ethnicity 
Not known
Sexual orientation 
Not known
Does the information include public's views? 
Yes
Does the information include carer's, friend's or relative's views? 
Yes
Does the information include staff's views? 
No
What was the main sentiment of the people who shared their views? 
Mixed

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Yes
Does the information contain a response from a provider? 
No
Is there evidence of impact in the report? 
No
Is there evidence of impact external to the report? 
Not known

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
 
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
 
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.