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Screening Administration Support for Laboratories, Colposcopy and Gynaecology Clinics

Laboratories: Sending test results

Laboratories send test results to PCSE, so we can then inform the patient of the result via letter.

Most laboratories send results to PCSE via lab links but there are a small number who still send files by email. We will acknowledge receipt of the files and confirm the number of items received in the file.

  • If we receive lab files before 12.30pm, we will endeavour to post any results requiring referral on the same working day.
  • All other results will be posted out the following working day.

Once a file is processed by the call / recall team, we will email you the lab CLLM/CLLP reports which provide details about rejected test results.

Colposcopy Discharge: 

Informing PCSE of women who are discharged back to Primary Care 

Public Health England (PHE) has developed national guidance for Colposcopy regarding the discharge of women back to Primary Care. The new guidance was published on 2 March 2017. 

To enable the PCSE screening team to update the Next Test Due Date (NTDD) appropriately, we would appreciate the support of colposcopy services in following the guidance.   

Colposcopy clinics should inform PCSE of women who have been discharged from colposcopy care for follow up in the community.  The method of notification is to submit a monthly list via PCSE’s online form.   

PHE have produced a template for submitting the monthly lists.  Use of the template is not mandatory but PCSE requests that lists submitted in alternative formats should include the same amount of information that is required for the template.

The discharge lists should be sent to PCSE via the online enquiry form which will guide users through a step-by-step submission process.

How to upload a completed Discharge list? 

  • Go to the Contact Us page and select ‘Screening – Colposcopy Discharge’ from the drop down menu under enquiry type
  • Complete the mandatory fields for your request
  • Upload the colposcopy discharge list document
  • Submit the request

PCSE will acknowledge receipt of the list and notify clinics if there are any records that cannot be amended.

The PCSE screening team will then update the next test due date (NTDD) of each woman as specified in the lists, according to the following:

  • Colposcopy will provide a recommended recall interval based on the date of the woman’s last adequate colposcopy examination in line with programme guidance.
  • The call and recall service will ensure that the maximum recall intervals are not exceeded.

It is recommended that colposcopy services provide data to the PCSE screening team on a monthly basis as a minimum.  The online submission form asks for a date range to be given.  We would also recommend that the lists are numbered sequentially as they are submitted – simply write the number onto the top of the discharge list before it is uploaded to the online form.

PCSE will not be able to undertake audits of data received if clinics are not submitting discharge lists.  Therefore, clinics must ensure that they submit data in a timely manner and maintain an appropriate audit of data sent.

When a woman has been discharged to Primary Care and PCSE has acknowledged receipt, ongoing responsibility for fail safe rests with the call and recall system and the woman’s GP.

Please note: The PCSE screening team cannot accept copies of GP discharge letters from colposcopy clinics as this is a breach of information governance (IG) rules. We will return any such discharge letters to the originating clinic unprocessed.

Colposcopy & Gynaecology: Ceasing women from the programme

Coloposcopy and Gynaecology clinics wising to cease women from the National Cervical Screening Programme should download and complete the form below:

Cease from Cervical Screening Programme

The form should be submitted via the online enquiry form, which can be found on our Contact Us page.

To submit the form, please follow these steps: 

  • Go to the Contact Us page and select ‘Screening – General Enquiry’ from the drop down menu under enquiry type
  • Complete the mandatory fields for your request
  • Upload the relevant form, signed as required
  • Submit the request

You will then receive confirmation that the request has been received.

FAQs

For further FAQs, visit our help page.

All coding of results should be undertaken by the laboratory who should also specify the appropriate action code and recall period for early repeat category tests.

NHAIS validates test results received from laboratories in line with the national ABC guidelines to ensure that women cannot be returned to routine recall after an abnormal smear test until at least 3 normal smears at least 6 months apart have been recorded.

Where the system rejects tests because they have failed validation against national policy the sending laboratory is notified by PCSE.

Tests that fail validation or are rejected back to the laboratory, are logged on NHAIS to prevent inappropriate invitation letters being sent to women. This ensures, as a failsafe, any tests that have been rejected can be identified.

The laboratory should check rejected tests and send amended reports back to the PCSE call / recall team who will audit the outstanding logged tests weekly to ensure that outstanding queries are followed up and result letters are issued in a timely manner. Details of any outstanding logged tests will be sent to the laboratory for review and action.

These are mainly around samples taken prior to the implementation of HPV triage and test of cure in 2012, for which the result required early recall and/or referral to colposcopy, but had not had appropriate follow up at that time e.g. DNA.

The NHAIS software has been designed that these results should follow the previous screening pathway, and therefore cannot be returned to routine recall unless the previous test date is over 5 years old.

This should be a short term issue, and laboratories should amend codes and return to PCSE, to allow appropriate results letters and subsequent recall to be initiated.

Validation Rules

Any ‘A’ coded test result being entered will need to be validated against the new rules. That is test results coded: 0A, 2A, B0A, E0A, G0A, M0A, N0A or X0A

The ‘ABC3’ guidelines governing a return to routine recall are as follows

Test results coded as ‘H’ and inadequate test results will be ignored when assessing if a woman may be returned to routine recall or not.

Test results are considered to be inadequate if they are coded 1 for cytology or U for HPV unreadable result. All insignificant inadequate test results are ignored when seeking to identify a woman’s last test result.

Insignificant inadequate test results are

1R, 1S, 19R, 19S, 1QR, 1QS, BUR, BUS, EUR, EUS, GUR, GUS, MUR, MUS, NUR, NUS, XUR, XUS

Private test results are: 0H, 1H & 2H

  • Return to routine recall will NOT be allowed if the most recent adequate NHS test is as follows:
    The test result is dated 5 or less years ago.
    and
  • The test result is coded as one of following:

4S, 49S, 4US or 4QS
5S, 59S, 5US or 5QS
6S, 69S, 6US or 6QS
7S, 79S, 7US or 7QS
3R, 8R or 9R

Please note: while it remains the case that a test result of 3R, 8R or 9R should be followed by 3 consecutive negatives at least 3 months apart, the system will continue to allow a woman to return to routine recall after five years or on her second negative result under the HPV triage/TOC protocol.

Test results that fail validation will be flagged by the Laboratory Links, CY screen, AJ-CINCD and the Cytology Integrity Checker AD-HOC option 10 in the usual way.

Return to routine recall will be allowed if

  • The test result (as specified above) is dated more than 5 years ago.
  • The previous adequate NHS test result was coded:

HPV Triage: HPV Primary Screening:

0A, 0R, 0S 09R, 09S, 0QR, 0QS
2A, 2R, 2S 29R, 29S, 2QR, 2QS
3S 39S, 3QS
40S, 50S, 60S, 70S
8S, 9S 89S, 8QS, 99S, 9QS
B0A, B0R, B9R, B0S, B9S X0A, X0R, X0S, X9S
E0A, E0R, E0S, E9S
G0A, G0R, G9R, G0S, G9S
M0A, M0R, M9R, M0S, M9S
N0A, N0R, N9R, N0S, N9S

In a small number of cases, a woman may ask that their result letter is not sent to their home address.

The ‘No Correspondence Marker’ was withdrawn from use in 2009, and PCSE is required to issue a result letter for all results, except for tests undertaken in Colposcopy.

Reminder guidance on the procedure for dealing with requests for no result letters to home (registered) address.

Where a woman attending for cervical screening asks that her result is sent to an alternative address, the sample taker should clearly mark the HMR101 form so that the laboratory is aware of the woman’s wishes, and should ensure that the alternative correspondence address is clearly shown on the form; this may be a C/O address provided by the woman or the surgery/clinic address.

National guidance requires that result letters are sent to the address shown on the report received from the laboratory.

When logging the test, the laboratory will need to record the correspondence address, which will be sent as part of the report details to PCSE in their lab file.

Please note: Laboratories should not email or fax PCSE the correspondence address details, as this may not be identified before the result is processed and data files sent to printers for letter printing and despatch.

Where the correspondence address is the surgery/clinic, the sample taker will need to ensure the woman received her result.
The correspondence address is only used for issuing the result. Invitation letters will revert back to the registered address.