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Tackling inequalities

3.43 Thirteen health authorities, all of them in deprived inner city areas, do not yet meet the national target of 80% cervical screening coverage.

The government has set a target that these health authorities should achieve the national 80% coverage rate by 2002. All PCTs should review their own screening coverage rates and where necessary draw up plans to increase the accessibility of screening among deprived and minority ethnic groups as part of their Health Improvement Programmes.

Action to improve cervical screening in inner cities

A national screening coverage working group has been formed to support the implementation of cost effective approaches to increase uptake of screening in inner city areas. Examples of action taken include:

  • Series of training workshops for staff in health authorities and primary care, sharing best practice and lessons learnt
  • Improving the accuracy of population registers to ensure women receive their invitations at the correct address
  • Specialist nurse practitioners to provide support to practice nurses and single-handed GPs in Ealing, Croydon, Kensington and other districts
  • Training of receptionists from ethnic minority backgrounds in Camden A cervical screening campaign using local media targeting young women from ethnic minority backgrounds in Lambeth.

These measures aim for fair access to screening for all women and also to improve the quality of service provided to individual women. 

3.44 People from minority ethnic groups have particular needs. There is evidence to suggest that women from these groups do not come forward for breast and cervical screening. Culturally-sensitive information and different approaches to giving information can often improve the accessibility of screening to these groups.

Good practice in screening for minority ethnic groups

The Woman to Woman study in Rotherham assessed the benefit of using Community Health Educators (CHEs) to inform women from minority ethnic groups about cervical screening. This was an action research project and its findings were implemented and refined as the project progressed. The success of the project was such that one of the CHEs was subsequently employed on a permanent basis by the GP practice with which she was linked. The report of the project was sent to all health authorities to inform local strategies on ethnic minority information. A national conference was also held using CHEs as presenters.

The success of the Woman to Woman study has also led to the development of training materials in the primary care setting, and the learning experience from the study has fed directly into the cervical screening training pack for primary care. This same approach is now being applied to breast screening, where a study in Wakefield will be working with women from different minority ethnic groups and a group of low income white women.

3.45 Women with learning disabilities often do not have the information and support they need to decide whether or not to attend for breast and cervical screening or to understand the need for breast awareness. The Department of Health has established a working group, including women with learning disability, to draw up good practice guidance and materials for women and their families, supporters and health care professionals.

Action and milestones

2000

  • Breast screening development sites trial new workforce arrangements National guidance and booklets on screening for women with learning disabilities published

2001

  • Prostate cancer risk management programme launched All women to receive results of their smear tests in writing All women to receive national information leaflet on breast or cervical screening
  • All Primary Care Groups to review their screening coverage rates and draw up plans to improve accessibility of screening for women in socially excluded and minority ethnic groups
  • Cervical screening development sites trial new workforce arrangements National pilots using liquid based cytology report

2002

  • Colorectal screening pilot completed National pilots using HPV testing as triage in women with mild or borderline smears to report

2003

  • All health authorities to have introduced two view mammography Subject to evidence of effectiveness, National colorectal screening programme to be introduced
  • Health Technology Assessment programme to review evidence for ovarian screening

2004

  • All Health Authorities to invite women aged 65- 70 for breast screening.

 

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