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Primary HPV laboratory configuration decision in England

In response to a query from a cytologist, and also by the BAC, asking when the announcement of the option appraisal decision for laboratory configuration was going to be, the following reply from NHS England was posted on the PHE blog on 3rd July: 

It reads:

Thank you for your comment. NHS England has provided the following update:
Following clinical recommendations regarding the configuration of laboratories to support the changes to the NHS Cervical Screening Programme made by the Options Appraisal Stakeholder Group, NHS England has been undertaking a series of appraisals to determine the affordability and operational deliverability of the options.

Alongside this, the broader impact of any strategic pathology reforms and impact that may have on laboratory configuration for delivery of the cervical screening pathway must be considered. Therefore, NHS England intends to carry out a series of engagements with its local commissioning teams and Public Health England to ensure that any decisions on the number of laboratories and their footprint does not contradict existing strategies.

We recognise that this process is taking longer than anticipated, and hope you will appreciate that it is of upmost importance that the right decisions on these service changes are made. NHS England will be informing all stakeholders of this outcome as soon as this process is complete.

Regarding the process to commission and implement the delivery of the HPV test as the primary screening within the NHS Cervical Screening Programme, the central public health team of NHS England will be working closely with local commissioning teams to explore available options in relation to securing contracts to deliver this change in service. This may require a procurement process in order to comply with EU regulations. If so, this will be led by NHS England as the accountable organisation for the delivery of the Public Health Section 7a Agreement.

We hugely appreciate your patience and support with this process, and will keep you updated on key developments throughout the next couple of months.

This announcement indicates that further discussions are to be held on the configuration, roll out and commissioning aspects and that this is ongoing.

The original blog regarding  the laboratory configuration options was posted on 31st January and whilst the general election and associated purdah has inevitably caused a delay, the silence and lack of a decision is frustrating to all those working in laboratories. Laboratories are working to deliver the current CSP under increasing backlogs and turnaround times, with many laboratories failing to achieve the 14 day turnaround target for many months now. 

The announced mitigation plan to help laboratories deal with their backlogs by means of the current six Pilot sites increasing their primary HPV screening to release screening capacity for other laboratories has so far delivered a small amount of capacity, but this falls a long way short of the demand.

Many laboratories are struggling with turnaround times in excess of the 14-day standard and 30 days or more is now not uncommon. The recent BAC workforce survey has highlighted  many staff with low morale who are desperately wanting a decision on primary HPV rollout so they can start to plan for their futures. The longer this uncertainty continues the worse the pressure on the service and its staff will be.

We all want the best decision for the programme and the women we provide the service for and accept that this does take time, but the lack of consistent communication and yet more delay whilst discussions take place is beginning to cripple the once highly motivated cytology workforce. 

However, please do use the PHE blogs to ask your own questions - many of the blogs do have replies posted quickly - so we can all share the latest information. On behalf of its members and the wider Cytology community, the BAC continues to take every opportunity to engage with, and constructively question, the process of HPV primary screening rollout as well as NHS England, the organisation that is responsible for it.