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The Southern Trust and the Public Health Agency have published three new reports on cervical screening, providing independent analysis of complex issues relating to the historical delivery of the cervical screening programme in the Southern Trust from 2008 to 2021.
Dr Stephen Austin, Medical Director at the Southern Trust, said the Trust apologises once again to all women who have been impacted by the cervical screening review. He acknowledged the past performance issues in the laboratory and fully accepted that the actions of the Trust at that time were not sufficiently robust and that this was an unacceptable breach of governance procedures.
Dr Austin welcomed the Health Minister Mike Nesbitt's announcement that a further independent expert review of all the published reports to date will be carried out to establish if there are any gaps or areas that need to be explored further. He said the reports scrutinise complex technical screening methodology and operational issues, provide considered professional opinions and review historical issues which will benefit from further expert consideration.
The Trust is committed to ensuring these failures do not happen again. Dr Austin said they have examined in detail the findings in these latest reports and many measures have already been put in place to address past failings. In addition, they will be implementing remaining recommendations that have been made and are not already in place. He stressed that much improvement has been made throughout the course of the review and it is important to note that the testing, screening and diagnostic pathway for the region was changed in December 2023 with the introduction of the primary HPV testing screening programme across Northern Ireland, which is the current screening standard in the rest of the UK.
Dr Joanne McClean, Director of Public Health at the PHA, said the PHA welcomes the publication of the three reports. Both the NHS England review of quality assurance processes and the summary learning report identify areas for improvement and make a range of recommendations. Dr McClean acknowledged that while their quality assurance processes identified concerns in relation to the Southern Trust laboratory, there were gaps in how these were communicated and subsequently appropriately escalated to senior executives to ensure the Trust took appropriate action to address the performance issues.
She said: "We are sorry for the failures in our governance model and our handling of these performance issues and apologise to all those adversely impacted by the previous poor performance in the Southern Trust laboratory and all those affected by the cervical cytology review carried out as a result of concerns about the performance in that laboratory. The PHA is committed to implementing all recommendations in the reports in full."
The decision in 2023 to review the screening history of over 17,000 women was taken as a precautionary measure to verify results issued by the laboratory in the Southern Trust following the concerns about the performance of that laboratory. The independent expert report has concluded that the cervical cytology review was robust and that the vast majority of the reviewed cytology results issued by the Southern Trust laboratory were correct.
Dr McClean explained that both the cervical cytology review and NHS England review span a long time period dating back to 2008, and the service in place today is very different from that in place for most of that time period with major improvements since then. These include the implementation of primary HPV testing into the programme in December 2023, which is the screening pathway recommended by the UK National Screening Committee and is more sensitive at detecting abnormalities which may go on to develop into cancer. The reconfiguration of the laboratory service into one regional laboratory is another important improvement, bringing the Northern Ireland programme into line with other programmes in the UK.
Dr McClean reminded all women that cervical screening helps to protect their health and save lives and it is essential that women continue to attend when they are invited. She said the screening programme is very effective and the improvements put in place will make the programme better at finding women with abnormalities which put them at greater risk of going on to develop cervical cancer, but they will only find these abnormalities in women who attend for screening. She asked all women who are invited to attend for cervical screening to please attend, as it could save their life, and reminded women who have symptoms that screening is for people without symptoms and if you have symptoms you need to seek medical advice even if your cervical screening result is negative.
