Three reports on smear test scandal released

THE Southern Trust (SHSCT) and the Public Health Agency (PHA) have today published three new reports on cervical screening.

The reports, which are available on both organisations’ websites, provide important independent analysis of the complex issues relating to the historical delivery of the cervical screening programme in the SHSCT 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. We acknowledge the past performance issues in our laboratory and fully accept that the actions of the Trust at that time were not sufficiently robust and that this was an unacceptable breach of governance procedures.

“Although the review and analysis which informed these latest reports has been exhaustive, we nevertheless welcome the Minister’s announcement today 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. 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. We 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, we will be implementing remaining recommendations that have been made and are not already in place.

“Much improvement has been made throughout the course of the review and it is important to stress 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, added:

“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. The PHA acknowledges that while our QA 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. 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.

“Both the cervical cytology review and NHS England review span a long time period dating back to 2008. The service in place today is very different from that in place for most of that time period and major improvements have taken place since then. These include the implementation of primary HPV testing into the programme in December 2023. This 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. These changes bring the Northern Ireland programme into line with other programmes in the UK.

“We would like to remind 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. Our 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 we will only find these abnormalities in women who attend for screening. I ask all women who are invited to attend for cervical screening to please attend. It could save your life. I would also remind women who have symptoms that screening is for people without symptoms. If you have symptoms you need to seek medical advice even if your cervical screening result is negative.”