Ardens has recently sought the advice of the NHS England Screening Authority with regard to Cervical Screening invitations and they have clarified the process for us. Also outlined in this link, the process should be as follows:

• Practice receives list of those patients due to be invited (previously the ‘Prior Notification List’ (PNL)) and practices process these to ensure patients are appropriately recalled;
• The Cervical Screening Administration Service invites all eligible patients, sending 2 invites;
• If the patient has not been screened after those 2 invites, the CSAS sends a list of ‘non-responders’ to the practice;
• The practice then undertakes (and optionally codes) a third invitation.

The Screening Authority have explained to us why it is important that the first 2 invitations are sent centrally, as this ensures that the correct information is sent to patients at the time they are eligible.

The risk of inviting based on local searches is: 

• Risk of inappropriate invitations  (i.e. to patients who have opted out)
• Risk of inappropriately worded letters
• Lack of appropriate information to give balanced view of benefits and harms of screening
• Risk of incorrectly timed invitations (e.g. shorter intervals for patients under surveillance or longer as they age)
• Risk of early tests being rejected by the labs

As a result, we have taken the decision to retire our Cervical Screening Invitation suite. We do, however, understand that this is a QOF domain and that there is the option to ‘exception report’ patients if they do not respond. This is a local exception and has no impact on the screening service. To facilitate this exception reporting, we will retain reports to identify those patients who have had a ‘third invitation’ coded by the practice. These will be the patients who were non-responders from the screening recall and to whom the practice will have sent a third invitation.