9 August 2018

NHS England takes up advice from the College, British Association for Cytopathology and the Institute of Biomedical Science.

Following the announcement by NHS England that it has agreed to begin a one-stage procurement process to reconfigure provider laboratories to support the roll-out of Human Papilloma Virus (HPV) primary screening into the NHS Cervical Cancer Screening Programme (CSP) in England, Professor Jo Martin, President of the Royal College of Pathologists, said:
 
We had concerns, and raised them, about the process for transition from cytology screening (smear tests) to full roll-out of HPV primary screening in December 2019. We called and hosted a very constructive meeting with PHE, NHSE and professional groups on 25th June, and are pleased to see that much of our advice has been taken on board. Making the transition safe and ensuring that future staffing is secure is paramount. Cervical screening is a key service for cancer prevention, and we will continue to work to ensure that the programme works well for women.
 

NHS England Statement on the roll-out of HPV primary screening across England
 

Following a review of its delivery strategy, NHS England has agreed to begin a one-stage procurement process to reconfigure provider laboratories to support the roll-out of Human Papilloma Virus (HPV) primary screening into the NHS Cervical Cancer Screening Programme (CSP) in England.

This decision, based upon learning from market engagement events held earlier this year will see the procurement commence in November 2018. To ensure the NHS Cervical Screening Programme continues to deliver a quality service to women during this period of change, NHS England will work with NHS Improvement to give all laboratories that meet the quality criteria, the opportunity to implement HPV primary screening ahead of the start of the procurement process.

In coming to this decision, NHS England has taken advice and support from the Royal College of Pathologists, the British Association for Cytopathology and the Institute of Biomedical Science.

The approach will be:

  • To run a national, one-stage open tender procurement process from a revised date of November 2018 to secure up to a maximum of 13 providers to deliver laboratory services to support the NHS Cervical Screening Programme with HPV primary screening. The providers would consolidate existing services to a maximum of 13 sites over a planned period
  • To offer all existing laboratories, working with their emerging pathology networks that meet the quality criteria and have a robust risk mitigation plan, to implement, as soon as possible, HPV primary screening prior to the procurement. Providers will continue this provision throughout the whole transitional period up to and following procurement until new service contracts start. This will bring the benefits of HPV primary screening earlier than originally planned to many women across the country.

The implications of these decisions
Women will continue to receive a quality service during the transitional period:

  • samples will be taken and the results returned in the normal way.
  • we expect the time from when a woman has her sample taken to when she receives the results to be shortened.
  • outcomes for women participating in the NHS Cervical Screening Programme will be improved further as HPV primary screening has higher sensitivity
  • levels for detecting cervical abnormalities than cytology and provides longer protection of a negative result

Once we achieve full implementation, from December 2019, all samples will be tested for the Human Papilloma Virus which causes more than 99% of cervical cancers. This could prevent around 600 cancers a year.

Moving to a national one-stage, open tender procurement process provides:

  •  a nationally-led and consistent approach to the whole procurement process, including a single panel evaluation of bids; and
  •  a simplified bidding process requiring bidders to submit one comprehensive bid without requiring a pre-qualifying questionnaire.

Next steps

  • Local providers should wait to be contacted by their local NHS England commissioners. A joint letter from NHS England and NHS Improvement will be issued to current service providers giving further information and guidance on the process to convert and the assurances required that will ensure the CSP remains a safe programme. A national meeting with Cancer Charities and Professional Bodies will be held on 15 August 2018 to brief them on the approach, enable them to ask questions and begin to plan the support they can provide to the process.
  • NHS England, Public Health England, and other key stakeholders will continue to encourage women to take up their cervical screening invitations during the transitional period.