GPs call for halt to cervical cytology screening roll-out

Scottish GPs are calling for the roll-out of a national cervical cytology screening system to be halted because of concerns the system places too much reliance on the internet with no paper back-up system.

Representatives from Glasgow Local Medical Committee will put a motion to tomorrow’s Scottish LMCs’ conference demanding that the Scottish Cervical Screening Call Recall System (SCCRS) should not be rolled out as planned at the end of May.

Under the new system invitations for cervical screening will be issued centrally. When women attend for a test the clinician will look up their details on the SCCRS online and print out a barcode which will be placed on the completed test and returned.

Dr Jim O’Neil, chairman of the LMC, said doctors main concerns were that under the new system no smear tests could be carried out if access to the internet was unavailable and doctors had been told they would not be able to revert to paper.

Dr O’Neil told EHI Primary Care: “The system at the moment which is paper based works fine. Under this new system the only way to perform a smear test will be to look up the details online. What if the links are down when you have a patient in front of you?

In an area like Glasgow a lot of patients don’t respond to call and recall letters and you have to get them when they come in for something else. If there’s no link to the internet when you need it you could lose that opportunistic chance.”

Dr O’Neil said the SCCRS would also mean every practice; branch surgery and family planning clinic would need to have access to the internet as well as label printers for the barcodes. He said each member of staff also needed to complete a two hour online training course in order to get a password that would enable them to use the system. He estimated that meant training 1000 staff in Glasgow alone.

Dr O’Neil said LMC members were also concerned that under the new system practices would not automatically receive the results of tests, which would be sent to patients, but need to look up the results on the SCCRS system.

He said: “The GP will be expected to go and look for the result on the system but if for some reason the doctor does not do that there is now no failsafe way of making sure abnormal results are picked up.”

Dr O’Neil said the system was also not integrated into GP clinical systems at the moment so results would have to be rekeyed into patient records.

He added: “We look to computers to help us not put in barriers and this could be a barrier to good patient care.”

Earlier this year the Scottish General Practitioner Committee called for rollout of the system to be delayed after it was discovered that practice staff could access the results of every woman in Scotland.

A statement issued by NHS National Services Scotland (NSS) said the SCCRS was initiated following a report in 2000 which concluded that call recall arrangements were fragmented and inconsistent and that a major redevelopment of current IT systems was needed.

It adds: “A six month pilot was run in two NHS Boards (Tayside and Ayrshire & Arran). The implementation date was delayed from December 2006 to May 2007 because the pilot Boards made recommendations for enhancements and fixes to the system and requested more time to test these. This demonstrated the value of user acceptance testing and piloting of the application.

To make modifications to access controls to satisfy the concerns raised by the BMA Scottish General Practice Committee, implementation was postponed from 1st to 29th May 2007.

”Phase 4 of SCCRS which is the link to GP systems has already been specified and will be developed and tested with an estimated implementation date of October 2007. It is essential that SCCRS is implemented and demonstrated to be working effectively as a stand alone system before Phase 4 is introduced.”

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