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In primary care, recall scheduling is a familiar administrative undertaking. Practices routinely run recalls for long-term conditions, chronic disease reviews, and vaccinations. Having an effective recall strategy also helps practices meet QOF targets.
Unlike long-term conditions, cervical screening recalls rely on a separate national system. With patient data moving between databases, gaps and errors mean that there is a chance of some women being incorrectly recalled or missed off the screening programme, putting their health at risk.
Taking steps to ensure that all primary care staff understand how cervical screening differs to other health initiatives, and where bad data can play havoc, helps practices build a safety net.
Rather than being managed solely by individual practices, cervical screening in England – including invitations, reminders, and tracking of eligibility – operates under the Cervical Screening Management System (CSMS).
The programme defines recall intervals for women and people with a cervix, as well as deferrals, cessations, and follow-up paths. This recall planning determines who should, or should not, be invited for screening.
Cervical screening recalls are therefore not handled by GP practices in the same way that long-term condition recalls are managed. While QOF-style recalls rely on reliable data collected by the practice, cervical screening demands logic and data managed by the national system.
The CSMS acts as the single source of truth for invitations, screening test results, and recall intervals, automatically calling and recalling patients for screening.
It maintains up-to-date records of screening status and screening due dates. Once a sample is processed, the results are sent back to CSMS to update the individual’s record and generate the appropriate follow-up action or recall date.
GP practices can access these records to confirm when a patient is due or overdue, helping ensure local systems mirror the national dataset.
Primary care staff also play many crucial roles in the process: encouraging uptake, addressing barriers, booking appointments, performing the screening test, and reconciling or flagging data discrepancies.
Despite cervical screening records being held centrally within the CSMS, errors can still occur.
Data must move seamlessly between CSMS, GP systems, laboratories, and administrative teams. Each transfer risks information becoming outdated, mismatched, or miscoded. This can lead to women not receiving their invitations, being recalled early or late, or being excluded from the programme altogether.
Failure points that could lead to bad data include:
Safety implications around recall scheduling aren’t just theoretical. A 2020 audit of the Scottish Cervical Screening programme found that over 400 women were incorrectly removed from the screening programme over a period of 24 years. A small number (less than five) developed cervical cancer after being excluded incorrectly.
A Quality Assurance report of the Cervical Screening Programme at the RUH, Bath NHSFT noted that IT system restrictions and the resulting manual processes led to results being allocated to consultants not involved in that patient’s care. It also stated that referrals and results could be overlooked, with appropriate follow up not being arranged.
A delay in detecting precancerous or cancerous cells can have profound consequences. “Bad data” is therefore not only an administrative problem – it’s a patient safety issue.
It’s important to remember that QOF lists support population health outcomes through performance monitoring. QOF is not designed to recall patients, and doing so can create safety gaps.
QOF searches don’t include patients newly registered with the practice in the last three months, or those who need accelerated follow-up after borderline or abnormal results. These women may not reappear on QOF reports for another three to five years, depending on age, leaving a high-risk group at risk of being missed. Cervical screening recall must therefore always be based on data from the CSMS, not QOF reports.
Even with a national system in place, practices can still play an important role in making sure no woman misses cervical screening. While the CSMS automatically identifies and invites eligible individuals, GP teams can act as the safety net – checking, reconciling, and engaging patients who might otherwise be missed.
A robust recall strategy doesn’t mean duplicating the national process. NHS England advises practices to align local lists with CSMS data, while keeping communication clear.
Practices can safeguard women’s health in the following ways.
Working in partnership with the CSMS rather than trying to replicate it can help practices create a safer, more reliable recall process to ensure those who are eligible are invited, informed and supported to attend.
At Suvera, cervical screening is excluded from our recall scheduling tool, Planner. This is to ensure that cervical screening remains aligned with the national process managed through the CSMS.
Instead, we focus on recall strategies that rely on data managed within primary care. Planner helps GP practices:
The centralised CSMS system was designed to protect women’s health through consistent, accurate recalls, yet errors and discrepancies can occur between local practice data and national records.
By understanding these risks and aligning practice processes with CSMS, staff in primary care can help safeguard patients.
Suvera supports this by streamlining other recall scheduling and planning tasks, freeing up valuable time so practices can focus on different aspects of clinical care.
To find out more about the impact of Suvera’s digital platform in managing long-term condition recall, explore Planner here, or book a quick demo.
