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Direct referral to colposcopy and failsafe

The laboratory has well-established systems of direct referral by the laboratory to all the colposcopy units in Greater Manchester, Cumbria and Lancashire. It provides patient identifiers and details of the test result to allow efficient allocation of appointments based on the cytology grade to ensure women at highest risk get the earliest appointments.

All primary care samples and tests taken in hospital clinics (except colposcopy) where a recommendation for colposcopy assessment has been advised are included in the direct referral process. This now includes tests reported as suspected invasive carcinoma or suspected cervical glandular neoplasia.

Each day a list of women who require colposcopy assessment is sent from the laboratory to the individual colposcopy units via secure nhs.net to nhs.net email addresses, using generic email addresses to ensure that lists can be processed by key staff.

Receipt of the daily list/email must be acknowledged by the colposcopy unit each day.

Laboratory Failsafe Protocol

All colposcopy referrals are subject to laboratory failsafe and the guidance issued in NHSCSP publication No.21, Guidelines on Failsafe Actions for the Follow-up of Cervical Cytology Reports 2004 is followed.

Laboratory failsafe for colposcopy referrals

All colposcopy referrals are covered by laboratory failsafe procedures and an enquiry letter is generated in the event that a colposcopy outcome is not notified to the laboratory within the predetermined timescales. It is important that sample takers are aware that they still have overall responsibility for ensuring the patient attends colposcopy, even when direct referral is in operation and they should respond accordingly when a failsafe enquiry letter is sent. Any cases where an outcome is not available are audited HBPC.

Suspected non-cervical glandular neoplasia

The department has a separate protocol for the referral of suspected glandular abnormalities of non-cervical origin. This involves contacting the GP or sample taker prior to authorising the report to discuss the result and explain that an urgent referral to gynaecology is required. Referral is to be made by the GP as there is no direct referral process to gynaecology. Actions are audited on a proforma, Form 1 below.

Cervical screening audit proforma

 

(Last reviewed November 16th 2017)