cervical smears

any_name_will_suffice

Hi,

I don't know if any of you have any experience of this.

I had treatment for abnormal cells ( severe dsykaryosis) in 2009, and after a couple of 6 month follow ups, the gynacologist discharged me but advised annual smears for 10 years.

After my 2nd six monthly smear in summer 2010, the regional screening board wrote to me saying it was clear, and to come for a 3 year recall.

I moved house and changed gp surgery (same county but comes under a different hospital trust), and when it was time for my summer 2011 smear, the surgery agreed to do it, after checking my discharge letter from the consultant.

However, the screening authority wrote to the gp surgery saying they wouldn't accept any more smears until 3 years had passed unless i presented with symptoms.

Roll on to now (i know it's late, i've had other problems with pg and miscarriage), the practice nurse is having to really escalate it with the screening authority to request they accept another smear. She has already faxed over a copy of my discharge letter, but it seems that has not been enough to convince the screening authority this far to accept annual smears.

I suppose what I want to know is, where do I stand? Are the screening authority able to over ride a consultant's recommendations?
Should I apply to the original hospital for a copy of my medical notes, or will be my gp surgery already be able to access these?

if you've reached this far, thanks for reading- I'm really hoping someone knowledgable will be able to advise

j.e.j.

I did not know there were limits on the number of smears a woman is entitled to under the system, but if you are concerned and the nhs are being obstructive, it is possible to have a smear + HPV test done privately.

I would be alarmed (though perhaps not surprised..:( ) if the screening dept can override what the consultant recommends.

Hopefully someone will be along soon who can advise.

Blackpool_Saver

Yes I too would have it done privately, it's usually by means of a GP appt and additional fee for the smear test.
I have done this a few times when met with this sort of thing.

kadison

I would take this up with your Patient Liaison (or PALS) at your nearest hospital, also write to your local health authority/trust, citizens advice and your GP surgery may also be able to help.

Come at it from these angles....

• That not having these smears may have an effect on your health and that funding smears would be much better cost-wise that possibly funding treatment at a later date (it's often a money thing)
• That having a three-year interval between smears is not appropriate given your history and is causing you distress by not having the peace of mind that more regular smears provide.

Basically anything you can come up with, persistence normally pays off and they need to realise you're not going to stop until you get what you're entitled to! Some health authorities are very low on funds so you need to fight for some things.

http://www.nhs.uk/NHSEngland/thenhs/about/Pages/authoritiesandtrusts.aspx

Good luck hun xx

any_name_will_suffice

thanks guys for the advice.

I have no problem paying for the screening privately if I have to, although I can't see why the consultant and the gynae nurse were so insistant I had to have annual smears if I am not entitled to them. I'm sure it's either a case of different areas having different policies or an administrative error somewhere along the line.

I have definitely had an hpv screen, and I haven't changed partners since then.

my GP (despite telling me my cervix looked abnormal during a recent internal exam :eek:) said she wouldn't do a smear just yet as I wasn't having any symptoms, but would leave it to the nurse to investigate. and to be fair, she is chasing them. I did think they had sorted it out in 2011, but apparently not!

I'm fairly sure I no longer have any of my hospital letters from 2009 -10, will there still be copies of them in my hospital records, and are they kept on a central database or do I need to get back in touch with the original hospital's gynae department?

when I was 21 i was living in lincolnshire and was offered a smear, I didn't have one as I was in the process of relocating to Hertfordshire. When I had got myself registered at a new GP surgery I enquired about one and was told they only offer them to age 25 upwards, so there's clearly local differences in how screening is offered. (I'm in Nottinghamshire now)

SUESMITH_2

all the letters should be in your medical notes

SparkyG

I had Cin 3, carcinoma in situ of the cervix in 1980 and needed a cone biopsy. This was before laser and other less invasive treatments were available. My consultant at the time said I should have annual smears FOREVER. I did until about 10 years ago when the surgery said that it went against government recommendations, as apparently "they" know better than a Consultant Gynaecologist!!

As I am now over 50, I am only entitled to smear tests every 5 years, despite my past history. A few years ago a study was carried out in Sweden which was reported in the Lancet, that proved that women are still at high risk of cervical cancer 20 years or more after the initial case. I showed the report to my doctor but they were adamant that they would not be reimbursed for smear tests which were carried out more often than the government guidelines, even with a past history of cervical cancer or abnormality. The Consultant's opinion and advice counts for nothing.

My only option now is to have a smear test anually at a local private hospital at a cost of approx £100. If I can't afford it..... hard luck!

j.e.j.

SparkyG wrote: »

I showed the report to my doctor but they were adamant that they would not be reimbursed for smear tests which were carried out more often than the government guidelines, even with a past history of cervical cancer or abnormality. The Consultant's opinion and advice counts for nothing.

My only option now is to have a smear test anually at a local private hospital at a cost of approx £100. If I can't afford it..... hard luck!

I had a feeling this might be the case..

any_name_will_suffice

SparkyG wrote: »

I had Cin 3, carcinoma in situ of the cervix in 1980 and needed a cone biopsy. This was before laser and other less invasive treatments were available. My consultant at the time said I should have annual smears FOREVER. I did until about 10 years ago when the surgery said that it went against government recommendations, as apparently "they" know better than a Consultant Gynaecologist!!

As I am now over 50, I am only entitled to smear tests every 5 years, despite my past history. A few years ago a study was carried out in Sweden which was reported in the Lancet, that proved that women are still at high risk of cervical cancer 20 years or more after the initial case. I showed the report to my doctor but they were adamant that they would not be reimbursed for smear tests which were carried out more often than the government guidelines, even with a past history of cervical cancer or abnormality. The Consultant's opinion and advice counts for nothing.

My only option now is to have a smear test anually at a local private hospital at a cost of approx £100. If I can't afford it..... hard luck!

Gosh, that's worrying. Have you ever had an abnormal smear since your treatment?

SparkyG

any_name_will_suffice wrote: »

Gosh, that's worrying. Have you ever had an abnormal smear since your treatment?

No I haven't, thank goodness! Hopefully the operation I had removed all the abnormal cells which were surface only, and hadn't spread to the underlying tissue.

Here I am, 33 years later, alive and kicking, but expected to pay for my own smear tests!:mad:

j.e.j.

Just to add, in European countries it is the norm for women to have smears annually. I recall one of my housemates saying they were surprised that it was only every three years here. She said to me "but anything could happen in three years..!"

Anyway, hope you can sort something out, OP.

@ SparkyG I know, it's getting like anything else these days (dentistry, opticians, etc) if you want decent healthcare you have to pay for it