Cervical screening – how accessible is it?
Earlier this month one of our Senior Solicitors in our Complex Injury Team, Olivia Boschat, wrote a very interesting article for Female First highlighting the importance of cervical screening for women. To quote Olivia, “anyone who’s had a smear test knows it is not an elegant experience” but it is an important one. In fact it can be lifesaving. Yet many women across the country are being denied access to this important test because GP surgeries, where the test is most commonly carried out, are not accessible for those with mobility issues. Stopping there for a second, many people might be reading that thinking ‘but my surgery doesn’t have stairs’ so it must be accessible. But accessibility doesn’t begin and end with being able to enter and exit a building. A wheelchair user may be able to enter a GP surgery but what good is that if they need a hoist to transfer onto a bed for a smear test and there isn’t one? Or if there is a hoist but the nurse on duty hasn’t been trained how to use it?
The government’s awareness of this issue has increased in recent years. In their study entitled Health matters: making cervical screening more accessible, dated August 2017 accessibility for those with physical disabilities was never even considered.
However in their July 2019 guidance Cervical screening: ideas for improving access and uptake physical access is considered:
Primary Care should consider the clinic facilities for women with a physical disability, including:
- access to the venue (can an alternative be offered?)
- the height of the couch
- the woman’s physical limitations
- the possibility of a domiciliary visit
- the need for assistance and seeking specialist advice if necessary
In the case of paraplegic women, the sample taker may need to make special arrangements, for example with the local colposcopy service, to take a sample at a clinic where a hoist is available.
Personally I have to steel myself to even make a run of the mill appointment with my GP surgery – I simply cannot imagine the stress involved in trying to coordinate an appointment with a local colposcopy service.
So if your GP isn’t accessible what are the other options?
For some smear tests, they can be arranged via a home visit but with the demands on GP surgeries ever increasing and the numbers of district nurses ever decreasing this simply won’t be an option for many people.
The use of at home smear tests has been widely promoted this year but is still only in a trial phase so won’t be available to all and whilst this may be the answer for some, it certainly won’t be for all in the longer term.
One alternative might be a private GP service, although there’s still no guarantee that it will be easily accessible and at a cost of upwards of £100 this simply won’t be affordable for some.
There’s no quick or easy answer to this and indeed we have to accept that for the government and GP surgeries money will be a big factor. However, the government needs to take more responsibility for effecting change in this area. The current guidance just isn’t realistic and reads like it came out of a round table ‘blue sky thinking’ session. It may well work in theory but it’s unlikely to be easy or even possible in reality and it’s easy to see how many women will simply be put off having the procedure or else delay so much that they miss the window for a potentially lifesaving diagnosis. If this happens even once, it is one time too many.
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