Barriers to accessing cervical screening

In November 2019, it was reported to Healthwatch North Lincolnshire, by a local disabilities campaigner, that some women were facing barriers to accessing cervical screening. These barriers included women with physical disabilities being unable to be tested at GP surgeries due to them not having hoists available within practices.  Healthwatch undertook research into take up using a survey and a focus group.  Altogether they spoke to 285 people.

Most women felt that cervical screening was important to detect pre-cancerous cells, but there are barriers that prevent some women from accessing this.  Disabled women who use wheelchairs and can’t get onto the examination table found they couldn’t get screened except at hospitals. Women have expressed that GP practices are not wheelchair accessible which makes attending an appointment in the GP practice difficult and can be a barrier for accessing screening. GP practices do not appear to be making reasonable adjustments for these women to ensure that have the same access to screening as those who are able bodied.

Some GP practices are ceasing offering appointments to disabled women who they consider do not require screening due to either assumptions or disclosures of not being sexually active. There is an inconsistent approach to providing accessible information across GP practices for women with a learning disability or difficulty. Some practices are taking the time to support women to understand the importance and process of screening and are providing easy read information to reinforce this. Those women who felt supported reported a higher level of satisfaction in the process. However, some women with a learning disability are not accessing cervical screening appointments due to lack of understanding of, and importance of attending regular screening. This is contributing to fears over attending the appointments. Information provided to patients is not accessible enough, and GP practices are not supporting women with a learning disability to understand the process, despite a plethora of easy read and accessible information available.

Some women find the prospect of cervical screening daunting, due to range of issues such as beliefs around screening, fear, embarrassment and previous negative experiences, including abuse. This means that some women are avoiding attending screening and are ignoring reminders to have this important test undertaken. Some GP practices are making a concerted effort to engage with women who do not attend appointments.

Women are finding attending appointments difficult due to caring responsibilities, work commitments etc which indicates a general inflexibility of GP practices to accommodate these needs.

The report contains 13 recommendations about making cervical screening appointments accessible for all women