To think a sexual health clinic should offer cervical smears?

[WellVersedInEtiquette]

I've booked an appointment to have my coil taken out. I'm due a smear too so I planned to have it done at the same time.
When I went to book it I was told they don't do smears anymore. So I've had to book an appointment at my doctors with the practice nurse for three days later.
It seems silly to be up there anyway and not be able to do it all in one go!

I have exactly the same problem, always used to go to the FPC for mine but now they've closed it and opened a fancy new SH centre for all contraception/SH services but they don't do smears. It means my only option is the practice nurse at my GP's and she's always booked as far in advance as their system will allow and even if you ring on the day they say new appointments will be released they've all gone by the time you can get through. In addition to this I had a really bad experience with a PN at my old surgery so it's shaken my confidence in them a bit, that's why I always went to the FPC. Seems a bit counterproductive to be cutting services like this when they're simultaneously trying to get us all to come for our smears

Groan...i didnt know this. I was planning on doing the same thing. Killing two birds with one stone by getting coil replaced and smear at the same time. What utter nonsense that they no longer offer this service!! Surely when they are down there anyway it makes sense to carry out all services required so to speak!

That’s not good. My smear tests are so awful I want them done at the same time as anything else going on down there to minimise the ‘discomfort’ as they call it. My GP surgery did both in one appointment last month.

Email your CCG. They're the ones not funding the service.

I read in The Guardian recently about all the campaigns encouraging people to get smears, but there's no one to do them. They are even talking about getting women to swab themselves at home and send them off, the situation is so bad!

www.theguardian.com/society/2019/mar/17/cervical-cancer-screening-service-in-meltdown-as-more-women-attend-smear-tests

Complain to your CCG. Women's health is not prioritised and it's a disgrace.

Mine does. I had mine done just before I had my coil put in. Actually they were quite keen as some of their staff in training needed to observe as part of their course. It was so much better than the nurse at the GP who makes me bleed every time.

But I work in sexual health (not at that clinic) and SHS are very strained in some areas. They just may not have the appointments to offer them everywhere.

Additionally, according to the article I posted, even if you can get someone to do the smear, there's no one to test it so you'll wait forever for the results!

Could be to do with them parcelling up and having private bidding for various services.

I went consultant gynae few years ago he said they all had lists of things they were allowed to do at different clinics etc as it was seen as most cost effective but ignored that it meant women might have to attend multiple appts when 1 could have done it, and ignored the time effort and given the intrusive nature, possible stress and even trauma.

My wife is a sexual health nurse. They used to do smears but now they don’t get the funding, it all goes to GP practices. Of course it would make sense for them to do it, but very little in health funding is based on common sense.

Yep this is why I’m overdue the only way I can do it is a drop in service which they’ve now removed. I don’t know in advance when I can go so booking weeks ahead with GP doesn’t work.

Yep, it’s to do with them not winning the contracts. There are a small number of ‘loopholes’ in which a smear can still be performed (opportunistic smears) but routine checks are done via practice nurses. Unfortunately it’s another sign of the vanishing sexual health care nursing sector .

The last time I had one done at a practice the nurse used a metal speculum and was so rough it tore me and it left a visible tear that I could see in a mirror like a slit and it took days to heal and it hurt v badly every time I went to the loo (wee). I do not want to go back there under any circumstances so what are my choices?

Can you really do one yourself at home?

Is it literally GP practice or nothing?

It is dependent upon CCG contracts
The sexual health clinic may not be contracted to do this because it’s contracted to the GP’s

I run an out of hours GP and nurse service and it’s taken us ages to get cervical screening up and running as the nurse must be trained then you have to apply for the nurse to get a log in for the cervical screening system, even then they can’t do opportunitistic smears they have to do them at recall

I wouldn’t do one at home as you probably would end up with an inconclusive result. Never heard of an actual smear at home but you can self swab your vagina

We offer them though we don't get paid to do do them and our commissioners made us remove them from our website and leaflets as they were listed as a service we offered and one day just disappeared. There's an argument that it should be the GP's offering them instead. It's not your clinics fault if they don't offer them, the people above who don't work on the front line and have no idea what's really going on make these decisions.

OK if I cannot do it at home I guess I will search for other places that may do them locally even if it is not listed on a website. Failing that I could find out if it is one nurse/the same nurse/what happens at the surgery I am with. I don't want to just leave it as I think that would be irresponsible tbh.

Self collected smears are the future for cervical screening. They are actually surprisingly accurate and easy to perform.
PrevMedArticle

JMS article

I didn’t read the whole article yet but what I did read was talking about looking at HPV on the self screening which is only one element of a smear. I haven’t got to the part where it is saying you are collecting cervical cells for any other screening ie cell changes

In England HPV screening as the primary cervical screen is being implemented: phescreening.blog.gov.uk/2019/02/01/new-hpv-implementation-guidance-for-cervical-screening-providers/

skybluee, I'm considering going private, have found one of the 4D scan places near me who offer the service, no idea if others are following suit but might be worth a look. It's £110 so not cheap but I think it's what I'm going to end up doing, I'm over a year overdue and still can't get an appointment at GP's.

I'm a practice nurse. One in four PN's are due to retire within the next ten years (myself included!) so can't see the situation getting any better. Some ladies are waiting weeks to get an appointment for a smear. To be honest, most of my clinics are full of chronic disease monitoring of mostly elderly. People are living longer with more co-morbidities. There just aren't enough hours in the day.

Some sexual health services are run by private companies. Virgin is in charge in some of the North west areas.
The nurses may be qualified in sexual health but not have the qualifications to perform a smear test and as the GP surgeries get the funding and money for this, it tends to be left to the surgery to do.

I don't recognise the name of the organisation that is in charge of the place now. I'm sure it's changed since I had the coil put back in in 2015.

Reading some of the comments has certainly made me think outside the box as to what i thought about the subject as first