Smear tests

[miriam25]

Hi all,
I seem to have developed a phobia of smear tests - today 10mg of Valium wouldn't even help! I've read about HPV blood tests - has anyone had one or does anyone have any idea where you can get them done?
I've also thought of having a course of hypnotherapy - has this worked for anyone one??
Many thanks

SinsterSal see Sugarcanes the Practice Nurses posts/comments who takes smears.

I was refused the pill after declining a smear by my GP. His attitude was appalling.

Funnily enough, the Family Planning Clinic had no problems with giving me a prescription without a smear.

Oddly the NHS say that routine prostate screening is not carried out by the nhs as it is invasive and carries a high risk of over treatment. Looking at the figures they look quite similar to the statistics for cervical screening. I do not understand this disparity and I have to say that I do not believe I was fully informed, or informed at all in fact, about the risks of screening.

Thanks Blis clearly this whole thing and the structure of it needs looking at, especially the fact GP salary is dependent on hitting the 80% target.

I had no need for contraception but I wonder if I had needed it if I would have faced the same issue as you? Our GP's seems similar!

I think you could try to get over your phobia so that then at least you can make a free choice whether to have a smear test. Your local IAPT (improving access to psychological therapies) should be able to offer a short course of cognitive behavioural therapy. You can self-refer in some areas. In other areas your GP will need to refer you.
Good luck.

Being uncomfortable about an intimate examination is not necessarily a phobia.

I would have thought it was perfectly normal for women to be apprehensive about such an examination and they shouldn't have it referred to as a problem or a phobia. Our bodies quite happily, in most instances, accept something being inserted when we're physically comfortable - a smear test is the exact opposite of being comfortable in any sense. Women are often treated with little dignity or compassion during a smear so to be apprehensive is entirely rational, not phobic or silly or uptight.

Having to be drugged for an examination is now just accepted as normal. That strikes me more that something has gone wrong in the way in which we conduct these tests.

Lizza why the assumption its a phobia? I have had loads of gynae treatment for other issues. Even I had a gynae issues and they offered me a smear just because they where examining me I would refuse. After weighing up the risks and benefit my informed choice is not to have one.

I agree with Bliss that its regarded as acceptable to drug woman for routine screening is very, very wrong. As is the fact GP salary/income is based on number of women screened.

How can a GP be objective when his salary/income is dependant on screening woman? In fact his income/salary is so dependant that he has to offer to drug them to attend!

They still get their money if you refuse to come.

Not that simply Penny! Yes you are removed from target figures if you get Screening Office not to send you letters. For patients who do not know how to opt out with their local Screening Office their failure to attend still counts towards the 80% target.

However GP Contract/RCGP guidelines means opt out Read Codes only last for 5 years which is why some GP's fail to respect women's views and hound in case its picked in their QOF Annual Review visit that they have a load of opt out Read codes on their computer for cytology.

Yes I have been a lay assessor at QOF visits ex NHS Manager.

Screening should not be linked to payments as GP's cannot be objective.

Hmm ok but not according to my practice manager.

The depth of knowledge of some Practice Managers is amazing you only have to read the Practice Manager forum its frightening.

Read RCGP guidelines which links into the contract obviously that is why there is only a 5 year opt out for Read Codes.

Depending on your area/Assessors your QOF team my pick up on this. Hence why some GP's worry about too many opt outs.

specialsubject Tue 31-Dec-13 18:53:40

"this thread could only happen in the entitled UK."

You said it.

Masses of sympathy for those who genuinely struggle with the physical elements of a smear test,

but those who are moaning about being sent reminders?!?!?!?!?!?!?!?!

?!?!?!?!?!

Its not just reminders its constant physical hounding from GP's/Nurses in consultations/phone calls see SugarCane's posts she is a Practice NUrse and yes it officially happens.

I am not asking for anything just be left alone so I can see a GP when I am actually ill. I AM ASKING to be entitled to anything as I am sure are nt the other posters who are affected by this! I fail to see how this makes us entitled

The only way I can be left alone and have my decision respected (even after making an official complaint it still continued after assurances it would stop) is to deregister from the NHS.

I am therefore saving the NHS money!

honeybee what constitutes hounding though? So, a letter every so often, and a phone call reminder? What of the women who genuinely forget or who put off and put off and put off their smears because they just don't want to do it - but it IS life-saving treatment?

I don't know why they would still contact you if you have asked to be left alone re some form of test, but why is it so big a deal just to ignore - chuck the letter in the bin, or if asked by the practice nurse, reply "Thanks for the reminder, but I am choosing not to have a smear and respectfully, it's not up for discussion whatsoever". Or something similar. I think that your decision to opt out of having a GP seems on the face of it like an extreme overreaction. But then, as you said yourself, if you need GP care you just sign on as a visitor so it's not exactly leaving you with zero medical facility, but you ARE pleased that they don't get paid as if you were a permanent patient.

Why are you so bothered about the money element? Why does it matter? All you have to do is not go for smears and refuse to discuss the matter if raised by a nurse I can't put this in any better way but it's as though you feel the NHS is some sort of authority figure who you have outwitted.

PS re the "entitled" bit (I am not writing the following with a snarky tone, I am being genuine) it's just that when there is a life-saving test AND treatment available from such as system as the NHS then I'm sure there are quite probably millions of women in the world who would be grateful for it instead of being annoyed by reminders or the fact that GPs get paid or that they could have lived with a 1-2% rate. It's because we have such a system in place here, that we don't have to pay private prices/rates for, that we DO have something to get narked about. Other countries- no test, no treatment, no letters, no nurses reminding you, no GPs, no problem! (except you may get cervical cancer, you suffer, you die)

Not that simple BunnyMama you get 10 min GP/Nurse appointment and you lose half that with them hounded see SugarCane Practice Nurse posts the computer flags you as not attending so its bought time and time again!

Temporary Residents/Emergency Patients are unable to have a hospital referral. in my area.

Yes I am pleased they will not get paid if I need antibiotics etc serves them right for not respecting my wishes.

I even had to threaten the GMC to get deregistered why should I constantly be hounded, even after I have made an official complaint?

I have had years and years of this and enough is enough. I would never ever trust a GP or the NHS again after this repeated failure to respect my wishes. AS SugarCane the Practice Nurse says she can understand why women disengage from the NHS. Dr Margaret McCartney who wrote Patient Pardaox is also worried about women not attending with significant symptoms due to pressure re screenings.

After years and years of it I hardly think it extreme it was the only option left to me and then I had to tell him I would make complaint to the GMC if he did not deregister me as he was arguing about that too. Enough is enough!

Only 10 would be saved per 10,000 people per 20 years eh?

Well 5 of those ten are here on this thread. How amazing is that?

They are not just cin1 results which may have corrected themselves. They are actual cancer cases that have been picked up earlier due to screening.
Ok mumsnet users are quite a high proportion of the uk population, but how many happened to be reading general health and this particular thread, yesterday and today?
Multiply us 5 by the rest of the uk population.

You can twist the statistics however you want.
2 - 3 % incidence in the whole population.
30% of cin3 results
These are not insignificant figures.

I'm finding this thread so very very sad, that people are so prepared to put principles over hard reality.

Happy New Year and bottoms up, to the 2014 that I may never have lived to see, had it not been for my smear test.
Sorry for feeling quite passioante about this. I've obviously been drinking the new year in.

sorry 1 -2 % of the whole population.

I also find it quite interesting that Sugarcane, the practice nurses opinion has been bandied around, as if her word is gospel, much like McCartneys.
Amazing that some people would rather listen to a couple of people who speak theoretically, rather than take notice of people who have actually experienced the benefits in real life and are alive because of screening.

I repeat that your informed choices should be listened to, but please don't try to convert other people to your way of thinking, even if it is dressed up with concern for peoples mental wellbeing. Yes, correct information should be available, no, people shouldnt be constantly hounded if they have made a decision not to be screened, but it should be opt out, not in. Screening saves lives - fact, as evidenced by at least 5 stories on here.

I had gas and air for mine , I sucked it constantly and was out of it .

Happy New Year :)

honeybee I do appreciate your POV but I think it's concerning that you appear to be harnessing your dissatisfaction with the NHS in general, to a discussion about what is in effect a life-saving test. There are posters here who would not be here posting had it not been for the smear test. It DOES save lives. The living proof is contributing to this thread. I know it's hard to answer but if hypothetically you turned out to be in the 1-2% would you seriously not have any regrets? You may have been able to process the wider info and the stats and make an informed personal decision but not all women are able to do that and also, presenting as 1-2% sounds minimal but it's actually a shockingly high incidence rate in my book!

As for concerns about women not attending with significant symptoms due to pressure re screenings - is there REALLY a large number of women who would otherwise definitely have gone for screenings had it not been for the "pressure" (ie reminders?) Would there be women who say "Well I was all set to attend my regular smear test and then I got a reminder and you know what, I've decided not to attend because of that?"

PS shewhowines best wishes for your continued good health.

redspotty you're right, the NHS doesn't screen men for prostate cancer, but men (in general) die younger than women. My dad and maternal Grandpa both died of prostate cancer, caught far too late.

I have been lurking on Mumsnet for while but my situation is similar to Honeys and UnduePressure so feel compelled to respond.

BunnyMama: If you read through this properly you find there is about as many women concerned with screening issues as there is that have cancer. Does that not tell you something?

Can you tell me where in Honey's or UnderduePressure threads you picked up the idea their dissatisfaction is with wider NHS? Have I missed something?

Honey and UnduepRessure concerns are not about receiving screening letters they are about the pressure the GP/Nurse is placing them under. The Practice Nurse SugarCane confirms first hand this happens on a regular basis.

Honey and UnduePressure in no way have suggested women should not have smears but they argued should that should be able to make an informed decision and have their decision respected. I am another patient who has had to unregister from the NHS to stop the constant "hounding" for want of a better term.

Surely this must imply something is very wrong with the system?

Indeed another person comments that her GP refused her the pill due to her not wanting a smear. This amounts to blackmail in my book and is completely unethical.

Honey and UnduePressure (as have the other women with concerns) have totally respected your views and decisions to be screened yet you seem unable to respect others points of views.

I am in my mid/late 50's and smelt a rat a few years ago re GP's when I was in my early 20'S and single I wanted a coil. I was told I could not have one because I was not married, I may sleep around ie I could be a slut! Therefore I may get an infection! Take a look at Basard Mirena in Contraception now the NHS is pushing coils as long term contraception for single/all women. I have asked my cousin who is a GP in his early 60'S and he remembers the time when women were not allowed coils due the reasons I have given and he informs me that it is in GP Contract that GP'S should push coils/implants now for single/all women! So again just as with smears clinical decisions are made on population medicine and needs/wishes/informed choices of individual women are swept under the carpet and not respected. The Bastard Mirena thread highlights the issues and some GP's are even refusing to remove coils/implants. Women are threatening to remove them themselves and in some cases doing so! No doubt GP's get paid for for pushing coils/implants too.

My view is if want to treated by a politician use the NHS if you want to be treated by an actual doctor you have to pay privately!

Honey- I deregistered after receiving paper invites and then I received (I keep my landline on voicemail) 8 phone calls from the Practice Nurse at my new Surgery. I gathered all the paper letters together scrawled GONE AWAY all over them and sent to the PCT. I was deregistered.

Yes I am another one who does not trust the NHS I now have a private GP. The difference in care is astounding my care is tailored to me and not based on political whims of the moment.

Women really do need to make their own informed decisions and really research what the NHS is telling them. The NHS gives out one sided biased information, in my opinion.

There needs to be research done on patients who are avoiding/deregistering from the NHS due to these types of issues. There seems to be quite a few of us around.

The Practice Nurse SugarCane confirms first hand this happens on a regular basis.

While I don't dispute SugarCane for one moment this does not happen at every practice.

I am a practice nurse, I take smears almost every day I am in, we do not "hound" our patients, we do not call them, we do not bully them into having their smear. I have worked at one other practice in the same area, they had a similar approach. Obviously I can't speak for all or even most of the GP practices in the UK but it seems we do not all have the same approach.