Being refused Post Natal smear test...

[Jessesgirl13]

Hi everyone,

Just looking for some advice/guidance.

Back in 2017 my routine smear test showed severe changes and I had LLETZ treatment done privately to remove abnormal cells. In January 2018 I had my test of cure smear done, which unfortunately showed moderate cell changes. I then had to have another procedure done under general anaethestic to remove more bad cells. 4 months later I became pregnant so couldn't have the next test of cure smear due in August (6 months after surgery).

I'm now over three months post partum and just rang the docs to book in a smear and they said I can't have one without a letter of invitation. I'm concerned as it has now been 16 months since my last smear and I was under the impression that once you had severe cell changes you were put on 12 monthly ones for a few years? Or have I got that wrong?

Has anyone ever had a letter inviting them after being pregnant? I feel like after having such bad results over the past two years I can't just wait around to see if I get a letter, i'd rather not take any chances and just go private.

Can you not just say you are overdue the smear test, due to missing one while pregnant?

I had put off booking my last smear for 2 years (a mixture of family death, new job, moving house, etc) and when I rang to book, they asked if I had my letter. I just said I had lost it but I was 2 years overdue. The lady tried to tell me I couldn't go without the letter. I told her she could see on her system the last time I was there for a smear was way over the amount of time it should be. I heard her mention it to a colleague and the colleague said to just book it

Was all your other treatment done privately? If so, then the NHS service won't know about it and will probably have you on the normal 3 yearly call up schedule

OP won't be due the normal smear until 2020 so isn't overdue on the routine smear.

Sorry, I missed the bit about private treatment

Yeah the treatment was done privately (due to the NHS wait times being too long). They have the treatment on their system though as the doc that saw me privately gave me a letter to hand in to the surgery with all my notes on. Plus the receptionist confirmed that she could see on my notes that my last smear was Jan 2018 which was done at a private hospital. With them having access to all of my notes I would have thought I'd be on 12 monthly smears and wondering whether this is something I should be questioning with them?

Who is telling you it’s not allowed? If the receptionist, I’d make a GPs appointment and discuss it with them. Even if just a phone consultation.

You are right. Every year for 5 years. I had moderate cells and surgery and that's what I received..phone and ask to speak to GP

Thanks for confirming! I really did think that was the case. It's the receptionist that's telling me they wont see me without a letter. I will ring up the GP and ask to speak to them about it.

Receptionist said that I will be sent for eventually, but I think that would be if its a routine 3 yearly smear. I'm already 4 months overdue and have had no letter so can't exactly just wait and see. Not when I've had such severe results in the past.

I'd personally just book to go private and get in for tomorrow .. but I'm anxious and impatient

I never had my follow up smears at the GP .... I had them done at the colposcopy clinic at the hospital..... maybe try them?
I kept getting a reminder from my GP for my 3 yearly smear even though I kept telling them I just had one done at the colposcopy clinic...

So you haven't had your test of cure (ToC) after the 2nd lletz then?
If the last NHS test was severe in 2017 and the private samples aren't on Open Exeter, then your screening status should still be set on 12 month recall from the failsafe recall on the severe. If the private cytology is Open Exeter then that's slightly more complicated but essentially you should still be showing as non responder as far as the NHS is concerned. It's unlikely your next test due date (NTDD) has rolled over to 3 year recall as your last test has a suspend status. Based on the screening history you've given, you're due a ToC for the 2nd lletz. If you're overdue for screening then you won't have an invitation letter, so the receptionist hasn't quite understood the recall system.

Please do contact the practice again for your follow up test.

BertieDrapper unfortunately some GP practices run their own recall in addition to the main screening database and it sounds like they haven't updated it to reflect the follow up at colposcopy.

I went this month as I knew I had my last smear just after my daughter was born and she just turned 3, as we have moved I assumed I hadn't had a letter because of that. The nurse gave me the 3rd degree about whether I was SURE it was due... and worse still, told me they would THROW IT IN THE BIN if it wasn't due. RIDICULOUS when we are trying to encourage screening and rates are at an all time low.

Then today I got the results, which was interesting because apparently now they first test you for HPV and if you are HPV negative they don't check the test sample (as so much cervical cancer is caused by HPV). I am a bit worried about how safe this is... is ALL cervical cancer caused by HPV?!

As I'm HPV negative I am also tempted to pay for the HPV vaccine myself privately - its quite a lot, over £400, but if it really reduces the risk it might be worth it...

Thoughts?

This seems odd to me. I had one abnormal smear, then a follow up that was normal, so no treatment, and I still had to have a test each year for three years.