We know that people may be put off attending cervical screening appointments for a number of reasons, including fear, anxiety, shame, previous trauma, or unease about the healthcare professionals involved.

Someone’s willingness to undertake cervical screening can also be impacted by their level of knowledge, the accessibility of the service, as well as social and personal factors (see portraits of women). Providing accurate and clear information to patients about cervical screening is one of the best ways to help them make an informed choice and overcome barriers to doing so, alongside making sure that every member of the team involved in their screening, or related queries, is as welcoming and helpful as possible.

If helpful, please use this resource to remind your teams to:

• consider any factors such as domestic, social, and work situation and the patient’s previous experience of healthcare
• listen to any health beliefs, concerns, and preferences that the patient has, and enquire as to what actions you could take that would help them
• respect their view and offer any support needed
• avoid making assumptions
• listen to and discuss any fears or concerns the patient has in a sensitive manner – patients may fear judgement from healthcare professionals for a range of reasons, which may or may not be based on their past experiences
• try to make sure the environment is as private as possible – booking an appointment at a reception desk, for example, may deter some people from making an appointment
• establish the most effective way of communicating with any patients attending cervical screening who are new to you and your teams, including using pictures, symbols, large print, Braille, different languages, sign language or communications aids, or involving an interpreter, patient advocate, or a family member if helpful
• always use words patients will understand, helping them with unfamiliar words, and checking understanding
• give the patient the information and support they need to promote them taking part in their care
• ask the patient whether they want to be accompanied at appointments by a family member, friend, or advocate, and whether they would like to take notes and/or an audio recording

With under-screened or never-screened people, you may wish to emphasise to your teams the importance of:

• building trust and creating an environment / relationship where the patient feels safe
• enquiring sensitively about past screening experiences to help identify any barriers
• taking time to help your patient feel supported, comfortable, and clear on the benefits of cervical screening
• demonstrating respect and inclusivity through language and by creating an inclusive atmosphere (for example, using easy to understand diagrams, and providing resources (if needed) in other formats or languages)
• reassuring them that the test will be undertaken carefully and respectfully
• letting them know they will be able to undress in private and be given a sheet to cover their lower body
• ensuring they understand that their test results will remain confidential
• giving patients time to feel comfortable with new information, ask questions and make informed decisions
• avoiding any assumptions about a patient’s cultural background, sexual history, sexual orientation, literacy levels or knowledge of their bodies
• using visual aids where appropriate, especially with patients with low literacy levels, where English isn’t their first language, or those who may be embarrassed
• asking on booking an appointment what can help put them at ease, for example, would they like to bring a chaperone or would they like someone from the surgery, would they like an interpreter, and so on

Next page: Engaging with people who face specific barriers