1. Cervical Sample Taker Database (CSTD)
Introduction
,100 Birmingham women were recalled after a nurse took smears with a tongue depressor.
,000 women were recalled after a Merton, Sutton and Wandsworth Authority computer error meant abnormal results were missed.
,000 smears were re-checked after a consultant from the Prince Charles Hospital in Merthyr Tydfil was suspended following allegations that he was under-reporting positive smear test results.
at Kent and Canterbury Hospital, where at least eight women died and 90,000 were recalled
,000 smear tests assessed at Inverclyde Royal Hospital in Greenock, Scotland, were reviewed after it was revealed some had been misread.
,000 tests from the James Paget Hospital in Gorleston, Norfolk, were rechecked after it emerged that lab workers were testing slides at home.
,000 women were recalled at St George's Hospital in south London after concern that some women with abnormalities were unsatisfactorily treated. This case is slightly different from the others in that it occurred after the initial screening process.
Presentation by: Martin Jones
Date: March 2016

2. Incidents
,100 Birmingham women were recalled after a nurse took smears with a tongue depressor.
,000 women were recalled after a Merton, Sutton and Wandsworth Authority computer error meant abnormal results were missed.
,000 smears were re-checked after a consultant from the Prince Charles Hospital in Merthyr Tydfil was suspended following allegations that he was under-reporting positive smear test results.
at Kent and Canterbury Hospital, where at least eight women died and 90,000 were recalled
,000 smear tests assessed at Inverclyde Royal Hospital in Greenock, Scotland, were reviewed after it was revealed some had been misread.
,000 tests from the James Paget Hospital in Gorleston, Norfolk, were rechecked after it emerged that lab workers were testing slides at home.
,000 women were recalled at St George's Hospital in south London after concern that some women with abnormalities were unsatisfactorily treated. This case is slightly different from the others in that it occurred after the initial screening process. 1

3. National/local context
NHSCSP Guidance ‘ABC2’ stated ‘Smear takers must have received proper training in smear taking’.
Introduction of LBC by the NHSCSP in 2006 , programme of retraining of both the sample taker’s and screening staff to ensure a high quality service
In 2000, NHSCSP Guidance ‘ABC2’ stated ‘Smear takers must have received proper training in smear taking’. Also, the person taking the sample should be recorded.
As part of the introduction of LBC by the NHSCSP in 2006 it was decided that there should be a programme of retraining of both the sample taker’s and screening staff to ensure a high quality service.
A number of publications regarding Sample Taker training. Eg:-
TAKING SAMPLES FOR CERVICAL SCREENING - A Resource Pack for Trainers (NHSCSP Publication No 23 April 2006)
Interim Good practice guidance for cervical sample takers - NHSCSP GOOD PRACTICE GUIDE NO 2 JULY 2011
Best Practice Guidance for Sample Taker Training in the North East, Yorkshire and the Humber - Version 2 July 2012 2

4. Why has this been developed?
There was no standardised method of issuing sample taker codes across the region
There was no centralised list of qualified practicing sample takers in the region
This has resulted in a failure to cease trainees from taking samples when they have failed to complete training
There was no standardised process for PCTs and GP practices to monitor sample taker competencies
QA did not have a method of monitoring sample takers or practice performance
There was no clear system of monitoring whether sample takers were attending update training every three years
In 2009, it became apparent that there was a need to carry out a full review of sample taker qualification and training due to serious incidents reported, notably the ‘Hull’ incident (June 2008) .
An audit was performed in 2009 which identified a number of weaknesses in the smear taker process, and illustrated the difficulty in being able to monitor smear taker performance effectively.
Therefore the NEYQARC decided a regionally managed system of mandatory smear taker registration would be introduced.
1) Support the Cervical Screening Programme by maintaining a register of sample takers and their training
2) to monitor adherence to basic training requirements and to improve performance by sharing sample taker performance data
3) to ensure that a high standard of service is provided to the relevant population
The point of this is improved quality of the CSP and the service provided to the patients. 3

5. What is it? Web based database
Register of all the sample takers in the North East, Yorkshire and the Humber
Performance management tool
Central location for recording all cervical sample taker training
Resource for current national, regional and local guidelines and protocols on cervical screening 4

6. Sample taker codes
All sample takers practicing cervical screening in the North East, Yorkshire and the Humber region should be registered on the Cervical Sample Taker Database (CSTD)
The CSTD sample taker code format is A1234 for qualified sample takers and A1234T for trainee sample takers 5

7. Sample taker codes (Ctnd)
You will only require one code for the region and this can be used at several locations
You should not share your sample taker code with another sample taker
The details of samples taken on this code will be uploaded to the CSTD for you to view 6

8. CSTD Access The CSTD has three parts:
Administration access (
Individual sample taker access (
Trainee sample taker access ( 7

9. Administrative Access
This can be accessed by the various user types including:
General practice managers / Sample taking coordinators
Hospital based programme coordinators
Screening and immunisations staff within the area teams
Training providers & Cervical screening mentors
CSTD management team
In order to fulfill the necessary administrative functions required by the system. Eg:-
Requesting sample taker ID codes
Monitoring performance & training
With different access to the database dependant upon the individuals specific role. 8

10. CSTD Sample Taker Access
If you have a CSTD sample taker code you will also have access to log into the CSTD website
You may use the CSTD website for the following:
Access regional and national cervical screening protocols and guidance
View your TZ and Inadequate rates and RAG (Red-Amber-Green) ratings
View details of the samples you have taken
Upload training records and certificates
Once you have qualified it is recommended that you log into the CSTD on a quarterly basis to review your performance data
Publication of forthcoming Training events
Distribution of appropriate documentation (policies, procedures, training guides etc)
Portal for Data Uploading or Report Downloads. 9

11. RAG Rating System
The RAG rating system is a tool used to monitor sample taker performance based upon the results of the samples they have submitted to their local participating laboratory.
There are two values that are assessed (using the same methodology):-
Inadequate Rate
TZ Sampling rate
The rating is produced following statistical analysis of all of the samples processed in a particular laboratory, with the individual sample takers performance compared to the overall laboratory values. 10

12. Interpretation of results
RAG analysis
Red - rate is significantly below average (>2 sd)
Amber - rate is below average (between 1 & 2 sd)
Green – rate is average (within 1 sd)
Minimum number of samples = 20.

13. Home Page 11

14. Dashboard 12

15. Your Details 13

16. Your Reports 14 Sample Taker Performance Report Samples Processed
Training Providers Update Training Records
Under 25’s (samples not processed)
RAG Rating 14

17. Sample Taker Performance Report15

18. Sample Taker Performance Report16

19. Combined RAG Rating Report

20. Documents and Updates

21. Contacting Us

22. Any Questions? Cervical Sample Taker Database
Sample takers only
Cervical Screening E-portfolio