Cervical screening (for women with Learning Disabilities) Care Pathway

Review in progress

Disclaimer: The guidance contains helpful primary care information for management of referrals and up to date referral criteria. These guidelines are locality specific to best reflect local services. This guidance does not override or replace the individual responsibility of healthcare and social care professionals involved in the delivery of care to make informed professional judgements appropriate to the circumstances of the individual.


This guidance refers to:

  • The cervical screening in women with a learning disabilities and contains guidance for GPs, practice nurses and easy read documents for patients.
  • Public Health England (PHE) screening team have collaborated with screening nurses, practice nurses and learning disability clinicians to improve the uptake of cervical screening by women with a Learning Disability by improving the information available and signposting other useful resources.


Suggestions that may help to increase a woman's understanding of cervical screening
  • Find out how the woman communicates - you may need to ask carers.
  • Find out which word the woman uses for vagina so that you don't get misunderstandings.
  • Offer a pre visit so that that the woman can feel safe whilst you explain about the test.
  • Show the speculum and sample broom to the patient. Let her handle it and explain how they work. For example "You will feel the speculum being inserted."
  • Show her the position that she will need to be in when she has the test.
  • Encourage her to get onto the couch to see what this feels like.
  • Suggest that she practices the position at home so she feels more comfortable about it. This can be done with her clothes on in her bedroom where she feels relaxed, so that she gets the feel of the right position. Carers may need to support this.
  • If she wishes to have somebody present during the test, reassure her that it's her choice.
  • Offer a longer appointment.
  • Consider prescribing your patient something to help her to relax if you think this is indicated.
Remember the woman
  • Needs to have an understanding of what will happen at the test.
  • Needs to be able to remember this information for as long as it takes to do the test.
  • Needs to be able to understand that by having the test that it will help her to stay healthy.
  • Needs to be able to tell you by any communication mean that she would like to try to have the test done.
  • Still needs to have an understanding of the signs and symptoms of cervical cancer - see easy read guide
Decision Making


Referral Criteria

  • If examination indicates the need specialist referral the appropriate care pathway should be followed taking into consideration the need to provide accessible information and additional support as required

Supporting Information

Shared Decision Making

  • Patients have a right to make decisions about their care and should be fully informed about the options they face. They should be provided with reliable evidence-based information on the likely benefits and harms of interventions or actions, including any uncertainties and risks, eliciting their preferences and supporting implementation.

Patient information/Public Health/Self Care

Accessible information

Evidence/Additional information

Assurance & Governance

  • This guidance was developed on: 03.2017
  • This guidance was ratified by: The OSCAR Assurance Group
  • Date ratified: 03.2017
  • Publication Date: 05.2017
  • Review Date: 03.2019
  • Ref No: OG1 - 03.2017
Any feedback or suggestions to improve this guidance should be sent to: oscaradmin@this.nhs.uk
Only the electronic version is maintained, once printed this is no longer a controlled document


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