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Hillcrest Medical Centre making great inroads to prevent cervical cancer

Hamilton-based Pinnacle MHN practice Hillcrest Medical Centre is having great success with its cervical screening rates thanks to a specific strategy involving a dedicated nurse making screening-related phone calls.

Recent NCSP data[1] shows that the percentage of screened women in the Waikato DHB area aged 25-69 years, in the three years ending 30 September 2017, averaged 76 per cent across ethnic groups. Just 61 per cent of Maori women are screened.

Pinnacle MHN quarter data for Hillcrest Medical Centre showed 81 per cent of non-Maori women on the practice's books are being screened, with 79 per cent of Maori screened. Impressively, the practice is screening 18 percent more Maori than the Waikato average.

"Hillcrest Medical Centre has a consistently high rate of cervical screening, even for the more hard-to-reach priority women on their books, and it's largely to do with the way they manage screening in-practice," Pinnacle MHN operations manager of clinical service, Puamiria Maaka said.

"Priority group women are Maori, Pacific or Asian women aged 20-69 years old, or any woman between 30-69 years old who hasn't had a cervical smear in the previous five years, or has never had a cervical smear.

"Reaching these women and convincing them to have their smear can be particularly difficult, but having a plan in place can make a world of difference and ultimately prevent cervical cancer," Puamiria said.

As part of Hillcrest's strategy to reach as many under screened and unscreened women as possible, they have specifically appointed practice nurse Julie Taylor to focus on recalling women in for their cervical smear. Remarkably, Julie has been in her role for about 13 years.

"Every month the practice sends a letter out to women who are due for their smear that month. If they don't respond, a text is sent. The third contact is me personally phoning them to talk them through coming in for their smear," Julie said.

"I have time set aside to make these calls every week and in a month I can phone between 100 and 160 women. We find that when you speak to a woman one on one, you discover the reasons they're avoiding their smear and can encourage and support them through those.

"Some women are embarrassed. Some have had a bad previous experience, to which I'll ask them if they want to talk about it. Some say cost is a barrier, and don't know that many women can get their smear for free. Some have children they think they can't bring in, however we can always arrange staff to look after them for a few minutes. There's almost always a solution to their concerns."

Julie is adamant it's a strategic team effort that sees them perform so well in their smear taking.

"We have 11 nurses at our practice and 15 GPs. Something that's important to us is that all of our nurses are proficient smear takers. That way, there's always someone available to offer a smear to women when they come in. This also prevents the GPs from running behind schedule.

"The GPs tell the nurses when they've seen a woman who is overdue for her smear. One of us will always fit her in that day - otherwise she might not come back!  After all, she's already here on the premises, so it saves her the from coming back again, time taken, and paying an additional charge. We all play our part in offering smears and encouraging women to do it on the day."

 "We also have another nurse who, as soon as new patients enrols with our practice, sends away for her smear history and enters all her smear information. This ensures our database is always up to date regarding who has had their smear and who has not.

Julie said if she had one friendly tip for other practices struggling to get women through the door, it would be to step up the personal contact. "Speaking to someone on the phone or while they're in the practice makes a huge difference. You can find out why they're avoiding their smear and walk them through all the options available to them."

"It's good if someone can be designated to it. That way it's their role, and they're responsible for ensuring no woman is falling through the gaps."

Julie said women almost always say the experience is less scary than they think once they've had their smear. "A lot of them will comment on how quick it was. Often the thought of it is worse than having it done."

"It can be a daunting task looking at the long list of women overdue for their smear, but ticking away at it can ultimately save lives. It's all worth it."

More about cervical screening

  • All women between 20 and 70 who have ever had sex should have regular smear tests. Find out how regular smear testing can prevent cervical cancer.
  • Most cervical cancers develop from an infection - called HPV, or the human papillomavirus - that almost everybody is exposed to if they have had sex. But with regular smear tests (every 3 years) HPV can be detected before it becomes cancer.
  • Women can choose to go to their regular doctor/nurse or choose to go to: any doctor or practice nurse; a midwife; Family Planning; your sexual health service; marae-based or other Māori health centres; community health services, eg, Pacific or women's health centres; screening support services.



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