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Cervical Smear Audit

1639 Posts

Posted:  28-Mar-2014 16:59
I've been asked to do this, GP wants written confirmation of acceptable percentage of "inadequate" smears but can't find this info anywhere.

I've tried numerous Google searches, local cytology lab, borough screening unit (not returning my calls) all to no avail. PN at a local surgery says it is 4% but GP unhappy to accept verbal info!

Any other places I can try to get this info??
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460 Posts

Posted:  28-Mar-2014 17:03
Local Cytology lab or CCG lead (if there is such a thing?)
The 4% does sound familiar though.
Sorry can't be more help

425 Posts

Posted:  28-Mar-2014 18:01
Laboratory average inadequate rate is 4% so anything above this rate requires investigation. We also have to look at transformation zone sampling rate. Should be  = or >  than 80% in women aged 25-50. Less than this requires review of technique and then auditing of their next 20 samples. Just recently done ours and found some interesting results which highlighted that one of the nurses technique was wrong and led to low transformation rate. 

1639 Posts

Posted:  28-Mar-2014 21:21
Thanks ladies!

Cloe, re tranformation sampling rates - does your Cytology lab inform you directly of that, as it's not recorded on the actual smear result?

425 Posts

Posted:  28-Mar-2014 21:54
Hi Della
not sure without looking. But when you put your smear taking code into the link I have for our local lab, it gives me the figures for all the above for all the smears I have done in previous years. I only have to work out the %.

1639 Posts

Posted:  28-Mar-2014 22:30
Oh right, we don't have a code where I work so no direct link to lab.

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1049 Posts

Posted:  29-Mar-2014 07:45
Our lab sends us these figures and tells us the inadequate rates for each smear taker in the practice.It also tells us the number of abnormals picked up.The lab should audit this and be able to send you the results.

65 Posts

Posted:  31-Mar-2014 13:05
Hi everyone - in the lab where I work (for those of you who don't know - I am a biomedical Scientis in Cytology), we are just beginning to produce a detailed audit report for our sample takers.

for accurate data we require sample takers to use an ID (PIN?). We then provide a breakdown of data for the lab as a whole, the surgery & for each individual sample taker. We give the inadequate, high grade & low grade rates, negative rate, the TZ sampling in under 50's & figures for sample taker errors (unlabelled & out of programme requests).

There is no 'official' inadequate rate for LBC (4% is a bit high though!) - but I'd say 2.5-3% is acceptable - remember to look at the population being screened when considering individuals inadequate rate.

Also - these days TZ presence or absence is not considered to be an accurate assessment of adequacy - but I guess it can be useful in some circumstances.

Remember - labs can only audit this if sample takers provide us with their sample taker ID - this may be set up within your practice or by the lab depending upon your area.

951 Posts

Posted:  31-Mar-2014 13:36
As Angel. All done for us!


65 Posts

Posted:  01-Apr-2014 14:48
You will probably find this document much more useful:


in there you'll find a summary of the national reporting ranges for all UK laboratories - as long as your practice falls within these ranges for inadequates you should be ok. Although - I'd say if you're towards the top end of the inadequate range then you might want to look more closely at things like reasons for inadequacy, sample taker technique etc.

19 Posts

Posted:  05-Feb-2016 18:25
Out of interest - would 'obscured by imflammatory exudates' be counted as inadequate range.

1639 Posts

Posted:  08-Feb-2016 21:08
Yes, you have to include them in your inadequacy figures but obviously that's due to circumstances outside your control, so won't reflect badly on your surgery or on any individual practitioner.

Have been told by my local lab this year that my local area acceptable inadequacy rate is 2.2%, and nationally there is no set figure but up to 3% is generally considered reasonable.
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18 Posts

Posted:  18-Feb-2016 20:43
I had a really good table once that included a random distribution element and said for how many smears taken what an acceptable percentage is for e.g. if you only took 20 smears 1 inadequate would be 5% but that isn't necessarily bad if it was only 1 inadequate . . . .I wish I could find it! I think with LBC an acceptable inadequate rate is much lower and closer to 2% . . . . . hard to audit when you have no reference of what is an acceptable amount. If anyone finds some numbers let us know . . . .

105 Posts

Posted:  19-Dec-2016 21:39

did you ever find that table that you mentioned? I'd like to see it if you have. Thank you.

22 Posts

Posted:  22-Dec-2016 13:41

I have just got my Sample Takers Profile for 2015 (not this year yet). I had to e-mail a Clinical Cytologist and Hospital Based Programme Co-coordinator within my healthcare trust, info was passed on to me by colleague, who obtained this from NHS England.



40 Posts

Posted:  03-Jan-2017 16:06
The NHSCSP statistical bulletin was published in November 16, this will give National Data and your local lab can give you your surgery split by smear taker.


105 Posts

Posted:  03-Jan-2017 21:47

I've tried to google for the NHSCSP statistical bulletin that you mentioned, but I cant find it. Do you have a link please? Thanks.

40 Posts

Posted:  04-Jan-2017 10:35
Here is the website sarahlouisen
It shows nationally the inadequate rate was 2.7%

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