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Care and treatment reviews to become ‘business as usual’

NHS England has yesterday set out how it intends that reviews of care and treatment arrangements for people with learning disabilities are to be embedded across the health and care system.

Care and Treatment Reviews (CTRs) were developed as part of NHS England’s commitment to improving the care of people with learning disabilities or autism. They aim to reduce unnecessary admissions and lengthy stays in specialist hospitals, and have been rolling out since October 2014; over 1,400 people had their care reviewed up to March this year, with hundreds more since.

They bring those responsible for the care of those who are in, or at risk of being admitted to, specialist hospitals around the table with the individual themselves and their families, as well as independent clinicians and experts by experience, to ensure that the care needs of that individual are being met.

Care and Treatment Review: Policy and Guidance (also available in easy read) has been produced by building on the learning from the reviews which have taken place so far, including extensive engagement with people with learning disabilities, their representatives and their families.

The document will help local Clinical Commissioning Groups and NHS England commissioners implement the recommendation from this learning that CTRs should become ‘business as usual’.

The embedding of CTRs across the health and care system aims to:

  • ensure people with learning disabilities and/or autism and their families are listened to, and treated as equal partners in their own care and treatment;
  • prevent unnecessary admissions into inpatient settings;
  • ensure any admission is supported by a clear rationale with measurable outcomes;
  • ensure all parties, including local councils, work together with the person and their family to support discharge into the community (or to a more appropriate setting) at the earliest opportunity;
  • help people challenge current care and treatment plans where necessary, and;
  • identify barriers to progress and to how these could be overcome.

The new draft policy and guidance will be finalised this autumn following feedback from those implementing it. It is the latest piece of work to emerge from theTransforming Care for People with Learning Disabilities programme, which is a joint piece of work between the NHS England, the LGA, ADASS, the Care Quality Commission (CQC), Health Education England (HEE) and the Department of Health (DH).

In line with the priorities of the Transforming Care programme, it is intended that CTRs will involve a significant shift in commissioning towards high quality community-based services over the next 18 months, that will lead to the closure of some inpatient beds and facilities.

Read the summary of further progress being made by the partners on the Transforming Care Delivery Board.

 

Channel website: https://www.england.nhs.uk/

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NHS rolls out discreet home-testing kits against cervical cancer for millions of women

25/08/2026 13:10:00

Nearly 4 million women will be offered HPV self-testing kits if they have not attended cervical screening appointments following invitations from the NHS in England.

The NHS is starting to roll out the new self-testing kits from today to encourage more women to complete their potentially lifesaving screening to detect human papillomavirus (HPV), which can increase the risk of cervical cancer.

England’s leading women’s health doctor described the move as a “gamechanger” given that around a third of those eligible aren’t up to date with their cervical screening, and this test provides a more “discreet and convenient option” for them.

The self-testing kit contains a swab, similar to a long cotton bud, which is used to collect a sample from the vagina. The sample is then posted back to the NHS for free, where it is checked for high-risk HPV.

If high-risk HPV is found, individuals will be invited to book a follow-up cervical screening appointment at their GP surgery or sexual health clinic, where a nurse or doctor will take a small sample from the cervix to check for cell changes.

Cervical screening helps prevent cervical cancer by checking for high-risk types of HPV. It is a common virus that can cause changes to cells in the cervix. These changes can usually be treated before cancer develops.

Women who are eligible will start receiving invitations today via the NHS App, text message, email or letter, and once invited they will be able to order a free kit through the NHS App or their NHS online account.

This is the next major step the NHS is taking in its pledge to eliminate cervical cancer by 2040, by making it as easy as possible for people to get the lifesaving HPV vaccination and increasing cervical screening attendance.

Dr Sue Mann, National Clinical Director for Women’s Health at NHS England, said: “Screening saves thousands of lives each year by preventing cancers and catching them earlier, but only around two-thirds of women are attending cervical screening appointments when invited by the NHS.

“Offering millions of women an alternative test they can do from the comfort of their own homes will be a gamechanger – making it easier than ever for them to get tested for HPV. 

“There are lots of reasons that may stop women from getting their cervical screening – embarrassment, lack of time, or worries about discomfort – and these kits provide a discreet and convenient option we hope will encourage more women to take up the life-saving test. 

“So, if you’re invited to take part, please order a test – it’s a simple swab you can do at home in minutes.”

Cervical screening appointments with a clinician remain the best way to help prevent cervical cancer, but HPV self-testing is being introduced by the NHS as an additional choice for people who have not taken up previous invitations.

HPV self-testing is an invitation-only offer and is being rolled out in phases across England as part of the NHS Cervical Screening Programme, starting with those aged between 30 and 65, who have not attended cervical screening following previous invitations.

The national rollout comes on the back of the YouScreen trial run by North London cancer alliances in collaboration with NHS England and King’s College London in 2021, which found offering self-testing kits to under-screened women at their GP practice or at home could boost the numbers screened in England by about 400,000 each year.

The UK National Screening Committee used evidence from this trial in its recommendation to roll this out wider.

The latest figures show that 68.8% of eligible women were up to date with their cervical screening – below the NHS England target of 80%. This means around 4 million women in England are not up to date with their routine check-up.

Women aged 24-64 are invited for cervical screening by the NHS every five years, or more frequently if HPV is detected.

Anyone who has been invited for cervical screening can still book an appointment at any time, even if the invitation was sent months or years ago.

It is still important to attend cervical screening appointments if you have been vaccinated against HPV as the vaccine does not provide protection from all types of HPV, so there is a still a small chance of getting cervical cancer.

People who routinely attend for a cervical screening test with a clinician at their GP practice or sexual health clinic should continue to book their appointments as normal.

Health and Social Care Secretary Yvette Cooper said: “Cervical cancer is preventable – but that’s why we want to make it as easy and convenient as possible for women to keep up with their screening.

“These free self-testing kits will be offered to four million women who are currently behind on their screening to make it easier for as many women as possible to keep themselves healthy and safe.

“This is the future NHS we are building – there for all of us when we need it, and acting as early as possible to stop preventable deaths.”

Cancer Research UK’s Chief Executive, Michelle Mitchell, said: “Cervical screening is a powerful tool that saves lives – it can prevent cervical cancer or spot it at an earlier stage when treatment is more likely to be successful. 

“While it’s best for cervical screening to be done by a nurse or doctor, there are barriers that make it challenging for some people to attend. At-home HPV self-testing kits will help more people take part in a way that works for them.

“If people receive their cervical screening or self-testing kit invitation, please consider taking up the offer and encourage loved ones to do the same. Beating cervical cancer means beating it for everyone, and this move brings us closer to that goal.”

Athena Lamnisos, Chief Executive Officer at The Eve Appeal, said: “There are many reasons why those eligible for cervical screening don’t attend.

“Challenges around the type of test it is, limited awareness around HPV and its role in cancer development, as well as practical barriers such as problems around booking and attending an appointment, stop many from going.

“Cervical screening is designed to prevent cervical cancer rather than respond to symptoms, attending a clinic requires people to actively prioritise an appointment among the many competing demands of everyday life.

“Self-testing which can be done at home will be a step-change for many. We have the incredible opportunity to see the back of cervical cancer. How brilliant would that be? But to achieve this, we need to support everyone eligible to attend screening.

“At Eve we welcome the rollout of this programme and its focus on the audiences who need it most in the first stage of the screening pathway. Looking to the future, we hope that self-testing will provide the under-screened and never screened with a new option to help address some of the key barriers. 

“This is not a replacement for clinician screening, and we will continue to work with and support those attending their traditional cervical screening, to help make their appointments more comfortable and accessible. 

“The NHS has set a 2040 target for eliminating cervical cancer. We hope that rolling out self-testing will help us reach it.”

Dawn Bryant, 62, from Hertfordshire, had cancerous cells found early thanks to NHS cervical screening and feels extremely lucky that it was detected and treated before the cancer progressed any further.

She says cervical screening may have saved her life and is encouraging other women who haven’t had theirs yet or have put it off, to book an appointment or do the at-home HPV test if invited.

“My nan died of cervical cancer when I was only 11 so I know how difficult it can be and how important cervical screening is.

“A screening test when I was 32 found I had severe high-grade cell changes, and after further testing I was told it was cancer. 

“I am so lucky it was found at an early stage and could be easily treated. I had some surgery to remove the cells, but I didn’t have to have chemotherapy, radiotherapy, or anything. It was a very scary time, but who knows what would have happened if I’d delayed having the test. 

“Since then, I have been regularly monitored, and had many tests and colposcopies, and although they can be a bit uncomfortable, I would not think twice about having them done again.

“I know lots of women who have put off having screening, and sadly, some who have been diagnosed with advanced cervical cancer after putting it off for years.

“It is so important women go for these check-ups or do the home-testing kit if invited. It doesn’t take very long and if you’re worried or have questions, the staff are excellent and will talk to you and help answer any fears you’ve got.”