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Opting out of cervical screening

(83 Posts)
TeaAndHugs Mon 26-Nov-12 13:47:37

This is not a thread to discuss the benefits or otherwise of cervical screening.

I want to officially opt out of the NHS Cervical Screening Programme. I have looked at the data regarding risk of cancer vs risk of unnecessary treatment and decided that I would rather live with the cancer risk (I have the necessary statistical training to make an informed decision).

However, every time I see the doctor or nurse the appointment is dominated by a lecture about screening, rather than a discussion of my actual health problems. I want to officially opt out of the screening program so that I stop showing as overdue for a test on the doctor's system.

According to the NHS Cervical Screening Programme Good Practice Guide I can opt out by putting my request in writing, but it doesn't say who I need to write to. Is it my local PCT (which is Oxfordshire)? Or is there a national admin center?

Has anybody else successfully opted out? How do you do it?

This is not a thread to discuss the benefits or otherwise of cervical screening.

LightastheBreeze Wed 23-Jul-14 20:38:33

I have ignored the last 2 letters they have sent me, luckily I don't go to the GP much. With the breast screening I just rang up and cancelled the appointments so they weren't wasted and someone else could use them.

I'm just waiting to be told it would be best to take statins daily, as I'm over 55, that seems to be the current thing now.

rabbitstew Wed 23-Jul-14 19:15:24

I agree that a GP should not put pressure on patients in that way, that talking about someone to a nurse while in front of that person is very rude, that it is not easy just to ignore letters telling you that you should have a screening test, and it is not always easy to explain at the time to someone why you feel they are putting undue pressure on you and that you do not appreciate it. Sometimes it is easier and better to set all this out in a letter, afterwards.

However, I disagree that it is acceptable for someone who specifically said they were "furious" in their first post and whose every other post has attacked anyone who disagreed with them in any way, to subsequently claim that they hadn't started out angry and that their offensive use of language is all the fault of someone they have so far called a troll, schoolyard brat, having no brain cells and this "rabbit" person. littleme61 -if you did not come onto this thread to be attacked for your comments, you have no right to be so unbelievably offensive yourself!!!

anothervisittothepark Wed 23-Jul-14 15:27:41

I must agree that ignoring the letters isnt that easy. I ended up being tested before i was even sexually active. I got sick of the letters being sent. I was still living at home and got embarrased that i was constantly being sent letters from gp. I tried telling them to stop but they just ignored me and co tinued harrassing me.

littleme61 Wed 23-Jul-14 15:23:46

Thank you Redtoothbrush....all the above agreed with and any agression or nit picking it totally uncalled for! I hadn't started out angry but after this 'rabbit' person finding something to be snidey about in everything I have posted I can only feel sorry for them to feel the need to do so instead of being constructive! I don't go online to pull someone else apart and don't expect others to do so either!
You can't just ignore everything, because when you are in the surgery for another reason they will try to get you at that point. And changing surgeries is not a quick fix answer either if doctors are told at every surgery to fill their quota.....I would have the same problem again. This is down to choice and not feeling harrassed....some interesting points made here!

Pinkfrocks Wed 23-Jul-14 15:19:13

I had an interesting chat with my consultant gynae about screening. He is one of the top consultants in the UK ( voted by other consultants) and as it's totally private he doesn't stand to gain anything financially from me being screened- I pay to see him for something unrelated and pay the hospital /lab for screening.

I trust him 100%.

His opinion on screening and 'over screening' is that it is beneficial to the individual who can then make an informed choice as to the next- if any- step.

Personally, I don't understand why anyone would opt out of cervical screening unless they are a nun or a virgin. I have 3 friends who had the worst level of pre cancerous changes picked up by a smear. It's clear what the outcome would have been otherwise.

RedToothBrush Wed 23-Jul-14 14:59:00

There is no evidence that having these check ups regularly will help the general population.

Not only is there no evidence, but no research has even been commissioned. They just implemented the idea without assessing its value based on the assumption its beneficial which is shocking. It could be costly, mean that people end up on medication without improving their health but putting them at risk of side effects, it could feed anxiety, it could restrict access to care for people who have conditions which do need monitoring by taking up appointments, it could even in theory have a negative effect on life expectancy through side effects of over diagnosis. The point is we just don't know. Its a live social experiment which we are unwitting guinea pigs.

In response to everyone saying "just ignore the letters" or "just change surgery" I think you don't fully understand the problem.

If you go to the doctors and you are being harassed in person it is very difficult for some people to assert themselves. I have previously been reduced to tears by on GP over it, and she still kept pushing. It destroyed my confidence in her. Thats NOT MY FAULT. That is the fault of the doctor for applying undue pressure which is totally unethical. So I can completely understand someone "sneaking out" as someone on this thread has delightfully put it. I can't abide that attitude as it assumes everyone feels able to do that and its just not the case and doctors have a professional duty to understand this.

As for "just changing GPs". Ever tried it? I have. Lets just say its not exactly easy and I encountered obstacles in doing this. The result is I avoided the GP completely and used other NHS service providers were necessary. It is fortunate I did not develop a health problem during this period.

I have opted out of my new GP's surgery. They don't bother me in appointments now unless its relevant. However, it has not stopped centralised letters coming.

Opting out is more than just ignoring letters. Its about feeling comfortable about going to the doctor, without fear that you are going to feel pressured to make an appointment and that your decision will be respected not constantly questioned.

Pinkfrocks Wed 23-Jul-14 13:10:06

The NHS doesn't seem to do joined up thinking when anyone does have these tests elsewhere. I have had 3 routine mammograms referred privately via my gynae and 2 smears. The results clearly go back to my NHS practice as the letters I get are ccd to them. However this must not be entered into the 'right' data base because I've since had 2 letters asking me to have a smear and mammogram, within months of having them privately. I have so far ignored them, tough did ring up about the mammo as they had given me a day and time for it at a local portable screening centre and I wanted someone else to have the option.

DayLillie Wed 23-Jul-14 12:55:58

Once you are over 40 something, they will send you letters for a health check where they will do these, along with a basic cholesterol test.

www.nhs.uk/Conditions/nhs-health-check/Pages/NHS-Health-Check.aspx

I have not found it useful, as I have had all those tests done recently for other things, so have not gone for it. There is no evidence that having these check ups regularly will help the general population.

At my gps, I saw the doctor and asked for a cholesterol test as I was worried about it and had it done. I am sure you could ask for a nurse appt and they would do a BP and urine test, if you wanted.

chockbic Wed 23-Jul-14 12:43:42

I've had three letters from the GP for cervical screening.

Never been given a blood pressure check or test for diabetes.

DayLillie Wed 23-Jul-14 12:41:18

I would have, with this situation sprung on me unexpectedly, been too cross and humiliated to reply sensibly, and it would have resulted in me being very rude to the receptionist and walking out in tears. It is made all the worse if it is something I feel strongly about. Leaving and complaining by letter is probably far better, and less likely to get you removed from the GPs list.

It is nice if you can complain correctly at the time, but I need more time to think things out and express them properly, and can understand littleme's situation.

rabbitstew Wed 23-Jul-14 07:49:49

littleme61 - perhaps you should consider the tone of YOUR comments before your accuse others of being unconstructive. You have been a combination of whiney, aggressive, defensive and downright rude from the moment you posted. You reacted badly in the GP's surgery, yet you accuse others of having the problem.

Bourdic Tue 22-Jul-14 23:23:24

My understanding is that they need an opt out form so that the surgery can reach the target which triggers the payment - the target % is a % of all eligible women minus any opt outs - hope this makes sense. So it s for their financial benefit

littleme61 Tue 22-Jul-14 23:04:28

It would be nice to have had some constructive replies but I must have mistaken this thread as a place where adults posted comments, not school yard brats! Anyone with a brain cell like to continue this thread?

littleme61 Tue 22-Jul-14 22:51:29

Rabbitstew.....I didn't realise there was a troll waiting to pick on my every word...!!! Next time I will save my conversations for nicer people! Get a life!

rabbitstew Tue 22-Jul-14 21:31:15

It is true, littleme61, that we all act differently in life, and some actions and reactions are more effective and constructive than others.

If you only wanted to know where to find a template for opting out, you shouldn't have posted a diatribe about the inadequacies of your GP's surgery and your personal reaction to it.

Pinkfrocks Tue 22-Jul-14 21:04:25

I still don't get the 'opt out'- we are not compelled to go- we haven't signed up to it, or 'contracted in' though I suspect a GP could - worst case- ask you to leave the practice is you were not willing to participate in preventative screening especially if they lose funding through it.

They will have a target- if the practice is in an area where uptake is low, then you are likely to be called/ pressured into having it done. If they already reach their target then they are likely to ignore the few women who don't turn up.

littleme61 Tue 22-Jul-14 21:04:01

Rabbitstew.....I think I already explained why I wanted out of the surgery...perhaps I should have just stood there and said excuse me...but I don't want your damn test...keep it to yourself...but didn't.
I have actually only seen my GP 2 times since I have moved into a new area....and actually been on his list for over a year before I was asked to see the nurse for high blood pressure...which sadly is heredatory in my family and has caused both the death of my nan and my mum! So this being something I need to keep a close eye on...I am not happy that I felt this was thrown at me whilst in the room..plus the nurse being called in...me not even being given eye contact and hearing the doc say...make her an appointment on the way out....didn't sit well with me. I am planning on writing an opt out letter...like alot of the other ladies here having received letters over many years (18 for me!)...and destroying them...I now feel cornered. I am rather worried about being struck off after reading some of the comments through this thread....so there you have it....I read about others going through similar which has caused me some concern. TBH.....if I was struck off I would simply complain to someone higher and find a new GP! Just to add Rabbitstew...we are all individuals and act differently in life. Amen for our differences!

Pinkfrocks Tue 22-Jul-14 20:59:18

another you won't have been exposed if both you and an only lifetime partner were virgins. Any other variation and then you will have a risk ..yes? I think- and may be wrong here- that HPV can be transmitted in other ways apart from just PIV.

anothervisittothepark Tue 22-Jul-14 20:38:36

Yes i did think the gp practice must have finsncial incentives.

PicandMinx Tue 22-Jul-14 20:33:52

Yes, GPs get funding by hitting cervical screening targets. Before the introduction of the screening and recall system in the late 1980's, there was a low uptake amongst eligible women. After a financial incentive was introduced, the uptake rocketed. Nice to know that it's perhaps not your health that your GP is worried about, but his/her nice fat bonus.

anothervisittothepark Tue 22-Jul-14 20:31:41

I get annoyed with the constant harrassing for smear tests too. I keep meaning to read up on it to understand the risks better. I think i must be very low risk as i cant have been exposed to hpv. I was judt thinking the other day, once you are married or with long term partner, why cant they test for hpv and if thats negative just opt out until such time circumdtances change. It is annoying they make you feel like its compulsory and dont even outline thr facts and risks properly.

Pinkfrocks Tue 22-Jul-14 20:19:22

Instead of all the fuss about opting out- why don't you just ignore the letters? I do. Because I've had them privately for years every 2 years- partly because of my age the NHS only offers them every 5 years ( and having known 3 friends with CN3 discovered at a regular smear appt) and also because I don't want to wait ( as it used to be) weeks and weeks for the results.

Interestingly the results never seem to make it back to the NHS database ( not the GP practice) because I am frequently called for a smear even when I've had 1 privately in the recent past.

Presumably though, GP practices get funding for hitting their targets for screening as they do for children's vaccinations ?

rabbitstew Tue 22-Jul-14 20:16:46

Sorry, littleme61, but the way you describe it, you were trying to sneak out! Maybe I'm just more upfront than you, but if someone had offended me and tried to organise something for me I didn't want, I would have told them that at the time and explained why. If you didn't feel able to do that and chose to try to leave quietly and complain later, then sneaking out quietly is a fair description, imvho. You also seem unusually concerned about being struck off your GP's list - if your relationship with your GP is that bad, it doesn't sound like a very fruitful relationship all round (certainly not one likely to lower your blood pressure!) and you might be better off in another surgery that shows more tact and sensitivity.

PicandMinx Tue 22-Jul-14 19:50:41

You can write to your GP and ask for an opt-out form. They are obliged to provide you with information.

I would also write a letter of complaint to the practice manager. Mention the dreadful behaviour of both the GP and the receptionist.

Cancer screening is an optional test. It is not compulsory but you wouldn't think that by the way some HCP disregard the concept of informed consent.

When you next visit your GP, state quite firmly, whilst maintaining eye contact, that you do not wish to waste the consult time discussing cancer screening. Do not engage the GP in an argument. Just smile and change the subject.

kilmuir Tue 22-Jul-14 15:59:46

Thankfully i have not seen GP for years.
I have made my decision and would not appreciate being made to feel an idiot. My body my choice

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