First Glasgow nurses trained in colposcopy to tackle waiting lists

Kirsty Galbraith and Alison McGowan, who can now carry out cervical investigations, biopsies and treatments previously only done by doctors, are already seeing around 100 patients per week.

Their dedicated clinics, at Stobhill, Inverclyde Royal, Vale of Leven and the Royal Alexandra Hospitals, are helping NHS Greater Glasgow and Clyde (NHSGGC) to tackle colposcopy waiting lists, caused by backlogs in laboratory and screening services during the Covid pandemic.

The Glasgow Times Don't Fear the Smear campaign, launched last year, aims to encourage more women to attend their cervical screening appointments.

A patient may be referred to colposcopy if their routine smear test has found changes or abnormal cells in their cervix – which can be caused by human papillomavirus (HPV) – or if they have had symptoms such as abnormal bleeding. 

Cell changes caused by HPV do not automatically mean a person has cervical cancer, but early investigations or treatment can prevent abnormalities from developing into the disease. 

Kirsty and Alison are now seeing more than 100 patients a week (Image: Robert Perry/Newsquest)

In many cases, no further action is required at colposcopy appointments, but a decision may be made to do a biopsy on the cervix, which, Kirsty explains, is a “very small pinch of tissue, smaller than a grain of rice.”

She adds: “It is daunting, but the exam itself is similar to a smear test and can often be more comfortable as we use couches made specifically for pelvic examinations in our clinics. 

“The most common thing we hear our patients say is, ‘that wasn’t as bad as I was expecting it to be’.”

Inside one of the dedicated clinics (Image: Robert Perry/Newsquest)

Alison explains: “In a lot of cases, no treatment is required and the patient is simply monitored.

“But keeping your appointment and having that investigation as scheduled, could mean that if you do need treatment to remove pre-cancer cells, that treatment will be minimal.

“We know that having both the HPV vaccine and routine cervical screening will dramatically reduce the number of people with cervical cancer in Scotland, and what we find is that the most serious cases we see are those who have defaulted on going for their smear tests.”

A new study by Public Health Scotland, in collaboration with the universities of Strathclyde and Edinburgh, this week revealed that no cervical cancer cases have been detected in fully vaccinated women following the HPV immunisation at age 12-13 since the programme started in Scotland in 2008.

In the coming weeks, NHSGGC is holding vaccination clinics in universities in its area to ensure it is offered to anyone up to the age of 25 who did not receive it at school. 

Dr Emilia Crighton, NHSGGC’s Director of Public Health, said: “Alison and Kirsty are seeing patients with all grades of abnormal smears, carrying out colposcopy examinations and treatments when appropriate. 

“We know that long waits can add to patients’ anxiety and we have worked extremely hard to significantly reduce colposcopy waiting times.

“Having both the HPV vaccine and routine cervical screening, as well as attending colposcopy appointments when required, will dramatically reduce the number of people with cervical cancer in Scotland.”

Kirsty, who qualified as a nurse more than 20 years ago, says the chance to gain this qualification was “exciting”.

“I’ve worked in outpatient gynaecology assisting on colposcopies, so I know how nervous many women are when they come for the procedure,” she says. “It’s not something anyone particularly enjoys, but it is extremely important that people attend their appointments for further investigation as it allows abnormalities to be picked up early.

“It is encouraging to see more young women, in particular, are much more aware of cervical cancer because of the HPV vaccination at school, for example, and understand the need to protect themselves.”

For more information about colposcopy, please visit NHS Inform.