63% of the 335 women surveyed said that they were unable to attend their cervical screening appointment because of their physical disability. Bearing in mind that GP practices are obliged to provide adequate adjustments to accommodate people with disabilities, this is a shockingly high statistic and contributes to our understanding of why cervical screening rates are at a 21-year low. People who use a wheelchair will often need a hoist and/or an adjustable examination bench in their doctor’s appointment, yet only 63% of respondents say that their GP surgery is wheelchair accessible. The corridors of the practice are often too narrow, meaning that someone in a wheelchair could turn up for their cervical screening and then literally not be able to get to their appointment.
A lack of wheelchair accessible GP surgeries is going to have a seriously detrimental effect on more than just women’s ability to attend their cervical screening; it is putting up a physical barrier to anyone who needs to use a wheelchair and preventing them from seeking medical help. Making a GP practice accessible needs to become obligatory, not optional.
We know that hoists and adjustable benches are expensive. There is no getting away from that, or the fact that public healthcare is under serious financial strain. However, if for whatever reason, practices aren’t currently able to accommodate their disabled patients, then surely it’s time to think outside the box? Surgeries have certain postcodes and a limited radius that they can accept patients from, but if a particular surgery can’t actually look after the access needs of their patients, then they should be exploring alternative methods of care. If a woman needs wheelchair access and a hoist in order to attend her cervical screening (or indeed any other appointment) but her GP surgery doesn’t have these facilities available, then why shouldn’t she be allowed to swap to another, properly equipped practice? We want to emphasise though that we don’t mean to unnecessarily blame GP’s, but rather the system that they have to operate within. This strict system is outdated, and clearly failing certain groups of people.
It seems like home testing or ‘self-sampling’ kits will prove to be a real game changer in terms of increasing cervical screening rates. At The Eve Appeal, we champion different approaches to cancer prevention, as long as they are safe and effective, which the home testing kits are proving to be so far. Still in its pilot phase, the kits are designed for people to be able to take an internal swab (no speculum involved) and send the sample away for testing. These kits are designed to test for high risk HPV, which causes over 99% of all cervical abnormalities and are ideal for people whose schedules prohibit them from going to a typical ‘working hours’ doctor’s appointment, or who indeed, have a physical disability preventing them from the normal in-person screening method. What though, if someone with a physical disability is unable to carry out the self-sampling procedure? Everyone with a cervix first of all can decide whether or not they have a cervical screening test or not, (although at Eve we do actively encourage everyone relevant to take part in this life-saving programme) and secondly, to be able to see a medical professional instead of having to ‘do it themselves’. It seems from the Jo’s report that home visits are hit and miss in terms of availability, dependent on the area the patient lives in. It can’t be one rule for one postcode and another rule for another postcode. An individual’s risk of cervical cancer shouldn’t be increased because of their address.
Get Lippy ambassador and campaigner for improved healthcare access, Dr Hannah Barham-Brown says; ‘If like me, you are interested in all things ‘Womens’ Health’, you’ve probably seen in the media recently that Cervical Smear uptake is at a 20 year low in the UK, with only 71% of eligible women screened adequately. Smears look for pre-cancerous changes in the cells of the cervix. If these changes are present, they can be removed before they develop into cancer.
‘Yet, data released by Jo’s Cervical Cancer Trust today shows that 63% of physically disabled women have been unable to attend screening because of their disability. As a GP Trainee, and a wheelchair user myself, this is heartbreaking, because I know that cervical screening quite simply saves lives.
‘There are a variety of reasons why disabled women aren’t getting their smears. Only 1% of the disabled women who responded said their GP surgery was able to provide a hoist to get them onto the couch to have their smear. But it isn’t just the practicalities like equipment that is stopping these people getting smears; 49% have deliberately chosen not to have their smear because they have had a bad experience previously, or they are scared of people’s reactions.
‘As a disabled woman myself, a big sucker punch for me was reading that 1 in 5 disabled women had reported professionals making the assumption that they were not sexually active, because of their condition. Now, I am getting kind of bored of having to break it to people that yes, disabled people have sex too. As such, we can get HPV, a family of viruses with some types causing cervical cancer. But even if a woman isn’t sexually active, or never has been, while she’s less likely to have HPV, that doesn’t mean she can’t develop pre-cancerous cells. So we need our smears too!
‘Disabled women need the same access to healthcare as everybody else. It’s time for the NHS to put the money into ensuring the equipment is provided and the information and support is out there for them. Because Cervical Cancer can kill us too.’
You can read Jo’s full report on their website: jostrust.org.uk/invisible