Direct referral to colposcopy and failsafe

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The laboratory has well-established systems of direct referral to all the colposcopy units in Greater Manchester, Cumbria, Lancashire, and Cheshire and Merseyside. It provides details of the cervical screening result to allow efficient allocation of appointments to ensure women at highest risk get the earliest appointments.

We have several years of experience with the direct referral pathway and currently operate a direct referral programme to 23 colposcopy units across the North West. All primary care samples and tests taken in hospital clinics (except colposcopy) where a recommendation for colposcopy assessment has been advised are included in the direct referral process.

Patient identifiable data and test results are sent via secure to email addresses.


All colposcopy referrals are subject to laboratory failsafe and the guidance issued by the PHE Cervical Screening: cytology reporting failsafe (primary HPV). [Updated 17 July 2019]

Laboratory failsafe for colposcopy referrals

All colposcopy referrals are included in laboratory failsafe procedures and an enquiry is generated if a colposcopy outcome is not notified to the laboratory within the predetermined timescales. It is important that sample takers are aware that they still have overall responsibility for ensuring the patient attends colposcopy, even when direct referral is in operation and they should respond accordingly when a failsafe enquiry letter is sent. Any cases where an outcome is not available are audited by the laboratory CSPL.

Suspected non-cervical glandular neoplasia

The department has a separate protocol for the referral of suspected glandular abnormalities of non-cervical origin. This involves contacting the GP or sample taker prior to authorising the report to discuss the result and explain that an urgent referral to gynaecology is required. The GP must make the referral to gynaecology as there is no direct referral pathway for this group of women.

(Last reviewed August 2021)