HPV coding in cervical screening results: what practices need to know

HPV results are fully coded within the national Cervical Screening Management System (CSMS), so practices do not need to manually code HPV status for recall safety.

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We have had queries from practices about cervical screening results arriving via ICE with only a generic “cervical cytology test” code, and the HPV status appearing in free text. Colleagues are understandably concerned about how this interacts with the move to five year recall for HPV negative patients and whether they should be manually coding HPV status for safety.

The short answer is: you do not need to create local workarounds or manually code HPV status for the screening programme to function safely.

  • Results from the regional cervical screening laboratory (BSPS) are sent into GP systems using the national Pathology Bounded Code List.
  • Under this standard, the only available code for cervical screening is a generic “cervical cytology test” code.
  • HPV status is included in the free text portion of the result but is not sent as a discrete, searchable code such as “HPV positive” or “HPV negative”.
  • This limitation is national rather than local and applies across England.

A new Pathology and Laboratory Medicine Reporting Information Standard is planned to replace the existing pathology messaging standard. This should improve messaging between laboratories and GP systems, but it is not currently expected to provide separate structured codes for HPV positive or HPV negative results.

Although GP systems do not hold HPV status in a structured way, the screening programme does.

  • Laboratories send fully coded results to the Cervical Screening Administration Service (CSAS).

  • CSAS enters the result into the national Cervical Screening Management System (CSMS) using the programme’s result and action codes.

  • CSMS is the system that:

    • Manages call and recall
    • Applies the extended five year screening interval for eligible HPV negative results in those aged 24.5 to 49
    • Supports referral to colposcopy where indicated

In other words, the logic that determines recall interval and onward referral is driven by CSMS, not by coding within the GP clinical system.

For most patients, the practical implications are:

  • It is not necessary to manually create local HPV positive or HPV negative codes in your GP system in order for the national screening programme to function correctly.

  • Practices should continue to:

    • File results in line with local clinical governance processes
    • Use CSMS as the definitive record for cervical screening history and recall status
    • Complete Prior Notification Lists (PNLs) on CSMS as per NHS England Digital guidance

Sample takers and administrators involved in cervical screening should have access to CSMS via NHS Smartcard. Role information is available on the CSMS job roles

You may wish to contact the LMC or local Screening and Immunisation Team if:

  • You are considering any local protocol that would materially increase workload, such as routine manual recoding of HPV status in all smear results
  • There appears to be a mismatch between the text of the result and the recall interval recorded in CSMS
  • You are unsure whether your practice has appropriate CSMS access and processes for managing PNLs

We will continue to monitor national developments around the new pathology information standard and will update this guidance if any future changes improve HPV result coding into GP systems.

For any questions, please contact the LMC office.