Evaluation of an audit and feedback intervention to improve cervical screening uptake

Cervical screening programmes are long-established and supported by robust evidence, but participation is declining. Around a third of those eligible did not participate in England in 2023-24.

To evaluate the feasibility and acceptability of an audit and feedback intervention to improve the uptake of cervical screening in general practice.

Semi-structured interview study with general practice staff in three Primary Care Networks (PCNs) and regional and national policy leaders.

Quarterly reports were generated for 23 general practices comparing cervical screening coverage with other local practices with similar population levels of deprivation, alongside resources and practical suggestions to improve screening uptake. Reports were emailed to practice managers requesting they be shared with teams. We conducted semi-structured interviews with practice staff and health service leaders to determine how the reports were received, understood, and used. Interviews were structured and analysed using Clinical Performance Feedback Intervention Theory (CP-FIT).

Fourteen practice staff and three service leaders were interviewed. Practice teams seldom recalled seeing the feedback reports prior to interview invitations but generally viewed them positively when shown at interview. Report format, length, frequency and content were considered appropriate. Staff involved in cervical screening found the reports clear and informative, and thought that enhanced awareness and motivation could prompt positive actions.

Audit and feedback cannot improve cervical cancer screening uptake if targeted recipients do not receive it. More effective methods are required to engage or circumvent practice 'gatekeepers' to ensure feedback reach.