Cervical screening attendance in England has been declining for over a decade. NHS Digital data shows that coverage among women aged 25–49 fell to 67.3% in 2024 — well below the 80% target set by Public Health England. Among women aged 25–29, the age group invited for the first time, uptake is even lower.
The renewed Women's Health Strategy, announced by the Department of Health and Social Care in April 2026, recognises that women must be better heard and better served across all healthcare settings. Community pharmacists — who see patients more frequently than any other healthcare professional — have a meaningful role to play in normalising screening conversations and addressing the barriers that keep women away.
The screening programme at a glance
The NHS Cervical Screening Programme invites women and people with a cervix aged 25–64 for regular screening:
| Age group | Frequency | Test method |
|---|---|---|
| 25–49 | Every 3 years | HPV primary screening (since 2019) |
| 50–64 | Every 5 years | HPV primary screening |
| 65+ | Only if recent results were abnormal | N/A — discharged if three consecutive normal results |
Since 2019, the programme uses HPV primary screening rather than cytology as the first-line test. Samples are tested for high-risk HPV strains first; only HPV-positive samples undergo cytology. This change improved sensitivity but has not, by itself, reversed the attendance decline.
Why women don't attend
Research from Jo's Cervical Cancer Trust identifies several barriers:
- Embarrassment and anxiety — the most commonly cited reason, particularly among younger women
- Practical barriers — difficulty getting appointments during working hours, childcare commitments
- Previous negative experiences — painful or uncomfortable procedures, feeling dismissed
- Misconceptions — belief that screening is unnecessary if asymptomatic, confusion about HPV and its link to sexual activity
- Cultural and language barriers — in some communities, discussing intimate health with a healthcare professional is difficult
- Fear of results — some women avoid screening because they are afraid of what might be found
What pharmacists can do
Pharmacists do not perform cervical screening, and this article does not suggest they should. The role is one of informed signposting — using the trust and accessibility of the pharmacy setting to have brief, supportive conversations.
Opportunistic conversations:
When dispensing contraception, HRT, or other medicines related to reproductive health, a brief mention of cervical screening can be natural and non-intrusive. For example: "Have you had your cervical screening recently? If you're due, it's worth booking — the test itself takes about five minutes."
Addressing common fears:
- "Will it hurt?" — For most women, the test is uncomfortable but not painful. The speculum comes in different sizes, and patients can ask for a smaller one. Slow breathing and relaxation techniques help.
- "I haven't been sexually active recently, do I still need it?" — Yes. HPV can remain dormant for years. The screening programme covers all eligible women regardless of current sexual activity.
- "I've had the HPV vaccine, do I still need screening?" — Yes. The vaccine protects against the most common high-risk HPV strains but not all of them. Screening remains necessary.
Self-sampling awareness:
NHS England is piloting HPV self-sampling kits, which allow women to take their own vaginal swab at home. Early trial data from the YouScreen study showed that self-sampling significantly increased uptake among non-attenders. Pharmacists should be aware of local pilot availability and can signpost patients who express strong reluctance to attend in-person appointments.
Signposting resources:
- Jo's Cervical Cancer Trust (jostrust.org.uk) provides evidence-based patient information, a helpline, and support for anxiety around screening
- The NHS Cervical Screening Programme website has appointment booking guidance
- Local sexual health clinics may offer screening outside standard GP hours
The pharmacy opportunity
According to PharmSee's data, England has over 13,000 community pharmacies, and the average person lives within a 20-minute walk of one. For women who find GP appointments difficult to access — whether due to working hours, childcare, or simply not being registered — the pharmacy may be the only healthcare setting they visit regularly.
The Women's Health Strategy specifically calls for women's voices to shape healthcare delivery. In the context of cervical screening, that means meeting women where they are — and for many, that is the pharmacy counter.
PharmSee's vacancy tracker currently shows 1,742 active pharmacy roles across England, reflecting a workforce that, despite recruitment challenges, continues to provide frontline healthcare access in every community.
The numbers that matter
Cervical screening prevents an estimated 2,000 cervical cancer deaths per year in the UK, according to Cancer Research UK. Yet approximately 4.4 million eligible women are overdue for their test at any given time. Even a modest increase in attendance — driven by brief, supportive conversations in pharmacies — could translate into earlier detection and lives saved.
Sources
- NHS Digital, Cervical Screening Programme statistics (2024)
- Jo's Cervical Cancer Trust, barriers to screening research
- Cancer Research UK, cervical screening prevention estimates
- NHS England, YouScreen HPV self-sampling pilot data
- Department of Health and Social Care, Women's Health Strategy renewal (April 2026)
- PharmSee pharmacy and vacancy data, accessed April 2026
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