The National Cervical Screening Programme (NCSP) is changing the way cervical screening is done in Aotearoa New Zealand. The primary test for cervical screening will change from a cervical smear test to a vaginal swab for human papillomavirus (HPV) test, with the option of self-testing. The College has been in communication with NCSP representatives and has the following information to share:

1. The launch of the new test will take place on 12^th September 2023. Priority groups for screening are those who are currently unscreened (have never had a screening test), under screened (haven’t had a test in the past 5 years), at higher risk requiring surveillance/follow up, Māori, Pacific, and anyone who is a community service card holder.
2. Providers who currently offer cervical screening will be able to commence the new HPV screening once they have the resources/training required to do so. For those who are not currently smear takers (including midwives) a progressive roll out over the next six months will allow time for education, resourcing, and implementation.
3. Some building blocks which need to be in place before midwives can participate include:
   1. Education: The Cervical Screening Using Human Papillomavirus (HPV) Testing course for accredited screen-takers, GPs, and midwives is available on LearnOnline made up of four e-Learning modules. Midwives who wish to offer HPV screening are encouraged to ensure their knowledge about the test is up to date
   2. The NCSP have agreed to develop an information summary which is specific for midwives, setting out referral screening eligibility, recommended testing and referral pathways for abnormal results. We will communicate this to members once it is finalised and available
   3. The recommended follow up for some HPV test results is cytology or colposcopy. Midwives are advised to familiarise themselves with local services and referral pathways in preparation for managing the onwards referrals which may be necessary, following return of results from HPV screens they have undertaken
4. Te Whatu Ora are investigating how midwives can access funding to be paid for providing HPV screening services– we will keep members posted.
5. The new recall timeframe for (HPV) cervical screening will be every 5 years (or every 3 years if immune compromised). This is because HPV testing is more sensitive in finding the virus that causes the cell changes, so it is safe to wait longer between screening tests.

Midwives who wish to commence offering HPV screening now are able to do so, however no payment will be available to compensate midwives for this work until Te Whatu Ora have completed it work investigating how midwives can be funded.

Here are some links to useful information:

• Te Whatu Ora has collated resources for the sector to help with the roll out of the HPV test
• The National Screening Unit website has a dedicated page to explain all the changes to the cervical screening programme, and is a great place to go first
• The College published an article about the changes in the June issue of Midwife Aotearoa magazine. A pdf version of this article is available.
• The Goodfellow webinar gives a great explanation of why, when, and how the cervical screening programme is changing