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Dear Member

The summer months in the NHS are often a more relaxed experience and many of us see a significant reduction in the E mail traffic that arises in our inboxes. Therefore we can reflect with a little bit more leisure on how things have progressed over the past six months and the Newsletter gives me an opportunity to update you on things that have happened within the Society and the National Colposcopy Advisory Group.

Liz, Debbie and Sharon have all now moved to new larger offices in the Birmingham Women’s Hospital. After the last few years of uncertainty we now have a long term arrangement with the Birmingham Women’s Hospital Trust for them to provide office space and IT facilities. We are, of course, paying slightly more due to the improved quality of the accommodation but the Executive felt that this was a sensible decision and proved to be much cheaper than moving to commercial premises. I am sure once the secretariat are fully moved in they will benefit from the improved and larger office.

Liz has announced the fact that she will be retiring from the Society following the Meeting in April 2012 at Gateshead. The Executive has therefore started to review the structure of the professional secretariat which supports the BSCCP to ensure that the Society continues to run in an organised and seamless fashion once Liz retires. We believe that once these plans have been put in place, the professional secretariat will remain as efficient and professional as ever.

The CTC and the Executive are currently re-visiting the criteria for re-certification and you will find more on this subject in the report from John Cullimore on page 3. It is likely that we will have a transition period between the two criteria requirements to maintain flexibility and al-low as many colposcopists to re-certify as possible.

How will HPV Triage and Test of Cure affect your clinic and where will you find help and advice ?

Summer2011

The BSCCP’s Secretary’s Update

A major change that occurred to the Cervical Screening Programme in England has been the introduction of HPV triage for low grade cytological abnormalities and the use of HPV reflex testing in the test of cure following treatment. This was formally started on 0l April 2011 although the only Centres to undertake this at present are those involved in the original Sentinel Site Study. Full guidance on implementation has now been released by the National Screening Office and this guidance can be found on the NHSCSP Intranet (www.csp.nhs.uk/logon.aspx). Full implementation is awaiting the final review of different HPV testing plat-forms which has been undertaken over the last six months. This will permit laboratories to decide which HPV testing platform fits best with their laboratory and pathology services. The remit of the multi-platform testing study was to ensure that the new technologies available have a similar performance to that of the Hybrid Capture 2 system used in the Pilot Site and the Sentinel Site Studies.

The introduction of HPV triage and test of cure will impact on most colposcopy clinics and in some cases may result in significant increases in referrals. There is guidance in the implementation document as to how referral numbers might change and this should allow colposcopy services to predict extra workload and plan pro-actively for this. Extra funding has been provided to implement HPV triage and the monies paid will be based on a figure that relates to the screening activity of the laboratory. However some of these monies will be required to support extra colposcopy clinics and therefore it will be important that these funds are identified and passed on to colposcopy services. Plans are now in hand for training relating to the introduction of HPV triage and we are working on a system of regional meetings that will allow colposcopists to update their knowledge and practice in light of these changes. We want each colposcopy clinic to be represented, at the training meeting, by either their Lead Colposcopist or a nominated deputy. This will allow training to be cascaded within any individual colposcopy clinic. Of course, if more than one member of a colposcopy clinic wishes to attend the meeting we will encourage that to happen.

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Over the last few months we have had the BSCCP Annual Scientific Meeting in Liverpool and this was recently followed by the IFCPC meeting in Rio de Janeiro. Jonathon Herod, Derek Parkinson, Pierre Martin-Hirsch and the rest of the team organised a superb meeting that was scientifically excellent and clinically orientated. Liverpool has certainly come a long way and the developments around the conference arena are superb, which is a testament to a city being revitalised following their ‘European Capital of Culture’ in 2008. During the meeting, we were able to award the BSCCP ‘Founders Medal’ to Professor Julietta Patnick. We also had other notable international contributions from Dr Saloney Nazeer and Professor Evangelos Paraskevaidis.

The 14th World Congress of Cervical Pathology & Colposcopy (IFCPC) saw Patrick Walker preside over the meeting in Rio de Janeiro. A new nomenclature was agreed at the meeting and details can be found at http://www.ifcpc.org/documents/nomenclature7-11.pdf. Silvio Tatti (who is also a BSCCP member) from Argentina takes over as President and Walter Prendiville is to be congratulated on being chosen as President-elect. The next meeting is due to be held in London in 2014 and Theresa Freeman-Wang gave an update of the plans to the Congress. Maggie Cruickshank will chair the IFCPC Scientific Committee in preparation for the London meeting.

There are significant developments occurring, especially in the role of HPV testing both in triage and as test of cure. Details of the planned changes are given within this newsletter and further information will be forthcoming from the NHSCSP.

Following discussion with Jo’s Cervical Cancer Trust, the BSCCP made a grant of £5,000 to establish their helpline and develop material for distribution in a primary and secondary care setting. Jo’s Cervical Cancer Trust has trained volunteers to work on this helpline which went live at the beginning of 2011. For those that wish to advertise this service, the contact number for the helpline is 0808 802 8000. We feel that this is an important charitable function and will continue to monitor this aspect of our work.

The BSCCP secretariat has moved into new accommodation in Birmingham which meets our requirements. We are grateful to the Birmingham Women’s Healthcare Trust that have made this possi-ble and fully appreciate their support over many years.

I personally would be delighted to hear from anyone in relation to BSCCP matters. This can either be via the BSCCP secretariat or directly by email – mah-mood.shafi@addenbrookes.nhs.uk or telephone –01223 348203.Mahmood Shafi—President of the BSCCP

A Letter from the PresidentSecretary’s Update continued ...

To help guide us through the transition, the NHSCSP will soon issue a colposcopy alert. This is endorsed by the NHS Professional Advisory Group and the BSCCP.

Many of us are aware of the significant amount of work that has been put into the National Cancer Audit and this of course does provide useful information in planning and managing the Cervical Screening Programmes. It has, however, been recognised that the workload is burdensome to many. The process is therefore under review and the intention is to make the process more streamlined. To this effect we are actively reviewing the colposcopy review section of the National Cancer Audit. We hope to develop some new guidance by the end of the summer for discussion at the next Advisory Group Meeting in October of this year.

The NHSCSP has set up a working group with the remit to evaluate the possible introduction of primary HPV screening with cytology as a triage. Three work streams have been identified including a group focussing on clinical algorithms for the management of patients. The intention is to develop an algorithm in the forthcoming months with a view to implementing HPV primary screening at the Centres which took part in the HPV Sentinel Site Study. Evidence from this study will then be evaluated to inform the NHSCSP in any future decisions regarding primary screening.

I would just like to remind you all that we still have the National Colposcopy Audit Resource and any suggestions or proposals for Audits are always welcome. Advice and a starter pack can be obtained from Sharon Parisi at the BSCCP Secretariat.

I wish you all well for the remainder of 2011. John Tidy

Attention all Lead Colposcopists

Do you wish to attend a training session on the Introduction of HPV Triage and Test of Cure?

If so please contact: Sharon.Parisi@bwhct.nhs.uk

If you have recently been appointed Lead for your Trust, please contact us with your details.

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Provision of supervision for training can be very rewarding but requires a commitment of time and energy. A minimum clinical caseload is required as well as close supervision throughout the training period. The society is committed to ensuring that high quality training is the norm. With this is mind, the CTC have proposed that Trainers in Colposcopy should be able to demonstrate appropriate training in assessing and giving feedback to their trainees, thus complying with PMETB/GMC standards for trainers. This proposal has been endorsed by the BSCCP Executive Committee. It is proposed that Trainers apply for certification with the society (in the manner described below) and that they maintain their skills as a trainer by re-certifying on a 3 yearly basis. The first op-portunity to apply for trainer certification will occur at the time of application for recertification as colposcopists in September 2012.

A new form will need to be completed to achieve cert- ification as a recognised trainer. The requirements will be:-

a) Certification through attendance at a recognised ‘Training the Trainers’ meeting

OR

b) Certification in training through an E learning course (The BSCCP has obtained written agree-ment from London Deanery to use their website for this purpose - www.londondeanery.ac.uk. Click on Faculty Development on the right hand side of the Home webpage, under Specialist Websites, and this provides the Link to the E–learning modules. As a minimum those modules on Clinical Supervision and Workplace assessments should be completed and a certificate can be printed and saved as evidence of completion of these module)

OR

c) Certification of Attendance at any 3 BSCCP Trainers Meetings since 2007

Trainers will be asked to confirm that they have read andunderstood the training syllabus.

Recertification of TrainersTrainers will be asked to either:-

1) Attend a BSCCP Trainers Meeting once every three years. (The BSCCP Trainers meeting takes place on the Wednesday afternoon before the main BSCCP Annual Scientific Meeting every year)

OR

2) To fulfil conditions a) or b) above in ‘trainer certification’.

The process of certification as a trainer is voluntary, but the society proposes to publish a list of certificated trainers

Quality Assurance of Trainers which will be visible to those requiring trainers and others who view the website.

Support for Trainers The CTC and BSCCP Executive Committee have observed that given the increased responsibilities of all trainers, the role of the ‘Lead Trainer’ within colposcopy units is less well defined, and in some areas there may be no ‘lead’ present. The time has come, therefore, for a review to provide more comprehensive back up for trainers. There is agreement that the Regional Representatives of the BSCCP can be referred to by any trainer who feels that there are issues/or questions relating to trainees for which external advice is needed in their particular region. In future, therefore, the role of a BSCCP Regional Representative would attract those with educational supervisor skills, although this qualification is not considered essential. More details concerning such changes will appear on the website in due course.

Appointment of Chairperson of Certification & Training Committee from May 2012The Executive wish to appoint a Chairperson to lead the BSCCP Certification & Training Committee (CTC). This post will commence after the BSCCP Annual Conference in Gateshead/Newcastle. This role replaces the post of Assistant Secretary which, to date, has been an elected post and has included Chairmanship of the CTC. However, in early 2009, the Executive agreed that a process of appointment of a suitably qualified individual was desirable for commencement in May 2012. Hence any BSCCP member with a passion for education who holds qualifications in Medical Education, e.g. at educational supervisor level or higher, is encouraged to apply. The Job Specification for the position can be found in the Mem-bers Area of the website in the Newsletter section together with the Nomination Form.

New criteria for Certification 1st September 2012The Executive has agreed that the criteria for recertification should change on 1st September 2012 in order to reflect the imminent changes to the Cervical Screening Programme. The details have yet to be finalised but the criteria are likely to be modified along the following lines:-

The audit period will be for 12 months rather than 6 months. The required minimum caseload will be 50 new cases per year. The 50 cases can be made up as follows:A) A minimum of 25 cases with abnormal cytology or HPV +ve with negative cytology B) A maximum of 25 cases referred with abnormal

symptoms or an abnormal appearing cervix or tertiary referrals within or between colposcopy clinics.

NB: Whilst the changeover is being initiated during the next round of certification in September 2012, those recer-tifying who wish to use the current criteria will be allowed to do so.John Cullimore—Chairman of the CTC Committee

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Well, this is my penultimate newsletter and my last sum-mer newsletter. At this moment in time I cannot imagine life without the BSCCP but, as one door closes another opens, or so they tell me. I am just hoping that the door which will be opening for me will not be the one to the retirement home! Hopefully I still have a bit of life left in me yet and so it will be a case of ‘watch this space’ which is all one can do. I will miss my meetings and the adventures which I always seem to have when I go anywhere that in-volves BSCCP matters, the latest one being a trip to Rio de

A Letter from ‘Liz’

Annual Scientific MeetingGateshead/Newcastle19/20 April 2012

Party? Whey Aye man, that’s right, Liz will be retiring after the BSCCP Meeting in 2012 so make sure you attend and pass on your congratulations and personal best wishes to the person who has taken the Society from strength to strength over two decades and built it up to one of the most respected medical institutions of our era. And remem-ber its re-certification year; we’re expecting a massive turn-out so make sure you book early!

Raj NaikChairman of the Gateshead/Newcastle Local Organising Committee

The Sage—Gateshead

EFC continues to develop. In April 2011 representatives from 28 of the 32 member countries met in Berlin to discuss the possibility of developing a Certificate of Completion of Training which will have the approval of EFC. There was unanimous agreement that some form of certification would be desirable. EFC member countries have agreed already on the 51 core competencies required for basic training. The intention is that each country will conduct an EFC approved exit examination with a view to giving joint certification from the host country and EFC. It is hoped that this will be agreed by the time of the next EFC Conference in Prague, May 2013.

EFC continues to host courses. So far this year courses have been held in Sweden, Georgia and Athens. A course was also held in Albania as part of RCOG Eurovision programme and in October 2011 there will be a further course, hosted jointly with RCOG and IFCPC in Latvia.ACCEA 2012– (Advisory Committee on Clinical Excel-lence Awards) The Clinical Excellence Awards scheme is currently under review by the Review Body on Doctors’ and Den-tists’ Remuneration (DDRB) who are asking the CEA to consider whether the 2012 Round should include applications for new awards. It has been suggested that the 2012 Round should only be run for the purpose of renewing existing awards. The DDRB should recommend on this in the coming weeks. However, as things stand at the moment, the 2012 Round is going ahead.Joe JordanEFC Executive Board

Janeiro for the IFCPC Congress. We were promoting the next IFCPC meeting which will take place in London in 2014, and will be hosted by our Society. This meeting will be very big and will take a lot of thought and organi-sation, but I must say, having spent nearly a week with the Local Organising Committee under the capable Chairmanship of Theresa Freeman-Wang, I have every confidence that it will be an absolutely excellent meeting and one not to miss. Of course, that will depend whether the other members of the London LOC can keep themselves intact! I cannot resist telling you a little story – when have I ever resisted?? We were obviously expecting to arrive in Rio to magnificent sunshine and tropical beaches, as you do. Not so - unfortunately ……….

We have a jam-packed conference arranged for 2012 in Gateshead/Newcastle at the iconic SAGE, situated on the historic and renowned Quayside within the heart of the bustling city amongst the bars, restaurants and clubs. We start with the Training the Trainers session and John Cullimore has planned an innovative interactive session which is guaranteed to educate and entertain! Guest peakers for the main conference include Professor E Parakevaides, Professor J Paaronen, Professor P Nieminen, and Dr John Doorbar with a special appearance from Pro-fessor Harald zur Hausen who will receive the Founders Medal. There will be an up-date from both the BSCC and the BSVVD. You can also look forward to a lively debate on HPV testing/triage/test of cure from the Sentinel Sites Study Group as well as a novel “Question Time” session when you will get your chance to put the experts on the spot! Mix that with an evening of entertainment in one of Europe’s liveliest party towns and you can look forward to a great meeting. Also, how can you miss Liz’s Retirement

liz.dollery@bwhct.nhs.uk

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the weather was awful. It was dull, raining and very cold. Had we not been such a conscientious bunch and thus arrived with any ideas of sneaking out for a quick sun bathe for half and hour or so it would have been impossible! Anyway, after a heavy day on the Exhibition Stand and partaking of a few cocktails in the evening to relax them, at 1.00 am, a small faction of the LOC decided that it would be lovely to get a bit of fresh air and take a little stroll on the beach opposite the hotel. Thereby lies a story!

A Letter from ‘Liz’ … continued

London are presented with the IFCPC flag in Rio de Janeiro

Suffice it to say, we are very lucky to have a local organising committee at all. They were overtaken by a wave which they likened to a Tsunami and had to creep back through the reception of the hotel a very embarrassed group, their lovely evening clothes soaking wet and covered in sand.

Back to serious matters. Please read carefully the article from John Cullimore regarding the new rules for certification of trainers and the next round of recertification for all colposcopists, which takes place next September. I will not be here to guide you through and so I am going to have to rely on all of you to make it easy for the girls by doing everything properly – I am making this statement with ‘tongue in cheek’, but do your best please. I will make sure that you receive full instructions both in the next newsletter and by a separate email, so please do not delete anything from the BSCCP in the foreseeable future and read everything carefully if you wish to remain on the BSCCP Register of Colposcopists.

Last but not least, if you wish to apply for an ACCEA in 2012 you will be interested in reading the next item.

Liz

The Clinical Excellence Awards scheme is currently under review by the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) who are asking the CEA to consider whether the 2012 Round should include applications for new awards. It has been suggested that the 2012 Round should only be run for the purpose of renewing existing awards. The DDRB should recommend on this in the coming weeks. However, as things stand at the moment, the 2012 Round is going ahead.

The bronze, silver and gold awards to Consultants apply in England and Wales only and the Society may make upto 10 nominations on behalf of its members. If you fitthe criteria and wish to nominate yourself for a clinicalexcellence award in 2012 you may wish to start prepar-tions now. You will find all of the information yourequire on the ACCEA website, www.advisorybodies.doh.gov.uk. You will be required tosubmit your application to the Society by mid-December2011. Members who wish to be considered should also preparea short 50-100 word self citation drawing attention totheir contribution locally, regionally and nationally to theclinical delivery of colposcopy services, education, teach-ing and research. We would also ask for a sheet of papercommenting on the following:

Are you a lead colposcopist? Is this session recog-nised by a notional half-day from your employer?

ACCEA—2012 Are you a representative on the regional QA? Is this position recognised by a salaried session from your employer?

Have you taken part as a visitor in a regional peer review QA exercise?

Has your unit been visited in the last 18 months for peer review? Was the peer review report satisfactory?

Do you contribute specifically to local audit? Please comment on any educational training or

research initiatives for which you have lead responsibility.

I will be asking for your applications in my Novembernewsletter and will give you full details then of how toapply, but I thought you would appreciate time to prepare.

Liz

Video Presentations from the BSCCP Conference in Liverpool 2011

Are now available onlineLog on to the Members area of the website (www.bsccp.org.uk), Educational section.

You may need to subscribe to VIMEO (it’s free!)

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BSCCP Scholarships and Awards

The following were elected onto the Executive Committee in April 2011:

Dr K W McMullen – (Scottish Representative)Dr S Dobbs – (Irish Representative)Mr A Oladipo – (South East Representative – nominated and seconded after the AGM)

Vacancies for Officers and Regional Representatives in April 2012Nominations are required for the following positions:-

President Elect Secretary Chairperson for the CTC Committee (preferably

with educational experience. See job specification) Treasurer Welsh Representative North West Representative South West Representative GU Representative (to be appointed by BASHH) Nurse Representative (to be appointed by RCN

Colposcopy Nurses Group)

The Nomination Form and Job Specification for the Chair of the CTC can be found in the ‘Members Area’ of the website in the ‘Newsletter’ section http://www.bsccp.org.uk/index.asp?PageID=38

BSCCP Elections

The Executive of the BSCCP have agreed that, as no applications for any of the various scholarships were received in April 2011, the time for applications should be extended to Autumn 2011 and so, this is your chance to apply – do it!! See below:-

The Travelling FellowshipThis award of £1,000 is made to enable an individual to further his/her research by visiting centres of excellence. Anybody currently engaged in research is encouraged to apply. Please give brief details of your proposed study plan.

The Overseas ScholarshipThis award of £1,200 is available to bring a doctor from a less developed country to the United Kingdom to train in colposcopy. If you are in a position to assist someone please send in your proposal. If you wish the Society to consider a reciprocal visit of the host trainer to the applicant’s own country to provide ‘hands on’ experi-ence, then it may be possible to increase the award by a further £1000.

The application should be from a Society member and should include i) Case of need ii) Brief details of training to be offered iii) CV’s of the applicant and proposed trainee.

The Jordan/ Singer BSCCP Research AwardThe BSCCP has an aim to ‘promote the best standards of care in colposcopy with structured training, audit and research’. The object of this BSCCP Prize is to encourage research, clinical or laboratory based, or to acquire additional clinical skills within colposcopy and related sciences. The work can be undertaken either within their unit, other centres in the UK or abroad. Up to £10,000 will be available annually. This may be in the form of a single Prize or shared amongst several individuals. The applicant and/or sponsor will be a member of the BSCCP. It will be possible for there to be more than one recipient in any one year, provided the total monies do not exceed the sum available (currently £10,000). Applications for the Prize are invited for the following:To provide monies to fund a pilot project, clinical or laboratory based in the field of colposcopy, or to provide monies to fund an extension of an existing project researching colposcopy related issues.

or:

To provide a contribution towards a travelling Fellowship to attend a recognised training centre, either in the UK or overseas, to obtain training in a particular aspect or research methodology relating to colposcopy or related issue.The following conditions apply:

Curriculum vitae of the applicant (two page summary).

The applicant and/or sponsor should be a mem-ber of the BSCCP.

The names of two referees. The individual(s) and centre(s) to be visited, their

particular expertise and confirmation of the pro-posed arrangements from that centre.

A short written account of the reasons for and benefits of the work to be undertaken

An undertaking will be given that a structured typewritten report will be provided at the end of the grant period and that the source of grant will be acknowledged in any related publications.

Successful applicant(s) will be encouraged to pre-sent their work at subsequent BSCCP annual scientific meeting (oral or poster presentation)

The estimated cost of travel/subsistence/other expenses, together with details of any other finan-cial assistance being obtained or requested.

The award may only be used for the purpose approved by the BSCCP assessment committee

and Executive.

Applications for the awards should be submitted to the BSCCP Secretariat liz.dollery@bwhct.nhs.ukbefore 21st October 2011