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Dear Member

Many members of our Society will be working hard on planning the implementation of the HPV Triage and Test of Cure Programme for England. A variety of HPV testing platforms have been evaluated and laboratories will be making final decisions on arrangements for implementation of these technologies. Plans for introducing HPV testing in Northern Ireland and Wales continue whereas in Scotland HPV testing will only be used in a Test of Cure setting. An extensive educational programme has been developed based on the Quality Assurance Reference Centres and no doubt many of you have either attended these meetings or are due to attend them in the near future. It is vital for the efficient introduction of this system that the lead colposcopist or a deputy attends one of these meetings so that the implementation of information can be cascaded to all the members of a colposcopy clinic. The funding for implementation of HPV Triage and Test of Cure is based on an allowance per sample screened but within this global sum of money it will be important to identify the support costs to fund the increased referral rate to colposcopy. It is therefore vital for lead colposcopists to discuss the funding with their colleagues in the laboratory based screening service. The full Executive Meeting of the BSCCP endorsed the changes for BSCCP certification. However in order to reduce any potential complications it has been decided that the new system will be introduced in parallel to the old criteria for certification during our next formal re-certification round. Members will therefore be able to re-certify using either method for the next round. Later this year we will see the publication of two new

The BSCCP’s Secretary’s Update

revision of the ABC Guidelines and guidance on reporting of histopathology samples within the Cervical Screening Programme. When these are available I would encourage all members to read them as they will include significant revisions compared with previous editions. The Joint NHSCSP/BSCCP Audit Programme continues to seek out new ideas that any member may suggest as topics for audit relevant to our practice. The process is simple and has been successful to date. The second peer review publication is currently in press. Many journals use quite strict criteria regarding whether to accept papers based on audits and surveys and it has always been slightly disappointing that we have not achieved a much greater response rate from our membership. This does limit in some ways the value of the audit but it also impacts on our ability to get the audit published in higher ranking journals. In order to maximise response rates we try and target the most appropriate members of a colposcopy clinic for their response and we plan to ensure that all clinics partake in these audits through the process of Quality Assurance visits. Our next Scientific Meeting in Gateshead/Newcastle will soon be upon us. This Meeting will be notable for several reasons including the retirement of Liz Dollery and the presentation of the Founder’s Medal to Professor zur Hausen. Hopefully many of you have already made plans to attend and I look forward to meeting you on the banks of the Tyne.

John Tidy Secretary

Recertification looms again If you need to attend a meeting come and join us in Gateshead - it promises to be memorable!

Winter 2011

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A further reminder that the process of trainer accreditation and subsequent 3 yearly re-certification will start in 2012. The process of certification as a trainer is voluntary, but the society proposes to publish a list of certificated trainers which will be visible to those requiring training and others who view the website. A new form will need to be completed to achieve certification 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. These can be completed, as a minimum those modules on Clinical Supervision and Workplace assessments and a certificate can be printed and saved as evidence of

completion of these modules. This section also details the requirements for Clinical Supervisors). OR c) Certification of Attendance at any 3 BSCCP Trainers Meetings since 2007 NB All Trainers will be asked to confirm that they have

read and understood the training syllabus when taking

on a trainee

3 yearly re-certification of trainers can be on the basis of a) and b) above or alternatively, attendance at future trainers meetings, once every 3 years as a minimum, as well as continued BSCCP certification as a colposcopist. The form can be found on the website http://www.bsccp.org.uk/index.asp?PageID=42 Appointment of Chairperson of Certification and Training Committee from May 2012

The Executive will appoint a chairperson to lead the BSCCP Certification & Training Committee (CTC), in early March 2012. Two candidates have put themselves forward for consideration. This role replaces the post of Assistant Secretary which, to date, has been an elected post and has included chairmanship of the CTC. The role will include executive responsibility for the organisation and the assessment of the OSCE exam, a

role which has previously been carried out with immense skill and dedication by Dr Manjeet Shehmar, and the Society would like to thank her for her outstanding contribution over the years.

President’s Letter Certification of Trainers There are significant changes occurring in cervical screening. These include the introduction of HPV triage and test of cure. The roll out is progressing and further details in relation to the HPV testing systems will be made available on the NHSCSP website. There is also a pilot planned using HPV testing as a primary screen. Various NHSCSP documents are due for updates (e.g. document 20 – colposcopy and programme management) and the BSCCP is fully engaged with this process. The BSCCP website will need a major update and this was discussed at an executive meeting recently. The IT committee will look at the changes that are needed and how these should be taken forward. Grainne Flannelly is leading on this project and details are to be found in this newsletter. The chair of Certification and Training Committee has been advertised and we plan to make an appointment in the new year. The next annual scientific meeting is in Gateshead – Raj Naik is organising and we look forward to the usual high standard of both the science and social aspects of the meeting. Professor Harald zur Hausen will be awarded the ‘Founders Medal’ at this meeting. Maggie Cruickshank will take over as President of the BSCCP at the Gateshead meeting. As it is recertification year, we expect a large attendance. Liz Dollery will be retiring as secretary of the BSCCP after the Gateshead meeting. She has served BSCCP admirably over two decades and has seen it grow from a small organisation to one that has over 2,000 members. We hope that as many of you will be able to join us in Gateshead to give her a suitable send off. As part of this process, Sharon Parisi and Deborah Lewis will have increased responsibilities within the secretariat from Spring 2012 onwards and no doubt they will have your full support. We also anticipate that with the proposed changes to the BSCCP website, eventually many of the functions can become more automated (e.g. registration, recertification) but it is always nice to have a friendly voice in the secretariat that we can talk to about any relevant issues. 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 – mahmood.shafi@addenbrookes.nhs.uk or telephone – 01223 348203.

Mahmood Shafi President

2012 subs are due!

If you have not done so already, please forward a

cheque for £60 (or €75) to the BSCCP

If you have a UK bank account and prefer to pay by

Direct Debit, please email Sharon.Parisi@bwhct.nhs.uk

for a mandate form

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1. The audit period will be for 12 months rather than 6 months

2. The required minimum caseload will be 50 new cases per year

3. The 50 cases can be made up as follows

(a) a minimum of 25 cases with abnormal cytology. All 50 cases could be in this category, but there is some additional flexibility i.e.

(b) a maximum of 25 cases referred with abnormal symptoms, or an abnormal appearing cervix, or HPV +ve with negative cytology, or tertiary referrals within or between colposcopy clinics.

‘Whilst the changeover is being initiated during the next round of certification in September 2012, those recertifying who wish to use the current criteria will be allowed to do so. Forms in the old and the new format are on the website http://www.bsccp.org.uk/index.asp?PageID=41’

Finally, we look forward to seeing as many of you as possible at the trainers meeting to be held at Gateshead on Wednesday afternoon, 18th April, immediately before the Annual Conference. (Please note that registration for the Trainers Seminar is now part of the registration process for the annual conference).

John Cullimore Chair of the CTC Committee

Happy New Year from the IT Subcommittee who has been looking closely at the IT needs of the society and trying to see what we can do to improve the experience of the membership by increasing the functionality of the website. Since

the design of the last website – (over seven years ago) the society’s secretariat has taken on ever increasing numbers of tasks for ever increasing numbers of members. As well as membership registration and maintenance recertification, there is tracking trainees and trainers, registering for Courses and OSCE examinations, organising meetings – the list is endless. The current website facilitates only a fraction of this workload and even with that the relatively old architecture of the site means that there is much room for improvement. The time has come for a major overhaul and we are currently in the process of tendering for a completely new site that should keep the best of what we currently have but increases the functionality significantly to enable more interaction and responsiveness. This will involve a lot of work and some expense but we think that it is worth it. The website should be the nerve centre of our organisation and we hope to get there in the first half of 2012. The challenge of course will be not to lose any of the really good aspects of our current site – we recognize that technology is constantly changing and we hope the development will lay the groundwork for future smarter information and provide a platform for the further development of e-learning. We are very excited about this new development but recognize that it may take some time so please be patient -good things will come honestly. Meanwhile we at the IT Committee are always looking for new recruits and if you are IT inclined and interested in joining our group please let Liz or Debbie know or contact me directly. If you have not done so already you can check out the presentations from last years annual meeting at the BSCCP Vimeo channel at www.Vimeo.com. We look forward to adding the presentations from Gateshead/Newcastle during the summer so watch this space.

Grainne Flannelly Chair IT Committee

Information Technology

Gateshead/Newcastle Meeting 19/20 April 2012

Plans for the 2012 BSCCP Meeting in Gatehead/Newcastle on the 19th and 20th April 2012 have gone from strength to strength. Not only will we be celebrating the 40th anniversary of the BSCCP with a Historical Presentation of the BSCCP from Albert Singer and Joe Jordon with photos and pictures from a world long forgotten but we've also managed to squeeze in a "Question Time" session chaired by David Luesley. Will he be able to control the panel members as they are flung a range of questions on HPV testing, colposcopy standards and training from the audience? We'll wait and see! Also, how can you miss Liz's retirement party? This surely is a party not to be missed. With the welcome ceremony at the Baltic, the conference at the Sage and the Conference Dinner at the Hilton, all sited on the Gateshead bank of the Quayside, only a Millennium bridge walk over the river Tyne to the buzz and fun of the Geordie Party Town with its bars, clubs and restaurants. Also, please remember, it is re-certification year. Be there or be square!

Raj Naik Chair of the LOC, Gateshead

The Baltic Arts Centre—Gateshead

Recertification September 2012

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Research Committee

The Research Committee submitted a grant application to the Health Technology Assessment programme for a randomized control trial of LLETZ compared to ablation to assess not only treatment failures but also obstetric outcomes in subsequent pregnancies. Our initial application was turned down as we needed significant monies to run this large trial. We have subsequently resubmitted a new application designed to look at treatment failures alone. We hope to hear in the Spring, if this is successful. If we are successful, we hope you can all recruit into this study.

Pierre Martin-Hirsch Chair Research Group

Two nurses were recruited by NNCTR (Nepal Network for the Cancer Treatment and Research), Miss Sita Pariyer (appendix 1) and Miss Mamata Shrestha (appendix 2). The selection of candidates by NNCTR was excellent. Both nurses were highly motivated with good verbal and written communication skills. Flights were funded, accommodation and lunches were provided. All transport costs were met. A lively social programme was put together and a grant of £120 per nurse was awarded. The day after their arrival their contracts and paperwork were processed and they

The IFCPC meeting in Rio de Janeiro in July 2011 was well attended – almost 2,000. It was a splendid meeting. Patrick Walker ended his 3-year term as President (having served for the previous 3 years as Honorary Secretary) and the new President is Silvio Tatti of Argentina. President-elect is Walter Prendiville (Ireland.)

IFCPC has worked with EFC in promoting courses in Europe, particularly Eastern Europe, and under the direction of Walter Prendiville there has been a further initiative. Walter has organised distance learning for 6 gynaecologists in India and 12 in Africa. These 18 gynaecologists will meet in Cape Town in January 2012. Lynette Denny has organised one week of practical training and assessment and this will be followed by an OSCE examination supervised by Maggie Cruickshank. This is a splendid initiative and Walter and his team are to be congratulated.

Report from PHASE of Nepal Nurses Colposcopy Training Programme 2011

a corporate induction day including infection control and manual handling. Shrewsbury and Telford NHS Hospital Trust provided accommodation free of charge on PRH hospital site. The nurses had access to libraries and IT suites in both hospitals with free internet access. They attended colposcopy clinics where they were trained as colposcopy nurses. This involved setting up the clinics, preparing the trolleys and cleaning them and taking care of the patients. They were instructed on the use of the colposcope. They observed colposcopy examinations and by the second week were performing colposcopy under direct supervision of JP and SG. They were instructed on scrub techniques, setting up equipment, assisted and performed colposcopy under direct supervision. Administration is essential if screening and colposcopy are to be successful and training was targeted at this. They spent time completing administrative tasks and data collection with the colposcopists and spent time with the colposcopy administrators. They attended a departmental audit morning and the gynaecology/pathology MDT meeting in addition to colposcopy MDT. Both nurses spent a day in the cytology laboratory and had a session in the histology lab where they observed analysis of cervical specimens including LLETZ biopsies with the Professor of pathology. Formal teaching and lectures were shared with the medical undergraduates of Keele University. In June a colposcopy examination was undertaken and both nurses were successful and were awarded certificates for completing the training programme and passing the exam. The visit was deemed to be successful. It involved close co-operation with many staff. The cost of the training is around £2500 and the BSCCP awarded a grant of £1000 towards this. Thanks to all who were involved in making the training programme a success.

Jane Panikkar The PHASE Nepal Colpocopy Group

Do you have a cold coagulator to donate?

The PHASE Nepal colposcopy group is dedicated to increasing colposcopy capacity within the country by training local gynaecologists in colposcopy (both in assessment and treatment). Several exchange visits have taken place between Nepal and the UK and two weekly colposcopy clinics have been set up in the capital. We are trying to improve access to treatments for CIN and would like to include cold coagulation as an option. If you have a functioning machine you are able donate please contact David Nunns on david.nunns@nuh.nhs.uk or 07887801279

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A Letter from ‘Liz’

ACCEA—2012

Courses & Meetings 2012

Details online

Log on to the website (www.bsccp.org.uk)

and visit ‘Events Calendar’

EFC has had several courses this year. Courses planned for 2012 are Stockholm (May 7th-8th), Tallinn, Estonia (May 9th-12th). The Tallinn course is held in conjunction with EBCOG. Antalya, Turkey (May 9th-13th). The Antalya course is held in conjunction with RCOG. These courses have been organised by Simon Leeson who is Chairman of the Education Committee. At this stage Simon thinks that there may be further courses towards the end of 2012, possibly Russia and Italy. EFC is working towards having some Form of Certification which recognises completion of Minimum Standards of Training in Colposcopy but would stress that this will not be an EFC Diploma of Competence. All 32 member countries of EFC are in favour of this and it is hoped that firm proposals will be put before the next EFC meeting which will be in Prague September 2013. The development of this Certificate of Competence is being led by Simon Leeson and Charles Redman. Charles has enlisted the help of Esther Moss who will be the using the Delphi technique (well tried and tested in the past!) to help us to take this forward. Anyone who is interested in any of the EFC courses (for which CME points will be given) then please contact ether Liz Dollery or Simon Leeson.

Joe Jordan EFC

I am sitting on a train again. I write so many of my newsletter articles on trains when I am travelling too and from BSCCP meetings. It is so quiet and great to have time to reflect and gather your thoughts. My thoughts are diverse. I am looking forward to having more time to myself and, at the same time dreading it, and wondering how I will feel when I am retired and I no longer have a regime! So many before me have thought the same I am sure, and then you hear that they have no time to fit everything in! Only time will tell. I have to thank you, the members of the BSCCP, for an exciting and fun filled 21 years – well most of it anyway! Not only have I met some wonderful people but I have been lucky enough to visit numerous UK cities and some fabulous places overseas. Since I joined the Society I have been to Chicago, Sydney, Buenos Aires, Rhodes, Barcelona and Rio de Janeiro for world congresses. My children have grown up, fled the nest, now pay for meals out for me, instead of visa versa, and I am a grandma. Wow – how time flies. I do not feel any different and certainly do not feel like a like a grandparent and I must admit it does not sit well with my image, or the one I have of myself anyway, but I am getting used to it. There have been so many changes in colposcopy since I first joined the Society and things are still changing on a regular basis. It seems as though you have just got your head around one change and it all changes again, but that has been the nature of things since I started! I wish you all the very best of luck. I will be in Gateshead/Newcastle for my last meeting in April, which will be very emotional, and so if you have time and the wherewithal to join me, please do come and say goodbye. I hope lots of you will be there AND don’t forget it is recertification year in 2012 (see CTC update for details) – an even better excuse to come. That aside the science and social is looking exceptionally good.

Liz BSCCP Co-ordinator E-mail: Liz.Dollery@bwhct.nhs.uk

Appeal for help from Bhopal, India

My organisation, the Bhopal Medical Appeal funds a clinic for the gas affected victims of the Bhopal gas-leak disaster which took place in December 1984. Because of toxic contamination of the environment and groundwater many children suffer ongoing birth defects and women are prone to gynaecological problems. We are looking for an expert in the technique of Colposcopy and in the treatment of cervical abnormalities which would include ultrasonography of the cervix and uterus/ovaries to screen the women visiting the gynaecologists at the Clinic. We are hoping to find someone here in the UK who would be willing to travel out to the Clinic to train our gynaecologists in the most up-to-date techniques. It is trainers which we need rather than practitioners. The women who come to the clinic will only be treated by a lady doctor (for religious and cultural reasons). If there is any way you can help us to fulfil this requirement, it would be greatly appreciated. We look forward to hearing from you at your convenience.

Dr Madhya Pradesh Sambhavna Clinic