Hippo Labs uses the official NHS England QOF Business Rules to help practices monitor cervical screening uptake — ensuring eligible women are recalled at the correct intervals, exclusions are correctly recorded, and screening data is up to date.
💬 Just a reminder: these indicators aren’t clinical guidelines — they’re operational definitions used for QOF measurement. They define which patients appear for recall, how achievement is calculated, and where gaps may occur.
📋 The Cervical Screening Register (CS_REG)
This register includes females aged 25 to 64 who are eligible for cervical screening. It underpins both indicators (CS005 and CS006).
Patients appear on the register if they:
Are recorded as female, and
Are aged 25–64 years on the achievement date.
✅ In short: all women aged 25–64 should appear on the register unless excluded (for example, total hysterectomy).
🩺 The Indicators
Cervical screening has two age-based indicators, reflecting the NHS screening programme’s recall intervals:
👩🦰 CS005 — Women aged 25–49 years
Measures:
% of women aged 25–49 who have had an adequate cervical screening test in the last 3 years and 6 months.
Counts as complete if:
A valid cervical screening (smear) result is recorded within 3 years and 6 months before the payment period end date.
Exclusions (Personalised Care Adjustments):
Cervix removed (complete hysterectomy)
Unsuitable for screening (e.g. clinical contraindication)
Pregnant within the last 12 months
Declined screening within the last 3 years and 6 months
Not responded to three invitations
Newly registered within the last 3 months
⚠️ Common pitfalls:
Recording a result without using a recognised SNOMED screening code
Missing the “adequate sample” code — incomplete results don’t count
Using the wrong time window (needs to be within 3 years 6 months)
Not coding exclusions (declined, unsuitable, or hysterectomy)
✅ In short: every woman aged 25–49 should have a coded smear result within the last 3 years and 6 months, or a valid exclusion.
👩🦳 CS006 — Women aged 50–64 years
Measures:
% of women aged 50–64 who have had an adequate cervical screening test in the last 5 years and 6 months.
Counts as complete if:
A valid cervical screening (smear) result is recorded within 5 years and 6 months before the payment period end date.
Exclusions (Personalised Care Adjustments):
Cervix removed (complete hysterectomy)
Unsuitable for screening
Declined screening
Not responded to three invitations
Newly registered within the last 3 months
⚠️ Common pitfalls:
Not differentiating recall intervals by age group
Missing codes for women who’ve had a total hysterectomy
Recording screening outside the allowed window
Free-text or results without formal SNOMED entries
✅ In short: every woman aged 50–64 should have a coded smear within the last 5 years and 6 months, or a valid exclusion.
🧩 Putting It All Together
Indicator | Age Group | Recall Interval | What It Shows | What to Do |
CS005 | 25–49 years | 3 years + 6 months | Uptake of cervical screening in younger women | Recall and record smear results within 3.5 years |
CS006 | 50–64 years | 5 years + 6 months | Uptake of cervical screening in older women | Recall and record smear results within 5.5 years |
🌟 Why This Matters
Following these indicators helps practices:
Maintain accurate, up-to-date cervical screening data
Ensure timely recalls based on age group
Identify women overdue or incorrectly excluded
Demonstrate QOF compliance and improved cancer prevention outcomes
✅ In short: the Cervical Screening Indicators ensure every eligible woman is invited, screened, or correctly excluded in line with national screening standards.
📚 Sources
NHS England QOF Business Rules v50.0 (Cervical Screening, April 2025)
Primary Care Domain Reference Sets (TRUD Portal)