Appendix 5: Colposcopy discharge pathways
Updated 24 June 2025
Applies to England
漏 Crown copyright 2025
This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gov.uk.
Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.
This publication is available at /government/publications/cervical-screening-cytology-reporting-failsafe/appendix-5-colposcopy-discharge-pathways
These flowcharts (illustrations and text descriptions below) describe the colposcopy discharge pathways for NHS cervical screening.
The discharge pathway is divided into 7 flowcharts under 5 headings:
- 1) For individuals referred to colposcopy via primary screening, or cervical abnormalities identified when referred for non-screening reasons
- a) Colposcopy assessment, diagnostic biopsy or treatment undertaken (as required) 鈥� discharge to primary care for follow up
- b) Colposcopy assessment, diagnostic biopsy or treatment undertaken (as required) 鈥� where the follow up screening test was taken in colposcopy 鈥� discharge to primary care for follow up
-
2) For individuals with no abnormality detected when referred for non-screening reasons
- 3) For individuals having a screening test taken on behalf of the GP
- a) Routine screening test taken in colposcopy on behalf of the GP
- b) Follow up screening test taken in colposcopy on behalf of the GP
-
4) For individuals returning to routine screening after having a follow up screening test taken in colposcopy
- 5) For individuals referred to colposcopy who are not eligible for call recall for cervical screening
Actions are for colposcopy staff to complete unless specified. Colposcopy staff may be required to respond to the call and recall provider queries if discharge information does not correlate with results or programme protocols.
Please review the key for the flowcharts.
Flowchart part 1: For individuals referred to colposcopy via primary screening, or cervical abnormalities identified when referred for non-screening reasons
1a) Colposcopy assessment, diagnostic biopsy or treatment undertaken as required 鈥� discharge to primary care for follow up
Action 1: Is the individual eligible for screening?
[decision]
Eligible individuals include those aged 24.5 to 64 years of age with a cervix or aged over 65 and under screening surveillance or not previously screened.
- Yes: Go to action 2 [colposcopy service action]
- No: Go to Flowchart 5 (for individuals referred to colposcopy who are not eligible for call recall for cervical screening)
Action 2: Discharge the individual from colposcopy. 聽
Go to action 3 [colposcopy service action]
Action 3: Set the appropriate early recall period, referring to the Cervical Screening Care Pathway.
This may be 6, 12 or 36 months. 聽Go to action 4 [colposcopy service action]
Action 4: Add the individual to the colposcopy discharge list to be sent to the call and recall provider
Provide required information [colposcopy service action]
No further action for colposcopy, however be ready to respond to the call and recall provider queries.
Action 5: The call and recall provider to amend the next test due date (NTDD)
[call and recall provider action]
This is calculated from the last colposcopy attendance prior to discharge.
1b) Colposcopy assessment, diagnostic biopsy or treatment undertaken (as required) 鈥� follow up screening test taken in colposcopy 鈥� discharge to primary care for follow up
The laboratory will report the screening test and send the result to the call and recall provider via lab link.
Action 1: Is the individual eligible for screening?
[decision]
Eligible individuals include those aged 24.5 to 64 years of age with a cervix or aged over 65 and under screening surveillance or not previously screened.
- Yes: Go to action 2 [colposcopy service action]
- No: Go to Flowchart 5 (for individuals referred to colposcopy who are not eligible for call recall for cervical screening)
Action 2: Discharge the individual from colposcopy
[colposcopy service action]
Go to action 3.
Action 3: Is the individual returning to routine recall?
[decision]
- Yes: Go to action 4 [colposcopy service action]
- No: Go to Flowchart 4 (for individuals returning to routine screening after having an early recall screening test taken in colposcopy)
Action 4: Set the appropriate early recall period, referring to the Cervical Screening Care Pathway
[colposcopy service action]
Set as:
- 3 months (inadequate cytology/unavailable HPV)
- 6 months (for individuals following a post treatment screening test at 6 months with histologically confirmed microinvasion (1a1), or CGIN/SMILE with margins incompletely excised)
- 12 months
- 36 months
Go to action 5 [colposcopy service action]
Action 5: Add the individual to the colposcopy discharge list to be sent to the call and recall provider.
Provide required information [colposcopy service action]
No further action for colposcopy, however be ready to respond to the call and recall provider queries
Action 6: The call and recall provider should correlate the discharge list against the screening results received via lab link
[call and recall provider action]
6a: Has the call and recall provider received a laboratory result for this individual? [decision]
- Yes: Go to query 6b.
- No: The call and recall provider sends query to colposcopy. [call and recall provider action]
6b: Do the discharge list and laboratory result received correlate? [decision]
- Yes: No further action required by the call and recall provider. [call and recall provider action]
- No: Go to query 6c.
6c: Is the action code 鈥淪鈥�? [decision]
- Yes: The call and recall provider to amend the next test due date (NTDD) according to colposcopy. [call and recall provider action]
- No: The call and recall provider sends query to colposcopy. [call and recall provider action]
Flowchart part 2: For individuals with no abnormality detected at colposcopy assessment when referred for non-screening reasons
Action 1: The individual is symptomatic with no cervical abnormality detected.
- Yes: Go to action 2. [colposcopy service action]
- No: Go to Flowchart 1 for individuals referred to colposcopy via primary screening or where cervical abnormalities are identified due to a symptomatic referral.
Action 2: Discharge the individual from colposcopy.
Go to action 3. Recall remains unchanged. [colposcopy service action]
Action 3: The individual is not added to the discharge list.
[colposcopy service action]
Action 4: The call and recall provider should query with colposcopy if such an individual appears on a discharge list. The call and recall provider should not amend the next test due date (NTDD).
[call and recall provider action]
Flowchart part 3: For individuals having a screening test taken in colposcopy on behalf of the GP
3a: Routine screening test taken in colposcopy on behalf of the GP 鈥� individual is eligible for screening
Eligible individuals include those aged 24.5 to 64 years of age with a cervix or aged over 65 and under screening surveillance or not previously screened.
The laboratory will report the screening test and send the result to the call and recall provider via lab link.
Action 1: Discharge the individual from colposcopy.
Go to action 2. [colposcopy service action]
Action 2: Set the recall period according to the test result and age of the individual, referring to the Cervical Screening Care Pathway [colposcopy service action]
- Test result is hrHPV+ve
- negative cytology: Early recall 12 months
- Test result is hrHPV-ve
- age 24.5 to 49: Routine recall 36/60 months according to policy
- age 50 to 59: Routine recall 60 months according to policy
- age 60 to 64: Cease from screening due to age according to policy
Go to action 3. [colposcopy service action]
Action 4: The call and recall provider should correlate the discharge list against the screening results received via lab link.
[call and recall provider action]
4a: Has the call and recall provider received a laboratory result for this individual? [decision]
- Yes: Go to query 4b.
- No: The call and recall provider sends query to colposcopy [call and recall provider action]
4b: Do the discharge list and laboratory result received correlate? [decision]
- Yes: No further action required by the call and recall provider. [call and recall provider action]
- No: Go to query 4c.
4c: Is the action code 鈥淪鈥�? [decision]
- Yes: Go to query 4d.
- No: The call and recall provider sends query to colposcopy. [call and recall provider action]
4d: Should the individual be ceased due to age? [decision]
- Yes: The call and recall provider request laboratory to resend result with the correct action code. [call and recall provider action] No: The call and recall provider to amend the next test due date (NTDD) according to colposcopy. [call and recall provider action]
3b: Follow up screening test taken in colposcopy on behalf of the GP 鈥� individual is eligible for screening
Eligible individuals include those aged 24.5 to 64 years of age with a cervix or aged over 65 and under screening surveillance or not previously screened.
The laboratory will report the screening test and send the result to the call and recall provider via lab link.
Action 1: Discharge the individual from colposcopy.
Go to action 2. [colposcopy service action]
Action 2: Is the individual returning to routine recall?
[decision]
- Yes: Go to action 3. [colposcopy service action]
- No: Go to Flowchart 4 (for individuals returning to routine screening after having an early recall screening test taken in colposcopy).
Action 3: According to the Cervical Screening Care Pathway, set the early recall period.
[colposcopy service action]
Set as:
- 3 months (inadequate cytology/unavailable HPV)
- 6 months (for individuals following a post treatment screening test at 6 months with histologically confirmed microinvasion (1a1), or CGIN/SMILE with margins incompletely excised)
- 12 months
- 36 months
Go to action 4. [colposcopy servicer action]
Action 4: Add the individual to the colposcopy discharge list to be sent to the call and recall provider.
Provide required information. [colposcopy service action]
No further action for colposcopy, however be ready to respond to the call and recall provider queries.
Action 5: The call and recall provider should correlate the discharge list against screening results received via lab link.
[call and recall provider action]
5a: Has the call and recall provider received a laboratory result for this individual? [decision]
- Yes: Go to query 5b.
- No: The call and recall provider sends query to colposcopy. [call and recall provider action]
5b: Do the discharge list and laboratory result received correlate? [decision]
- Yes: No further action required by the call and recall provider. [call and recall provider action]
- No: Go to query 5c
5c: Is the action code 鈥淪鈥�? [decision]
- Yes: The call and recall provider to amend the next test due date (NTDD) according to colposcopy. [call and recall provider action]
- No: The call and recall provider sends query to colposcopy. [call and recall provider action]
Flowchart part 4: For individuals returning to routine screening after having a follow up screening test taken in colposcopy
The laboratory will report the screening test and send the result to the call and recall provider via lab link.
Action 1: Discharge the individual from colposcopy.
Go to action 2. [colposcopy service action]
Action 2: Set the recall period according to the test result and age of the individual, referring to the Cervical Screening Care Pathway.
[colposcopy service action]
- Test result is hrHPV-ve
- age 24.5 to 49: Routine recall 36/60 months according to policy
- age 50 to 59: Routine recall 60 months according to policy
- age 60 to 64: Cease from screening due to age according to policy
Go to action 3. [colposcopy service action]
Action 3: Add the individual to the colposcopy discharge list to be sent to the call and recall provider.
Provide required information. [colposcopy service action]
No further action for colposcopy, however be ready to respond to the call and recall provider queries.
Action 4: The call and recall provider should correlate the discharge list against the screening results received via lab link.
[call and recall provider action]
4a: Has the call and recall provider received a laboratory result for this individual? [decision]
- Yes: Go to query 4b.
- No: The call and recall provider sends query to colposcopy. [call and recall provider action]
4b: Do the discharge list and laboratory result received correlate? [decision]
- Yes: No further action required by the call and recall provider. [call and recall provider action]
- No: Go to query 4c.
4c: Is the action code 鈥淪鈥�? [decision]
- Yes: Go to query 4d.
- No: The call and recall provider sends query to colposcopy. [call and recall provider action]
4d: Should the individual be ceased due to age? [decision]
- Yes: The call and recall provider request laboratory to resend result with the correct action code. [call and recall provider action]
- No: The call and recall provider to amend the next test due date (NTDD) according to colposcopy. [call and recall provider action]
Flowchart part 5: For individuals referred to colposcopy who are not eligible for call recall for cervical screening
Action 1: If not eligible due to age:
[colposcopy service action]
- If aged under 24 years & 6 months: manage and follow up in colposcopy only, individual is not part of the screening programme.
- If aged over 64 years & ceased due to age: retain in colposcopy until management and follow up is complete.
Go to action 3. [colposcopy service action]
Action 2: If not eligible due to status :
[colposcopy service action]
- Individual does not have a cervix: Manage according to local protocols.
- If ceased for informed choice or Mental Capacity Act (aged 24.5 to 64):
- If individual opts back into the programme, manage according to flowcharts 1 to 3
- Otherwise retain in colposcopy until management and follow up complete.
Go to action 3. [colposcopy service action]
Action 3: Discharge the individual from colposcopy.
Go to action 4. [colposcopy service action]
Action 4: The individual is not added to the discharge list.
[colposcopy service action]
Action 5: The call and recall provider should query with colposcopy if an underage or ceased individual appears on a discharge list. The call and recall provider should not amend the next test due date (NTDD).
[call and recall provider action]