Those women who have had a hysterectomy and require follow up vault smears, should be followed up by gynaecologists; this work should not fall to GPs.
A meeting was held with GPC representatives and the NHS Director of Cancer Screening in July 2010, with regard to vault cytology which is not part of the NHS cervical screening service, and it was confirmed that:
the responsibility for follow up care of women who required vault cytology lay with their gynaecologist, not GP. GPs do not have the skills or the equipment to be able to provide failsafe care for these women, of whom there will only be a minute number per practice.
Full guidance can be found in 'Colposcopy and Programme Management - Guidelines for the NHS Cervical Screening Programme, Second edition'.
We raised the point that these guidelines could be interpreted ambiguously on the follow up of women who had undergone hysterectomies, with the risk of inappropriate delegation to GPs. This was accepted and the NHS Cervical Screening Team will amend them accordingly.