Overview

During the coronavirus (COVID-19) outbreak it is very important we maintain, as far as possible, our illness prevention and early intervention services.

To protect children and vulnerable groups, immunisation services throughout Scotland have continued.

Some NHS Scotland national screening programmes which were paused in March because of coronavirus (COVID-19) are set to resume safely, carefully and in a series of stages.

Cervical screening

From Monday 29 June anyone who was invited for cervical screening before the pause and was yet to make an appointment or had their appointment cancelled, will be able to contact their GP practice to make an appointment.

Find out more about the cervical screening resuming.

Updates

Stay updated about immunisation and screening services on our NHS Inform Healthy Living pages. Follow the @NHSImmuniseScot twitter account for updated advice on immunisation.

Other languages and formats

This guidance is also available in the following languages and formats:

Please note: These translations will be updated soon to include information on the resumption of cervical screening

Message from the Deputy Chief Medical Officer (https://www.youtube.com/watch?v=7e4bb7KEfyY)

Protecting children and vulnerable groups is vital during the coronavirus outbreak, says Deputy Chief Medical Officer Dr Nicola Steedman.

Immunisation

Immunisation appointments will continue during the coronavirus outbreak, in order to protect children and other vulnerable groups against vaccine-preventable diseases.

For more details read the following information:

Immunisations for children aged up to 5 years

Parents/carers will continue to receive immunisation appointment letters during this time. 

Please attend your child’s immunisation appointment to protect them against serious diseases.

Immunisations are one of the important medical reasons for leaving your home.

If you think you or your child are showing symptoms of coronavirus, please call the number on your invitation to rearrange your appointment.

Immunisations for young people at secondary school

As schools are currently closed, immunisations for young people at secondary school (including HPV and boosters for tetanus, diphtheria and polio) cannot be given at this time.

Your local Health Board will reschedule immunisation session dates as soon as possible once schools re-open.

Immunisations for pregnant women

Pregnant women are strongly advised to attend their appointment to receive their whooping cough vaccine (from week 16 of their pregnancy) to protect themselves and their baby against whooping cough.

Immunisations are one of the important medical reasons for leaving your home. 

If you are showing symptoms of coronavirus, please contact your health professional to discuss rescheduling your vaccination appointment.

Shingles immunisations for adults aged 70-79 years

Routine shingles vaccination appointments have been temporarily suspended, in line with current coronavirus advice for adults aged 70 years and over.

However, if you are eligible for the shingles vaccine and need to attend your health professional for another medical reason, you can ask your health professional if it’s possible to get your shingles vaccine whilst there.

Pneumococcal immunisations for those in risk groups aged 2 - 64 years and those aged 65 years and over

Pneumococcal vaccination will continue.

Those aged 70 years and older can be vaccinated if presenting for another scheduled appointment.

Immunisations are one of the important medical reasons for leaving your home. 

If you are showing symptoms of coronavirus, please contact your health professional to discuss rescheduling your vaccination appointment.

For further information visit our immunisation pages.

Cervical screening has resumed

From Monday 29 June anyone who was invited for cervical screening before the pause and was yet to make an appointment or had their appointment cancelled, will be able to contact their GP practice to make an appointment.

Appointment invitations and reminders will be posted from mid-July, with invitations sent to those who receive more frequent (non-routine) cervical screening appointments first.

Routine screening will recommence once NHS Scotland has caught up with non-routine appointments affected by the pause.

Cervical screening is the best way of finding out if you are at risk of cervical cancer

Who will be offered screening

Cervical screening is routinely offered to women and anyone with a cervix between the ages 25 and 64.

If you need more regular screening, you will be invited up to 70 years of age.

Anyone who was due their last screening invite during the pause will get one – regardless of age.

Coronavirus symptoms, self-isolating and shielding

If you have symptoms of coronavirus, or have been in contact with someone who does, you should not go to your cervical screening appointment.

Contact your GP practice and let them know you have coronavirus symptoms. They can help rearrange your appointment for after you have isolated.

If you're in shielding, you may want to discuss your risk of coronavirus with the healthcare professional who helps you manage any conditions. It may also help to contact your GP practice and ask what safety measures they have in place.

Shielding information may change, so check the most up-to-date advice on shielding.

Making an appointment

If you have had your cervical screening invitation, you can contact your GP practice to book an appointment.

However, it may take some time before your GP practice can offer you an appointment, as they prepare the practice to keep you and their staff safe.

Attending your appointment

It's your choice whether to book an appointment for cervical screening.

Safety measures have been put in place to keep you and their staff safe and well. If you want to know what your GP practice is doing, contact them by phone.

Most GP practices are asking that you don’t take anyone, including children, to your appointment to keep you and everyone who works there as safe and well as possible.

You may be able to have an extra member of staff with you, if having another person in the room is helpful. This person is sometimes called a chaperone.

If you find cervical screening difficult without having a trusted person with you, or need them for assistance, tell your GP practice.

If you have a childcare issue or need to have your child with you for another reason, tell your GP practice. They may be allowed to come with you.

Cervical cancer symptoms

Should you have any symptoms of cervical cancer it's important you contact your GP practice.

A doctor should assess you over the phone or by video call. They can decide whether you need a face-to-face appointment to do a further examination.

Cervical cancer is rare, so the likelihood that your symptoms are caused by cervical cancer is low, but it's still important to get medical advice.

Screening results

You should still get your results within 2 weeks after your appointment.

If you don't receive your results within the expected time, you can phone your GP practice to ask when they might arrive.

Common questions and answers

My invite was due during the pause. When will I receive it?

If you were due an invitation or reminder while the cervical screening programme was paused you will still receive this and can then contact your GP to book an appointment.

Please be patient as appointment invitations and reminders will be posted from mid-July, with invitations sent to those who receive more frequent (non-routine) cervical screening appointments first.

Routine screening will resume once NHS Scotland has caught up with non-routine appointments affected by the pause.

Can I make an appointment now?

If you have already received your invitation, you can contact your GP practice to book an appointment. 

It may take some time before your GP surgery can offer you an appointment, as they prepare the practice to keep you and their staff safe.

Please be patient as appointment invitations and reminders will be posted from mid-July, with invitations sent to those who receive more frequent (non-routine) cervical screening appointments first.

Routine screening will resume once NHS Scotland has caught up with non-routine appointments affected by the pause.

Is it safe to go to my cervical screening appointment at the moment?

Yes. Your GP practice will only offer cervical screening if they are confident they can keep you and their staff safe. Follow any instructions they give you, for example about arrival times or whether they advise you to wear a face covering.

If it is not safe for any reason, for example if you are self-isolating or shielding, your GP practice will explain this and help you make arrangements once it is safe.

Will my cervical screening appointment be the same as before coronavirus?

Your experience at your GP practice may be slightly different to usual because they will have safety measures in place.

You may be asked to arrive as close to the appointment time as possible and your nurse or doctor may be wearing a mask.

The cervical screening test itself, where your nurse or doctor takes a sample of cells from your cervix, will be exactly the same and should only take a couple of minutes.

Do I need to wear a mask or gloves to my appointment?

You may be asked to wear a face covering during your appointment, in line with national guidance.

A face covering is a piece of cloth that covers your nose and mouth to protect the people around you from coronavirus.

It is important to wash your face covering once you are back home.

Current evidence does not suggest that wearing gloves is helpful for the general public.

It is better to wash your hands well and often, so you may want to take a hand sanitiser containing at least 60% alcohol to your appointment.

What should I do when I arrive at my appointment?

Your GP practice should give you specific instructions about what to do once you arrive at your appointment, either when you book or a few days before your appointment.

Some GP practices are not using their waiting rooms at the moment so you may be asked to wait outside the building, sometimes at a specific door and always keeping distance from other people.

If you're asked to do this, your nurse or doctor will come and collect you for your appointment.

If you are invited to wait inside your GP practices, they will follow government guidance and make sure everyone is spaced apart from each other.

You can choose to wait outside – just make sure you let your nurse or doctor know where you are.

How long will my cervical screening take?

Some GP practices are currently allowing for longer appointment slots, usually about 30 minutes, which includes time spent waiting for your appointment and being shown to the examination room.

This longer time means the practice can follow their safety measures and make sure there aren’t too many people coming in and out of the building at once. However, the test itself should only take a few minutes.

You will still have time to ask any questions you want to ask before and after your appointment – your nurse or doctor is there to support you with any concerns.

Should I put off booking my cervical screening appointment until the coronavirus pandemic is over?

We don’t know when the coronavirus pandemic will end or the government guidance will change.

If you put off your cervical screening appointment, we can’t say how long you may be waiting for one.

You will need to think about this potential delay and your individual situation when making your decision.

Talk with your nurse or doctor about your situation, the safety measures they have in place, and any other concerns you have.

I’m worried about going to my cervical screening appointment and possibly bringing coronavirus back to my loved ones. What should I do?

Your GP practice will have safety measures in place to make this risk as low as possible.

You can help keep the risk low by following any instructions given to you when you arrive, as well as general guidance for keeping yourself safe.

Find out more about keeping yourself safe.

Is it possible to get coronavirus through cervical screening?

Coronavirus is a respiratory illness, which means it affects the lungs and airways.

It is most commonly spread by droplets from the mouth or nose, when someone coughs or sneezes.

Cervical screening is not considered high risk for passing on or getting coronavirus. Your nurse or doctor should be wearing personal protective equipment (PPE) to make sure the risk is as low as possible.

You can also keep the risk low by following any instructions your GP practice give you about safety measures.

Can I ask to see a specific nurse or doctor?

You can ask if a specific nurse or doctor is available, but be prepared that this may not be possible.

If you would prefer to wait for a specific nurse or doctor before having cervical screening, you can choose to do this.

However, you may be waiting for an appointment for a while, as we don’t know how long the risk and safety measures will last.

The commonly asked questions are based on information available on the Jo’s Trust website. Visit Jo’s Trust where you’ll find more guidance about cervical screening and cervical cancer.

Paused screening programmes

The following screening programmes remain temporarily paused:

Please note that bowel screening colonoscopies have resumed. Your NHS board will be in touch if you are due to attend an appointment

We’re working hard to resume these screening programmes. We’ll update these pages as soon as we have more information.

Pregnancy and Newborn Screening programmes have continued throughout the coronavirus outbreak. These are tests and scans offered during pregnancy and just after birth.

Please see our common questions section for details.

Be symptom aware

Between screening appointments or as you wait for your rescheduled screening appointment, be aware of any symptoms or signs of the conditions we screen for.

Our screening condition pages have symptom details. If you have any of the symptoms contact your GP practice.

Common questions

Some screening programmes have been temporarily paused during the coronavirus outbreak.

We know you will have some questions about this change and have prepared questions and answers about each affected screening programme.

Bowel screening

What should I do if I have a kit at home that I’ve not completed?

If you have a bowel screening test kit which you haven’t used, keep it safe until we re-start the programme. You can then do the test and send it to us.

I’ve just turned 50 and was expecting to receive my invitation but haven’t received it?

Please be assured that you’ll receive your invitation when screening re-starts.   

What happens if the results of my test show I need further investigation?

If the amount of blood found in your poo sample is above the normal screening limit, a colonoscopy is required.   This is to find out the cause of bleeding.

Will my colonoscopy still take place?

Yes, however there may be a delay in your colonoscopy taking place.

Your NHS Board will contact you as soon as possible to fully explain the colonoscopy to you, including how to prepare and the risks involved.

I need a colonoscopy. Does this mean I have cancer?

We know a delay to your colonoscopy may cause you considerable anxiety.  Please remember that:

  • it’s very unlikely that you have bowel cancer at the moment. Only about 5% of people requiring a colonoscopy have bowel cancer, and in those that do it is usually at a very early stage
  •  it’s much more likely that you have a polyp. This is a small growth which is quite harmless in itself, but may develop into cancer in the future if left untreated.  It’s therefore very important to remove polyps
  •  it’s highly unlikely that the delay in your colonoscopy will cause any harm.
When will I get my colonoscopy?

We’ll ensure that you have your colonoscopy as soon as it’s safe to do so. You’ll receive a letter inviting you for this. 

What should I do as I wait for bowel screening to re-start?

While the bowel screening programme in Scotland is temporarily paused due to the coronavirus outbreak, it’s important to be symptom aware.

If you notice anything unusual such as blood in your poo, a change in bowel habits or abdominal (tummy) pain, contact your GP practice.

Signs and symptoms of bowel cancer

Breast screening

I have been invited to attend for further assessment. Should I still attend my appointment?

Assessment clinics continue to be held within our screening centres.  If you do not wish to attend or you’d like to discuss your attendance in further detail with a member of our clinical team, contact the screening centre.

Am I at risk of developing breast cancer as I wait for my screening appointment?

We understand that the delay to your breast screening appointment may cause anxiety.

However breast screening is designed to pick up breast cancers at a very early stage when they are too small to see or feel. 

For every 100 women going for screening, one will be diagnosed with breast cancer. 

And this is normally at a very early stage when it’s treatable. It’s therefore highly unlikely that the delay in your screening appointment will cause any harm.

What can I do as I wait for my screening appointment?

While the breast screening programme in Scotland is temporarily paused due to the coronavirus outbreak, it’s important to be symptom aware.

If you notice any changes to your breasts, like a lump or swelling in your breasts of armpits, or changes in your nipple, contact your GP practice.

Signs and symptoms of breast cancer

Abdominal Aortic Aneurysm (AAA) screening

I have AAA and my monitoring scan is due. When will I now be invited for this?

You’ll be re-invited for your monitoring scan when it’s safe to re-start the AAA screening programme.

When this happens, invitations will be re-issued and appointments re-arranged. We’ll do everything we can to ensure screening invitations and appointments are prioritised appropriately.

I’ve been invited to attend for further assessment, should I still attend my appointment?

If you have been diagnosed with a large aneurysm you’ll have been referred to vascular services for assessment. The vascular surgery team will contact you directly to discuss what happens now.

I am almost 65 years old. When will I be invited for my AAA screening?

Please be reassured you’ll not miss out on your screening test.  When screening re-starts, you’ll be sent an invitation through the post.

What should I do as I wait for my screening appointment?

While the AAA screening programme in Scotland is temporarily paused due to the coronavirus outbreak, it’s important to be symptom aware.

If you have unusual or unexplained abdominal (tummy) or lower back pain, contact your GP practice.

Signs and symptoms of an AAA

Diabetic Retinopathy Screening (DRS)

What happens if the delay takes me over the routine annual or 6-monthly screen?

Please be reassured that the risk of delaying your screening is small. It’s more important to protect you from coronavirus, as people with diabetes are at greater risk. You’ll be re-invited for screening when it’s safe to re-start screening.

When this happens, invitations will be re-issued and appointments re-arranged. We’ll do everything we can to ensure screening invitations and appointments are prioritised appropriately.

I have already been for screening and have been invited to attend for further assessment. Should I still attend my appointment?

If you have been referred to the ophthalmology department for assessment, you will only be invited if the consultant thinks it is safe to do so. We’ll be in touch if your appointment needs to be postponed. 

If you do not wish to attend or would like to discuss your referral in further detail with a member of the clinical team, please contact the Ophthalmology department (the phone number will be on your appointment letter).

What happens if I have been newly diagnosed with diabetes or I’m pregnant?

You’ll be invited for your initial screen when it’s safe to re-start screening.  The risk associated with spreading coronavirus is greater than the risk associated with delaying your screening appointment.

What should I do if I have concerns about my sight?

While the diabetic retinopathy (eye) screening programme in Scotland is temporarily paused due to the coronavirus outbreak, it’s important to be symptom aware.

If you have diabetes and notice any changes to your sight, contact your GP practice, diabetes specialist or optician.

Signs and symptoms of diabetic retinopathy