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 will continue.

However, many of our national screening programmes have been temporarily paused to allow NHS Scotland staff and resources to focus on dealing with the coronavirus outbreak.

This decision has been taken reluctantly but is necessary to maintain social distancing and prevent, as far as possible, the further spread of coronavirus.

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:

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.

Screening

The Scottish Government has taken the decision to temporarily pause the following screening programmes until further notice:

This is due to the rapidly changing situation with coronavirus, its impact on clinical services and the requirement for social distancing.

We have now stopped inviting people for these screening tests and no more tests will be carried out until further notice.

Pregnancy and Newborn Screening programmes will continue where practical – these are tests and scans offered during pregnancy and just after birth.

If you've been screened recently, your results will continue to be processed.

Please see our common questions section for details.

Bowel screening kits

If you have had a bowel screening test kit which you haven’t used yet, keep it safe until we re-start the programme.

Once testing resumes, you can do the test and send it to us.

If you have already completed your bowel screening test kit, return it in the envelope provided.

If you're waiting for a colonoscopy appointment you'll be contacted directly.

When screening re-starts

Please be reassured we'll re-start screening programmes as soon as we can. Coronavirus evidence and information is being reviewed regularly.

When screening re-starts, invitations will be issued and appointments re-arranged.

We'll do everything we can to ensure screening invitations and appointments are prioritised appropriately.

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.

For more information, please visit our screening condition pages or call NHS Inform on 0800 22 44 88.

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 have already completed my test but not sent it back yet.

If you have already completed your bowel screening test kit, return it in the envelope provided.

I have already completed and returned my test kit but have not received my result.

You’ll soon receive your results letter.

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?

In normal circumstances, your NHS Board would contact you as soon as possible to fully explain the colonoscopy to you, including how to prepare and the risks involved.

Unfortunately, due to the coronavirus situation, there will be a delay in your colonoscopy taking place. This is because medical and nursing staff are required to focus on patients affected by the virus.  

Having a colonoscopy also increases the risk of spreading the virus between staff and patients.

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 already been screened but have not received my result.

You’ll still receive your results letter.  If you require further assessment, you’ll be invited to attend a clinic.

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

Cervical screening

I’ve already made an appointment for my cervical screening (smear) test at my GP Practice / clinic. Should I still attend?

No. GP Practices and other clinics have stopped cervical screening. Your GP Practice / clinic may contact you to cancel your appointment, however they’re extremely busy at this time so if this does not happen please do not attend.

I have an appointment at a colposcopy / specialist clinic for further assessment or treatment. Should I still attend?

Colposcopy and specialist clinics are still being held where possible.  Should you not wish to attend or would like to discuss your attendance in further detail, please contact the clinic.

I have already been for my cervical screening test but have not received my result.

Results for people who have recently been screened will continue to be processed, a result letter sent and a referral made if necessary.

If you do need further assessment, you'll receive a letter from your health board explaining what happens next.

I require more regular screening and will miss my follow up appointment. When will I now be invited?

When screening re-starts, invitations will be re-issued.  We plan to re-send invitations to those requiring more frequent screening first.   

Am I at risk of developing cervical cancer in between screening appointments?

We know a delay to your cervical screening may cause you anxiety, especially if you require more frequent screening due to previous results.

But remember, cervical screening is designed to stop cervical cancer before it starts.

The test checks the cells from your cervix (neck of the womb) for human papillomavirus (HPV).  If HPV is found, we then look at the same sample for cell changes.

HPV or cell changes take many years to develop into cervical cancer, not months.   Less than 1% of cervical screening tests find cervical cancer, even amongst those who require more regular screening.

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

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

If you have unusual discharge, or bleeding after sex, between periods or after the menopause, contact your GP practice. These are usually caused by something other than cancer but it’s important to have them checked.

Signs and symptoms of cervical cancer

Where I can I find more information?

Visit the Jo’s Trust website where you’ll find more guidance about cervical screening and cervical cancer. 

www.jostrust.org.uk/coronavirus

Abdominal Aortic Aneurysm (AAA) screening

I have already been screened but have not received my result. When will I receive it?

Your result will be sent to you within two weeks of your screening appointment.

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)

I have already been screened but have not received my result. When will I receive it?

Your result will be sent to you by 15th April.

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