Education pathway • section 3.1, added clarification to arrangements for nursing associates and physician associates • section 3.2, clarified the requirement for course accreditation • section 3.3, added the main elements of a quality framework • section 3.4, added employer responsibilities • section 3.6, clarifications to the role of NHS cervical screening mentor • section 3.7, clarifications to the training period • section 3.8, clarification to the duration of theoretical course • section 3.9, clarifications to the training model • section 3.11, added new topic 9: hrHPV self-testing • section 3.12, enhanced guidance on the use of pin code or code number • section 3.18, added the management of trainees exceeding the maximum sample limit • section 3.20, enhanced guidance on training records and portfolio documentation • section 3.21, clarified the assessment and ratification of trainee portfolios • section 3.22, clarified the certification process • section 3.23, clarified the management of trainee performance • section 3.24, added transfer of trainee progression between providers • section 3.25, added returning to cervical sample taker training (after absence) • section 3.26, added post certification competence and ongoing practice requirements • section 3.27, clarified update training requirements • section 3.29, added governance, escalation of risks, issues, and incidents Topic 1 • section 3.1, updated milestones • section 6.2, transgender (trans) men opt-in • section 6.6, people living with HIV Topic 2 • section 2.1, updated epidemiology Topic 4 • section 1.2, updated further reading and resources list • section 2.1, information leaflet on hrHPV self-test for under-screened individuals • section 3.1, added people with disabilities • section 3.3, enhanced guidance on screening people with a physical disability • section 4, updated pathway Topic 5 • section 5.2, hrHPV self-testing samples Topic 8 • section 10.1, mindful observation, and reporting of unusual findings Topic 9 • topic 9, hrHPV self-testing (self-test offer and clinical pathway)

Updated link to cervix chart.

Rewording of paragraphs in Topic 1 (sections 3.1, 6.1 and slides 5, 10, 11, 17, 18) and Topic 6 (section 3.3 and slide 8) to reflect extension of screening interval to 5 years.

Removed references to PHE within topic 3. CSMS and colposcopy discharge updates. Removed outdated slides. Removed signposting to Jo's Cervical Trust web page.

Added clarification that publication was previously published by Public Health England. Removed screening helpdesk information.

The guidance has been updated to include: • the addition of registered paramedics working in primary care to the list of healthcare professionals eligible for training to take cervical samples (Chapter 3, section 3.1) • a change to name of the 'interim' test to initial test to provide clarity on when in the training programme it should be completed (Chapter 5) • clarification that trainee sample takers must not include patient identifiable information (PID) on their records of samples taken documented in their workbook (Recording form and template examples) • clarified that it is the sample taker's responsibility to provide evidence of completed update training to the NHS cervical screening laboratory that holds the sample taker register for their locality (Chapter 3, section 3.23) • the addition of information on adapting theoretical content for a virtual platform (Chapter 4, section 4.5) • clarification of when to take a cervical sample after any clinical intervention (Topic 8, section 3.4) • the addition of information on taking a sample when an IUCD is in situ (Topic 8, section 3.4)

Update of guidance to include paramedics as registered sample takers

Updated following the implementation of primary human papillomavirus (HPV) screening in the NHS Cervical Screening Programme.

First published.