I apologise unreservedly and express my sincere sympathy to all those affected by exposure to diethylstilbestrol (DES), including those exposed in utero and their families. National Health Service records are held by individual NHS organisations and general practices, and clinicians can record clinically relevant information, including known exposure to DES, in a patient’s own medical record where this is brought to their attention and is relevant to their care.

Women who believe or know that they were exposed to DES in utero may need regular colposcopy, which falls outside the routine screening programme. They should speak to their general practitioner about this, as local arrangements should be made for the follow up of women who have been exposed to DES where clinically indicated.

NHS England has asked Cancer Alliances to cascade existing guidance to clinical networks, including general practitioners and other health professionals who may come into contact with DES-exposed patients, so that appropriate follow-up can be arranged locally where needed.

The Department has commissioned the University of Exeter, through the National Institute for Health and Care Research, to review the latest evidence on the impacts of DES, including its long-term, intergenerational, and psychosocial effects. That work will help inform future decisions on clinical guidance, treatment pathways, and any screening arrangements for people affected by DES.

The Department will continue to work with NHS England and relevant partners to support awareness of the existing guidance for clinicians and patients affected by DES exposure.

The Government is committed to improving cancer screening services in line with the National Cancer Plan and as part of the 10-Year Health Plan’s shift from sickness to prevention.

Later this year, we will start to offer self-testing for human papilloma virus to women who have missed their cervical screening appointments by at least six months. This expansion aims to overcome barriers that stop women from taking up cervical screening which can both prevent and catch cervical cancer early.

NHS England takes a digital first approach to issuing invitations and results in the National Health Service cervical screening programme, using the NHS App and SMS.

NHS England is committed to making it as easy as possible for those wishing to participate in cervical screening to book an appointment.

For many people registered with a general practice (GP), they can already book appointments using the NHS App.

However, as NHS England finalises the first phase of its digital approach to correspondence, it is exploring the feasibility of providing a direct link from the screening invitations on the NHS App to GP booking systems, making it even easier to make appointments.

Cervical screening sample takers, for example GP nurses, are flagging with patients that results may be sent to them via the NHS App and are encouraging them to use and switch on notifications on the App.

The Government has announced the introduction of human papilloma virus (HPV) self-testing in the National Health Service cervical screening programme for the under-screened population in England. The NHS has begun planning an in-service evaluation (ISE) of HPV self-testing in the wider population.

The purpose of the ISE is to ensure that the self-test is acceptable, accurate, and feasible compared with a clinician collected specimen, and to evaluate its impact on cervical screening uptake and ensure that the programme continues to prevent the same number of cancers. The findings of the ISE will inform any future UK National Screening Committee recommendation to ministers to offer self-testing across the whole population, alongside clinician-led screening.

The Government is committed to its ambition to change the National Health Service so that it diagnoses earlier and treats faster. The NHS Cervical Screening Programme plays a vital role in this. Across the NHS, local systems and partnerships are working together to find ways to make cervical screening more accessible for people with a learning disability.

Following the launch of the Reasonable Adjustment Digital Flag Information Standard, NHS England is considering the role this digital flag has in further personalisation in the programme.

Reasonable adjustments can include:

• a longer or double appointment;
• information in other languages or formats, or an interpreter;
• a chaperone in the room; and/or
• an appointment with a trusted doctor or nurse who the individual already has a good relationship with.

Additionally, in early 2026, the NHS Cervical Screening Programme will be offering a self-testing kit to under-screened women, starting with those who are the most overdue for screening. This will help tackle deeply entrenched barriers that keep some away from screening.

The Government is committed to eliminating cervical cancer by 2040 through improved uptake of cervical screening and human papillomavirus (HPV) vaccination, as set out in the 10-Year Health Plan for England.

From early 2026, under-screened women will be offered a home testing kit, starting with those who are the most overdue for screening. This will help tackle deeply entrenched barriers that keep some away from life-saving screening.

New digital services will support screening participants to manage their screening appointments via the NHS App as well as delivering new, artificial intelligence ready services for staff, freeing up their time to focus on care.

NHS England is launching its first ever cervical cancer elimination creative campaign and communications toolkit for Cervical Screening Awareness Week.

We are delivering screening in any primary care setting, including sexual health clinics, rather than just at general practices. This includes evenings and on weekends.

The 10-Year Health Plan for England: Fit for the Future, restates the National Health Service’s aim to eliminate cervical cancer by 2040 through improved uptake of cervical screening and human papillomavirus (HPV) vaccination. Delivering the plan and making progress towards committed targets is a key priority for NHS England, working with the Department, providers, and wider health system partners.

As part of this, NHS England is transforming its approach to cervical screening for under-screened women. From early 2026, they will be offered a home testing kit, starting with those who are the most overdue for screening. This will help tackle deeply entrenched barriers that keep some away from life-saving screening.

National and international evidence suggests that offering the option of HPV self-testing in under-screened groups could help overcome some of the barriers to taking part in cervical screening, leading to improved participation, and ultimately preventing more cervical cancers and associated deaths.

The equality impact assessment on the introduction of human papilloma virus (HPV) self-sampling for the under-screened population in the NHS Cervical Screening Programme can be accessed at the following link:

https://www.gov.uk/government/publications/cervical-screening-hpv-self-sampling-impact-assessments

The self-testing kits, which detect HPV, allow people to carry out this testing in the privacy and convenience of their own homes.

Self-testing specifically targets those groups consistently missing vital appointments, with younger people, ethnic minority communities facing cultural hurdles, people with a disability, and LGBT+ people all set to benefit. Those who are HPV positive on their self-test will need to be followed up with a clinician for a cervical screening test, so it is acknowledged that not all barriers to attendance will be removed with the implementation of self-testing.

Therefore, it is anticipated that there will be an increase in participation from groups that are under screened. NHS England will monitor and evaluate the impact of this programme.

The 10-Year Health Plan for England: Fit for the Future restates the National Health Service’s aim to eliminate cervical cancer by 2040 through improved uptake of cervical screening and human papillomavirus (HPV) vaccination. Delivering the plan and making progress towards committed targets is a key priority for NHS England, working with the Department, providers, and wider health system partners.

NHS England will be monitoring and evaluating the success of all the individual activities included with its elimination plan and new initiatives as they are developed and implemented. In addition, the World Health Organisation’s cervical cancer elimination targets will be used as the basis for ongoing monitoring, along with regular assessment of cervical cancer rates.

Achieving cervical cancer elimination is a long-term goal that depends on joined up delivery of HPV vaccination and cervical screening programmes at national, regional, and integrated care board (ICB) level.

ICBs are well placed to understand the needs of their local populations and work with partners to offer services that meet those needs. They are best positioned to plan vaccination and screening services, using the recommendations set out in the cervical cancer elimination plan.

I refer the noble Baroness to the answer provided on 30 January 2025 to question 25707, a copy of which has been reproduced below for ease of reference:

Unitaid are a leading funder of innovative tools to find and treat cervical cancer in low- and middle-income countries, with HPV tests the most accurate way to identify if a woman is at higher risk of developing cervical cancer. Together with partners, Unitaid's interventions lowered the cost of HPV testing by nearly 40 per cent and reduced the price of portable thermal ablation devices for treating precancerous lesions by more than 45 per cent. Unitaid's work is laying the groundwork for national cervical cancer elimination programs worldwide. We highly value our Unitaid partnership and have contributed more than half a billion pounds in funding.

NHS England is committed to eliminating cervical cancer by 2040. Following ministerial endorsement of a UK National Screening Committee recommendation, in June 2025, NHS England indicated its intention to transform its approach to cervical screening for under-screened women. From early 2026, they will receive home testing kits starting with those that are the most overdue for screening. This will help tackle deeply entrenched barriers that keep some away from life-saving screening.

As part of implementation, NHS England is developing a communications and engagement plan to raise awareness of the option of self-testing. This includes underserved groups, NHS staff providing screening services, and key stakeholders such as charities. Materials developed have been tested with the Eve Appeal and build on extensive insights and user testing in the NHS cervical screening programme.

The Government is committed to improving vaccine uptake and access across all immunisation programmes by exploring new and innovative delivery models, including expanding routes such as community pharmacies, as set out in the NHS Vaccination Strategy and the 10-Year Health Plan for England.

In June, the UK National Screening Committee, which advises ministers on all aspects of screening, recommended a human papilloma virus (HPV) self-sampling option to women and people with a cervix who never or rarely attend routine cervical screening appointments. From early in 2026, they will receive home testing kits if they have not responded to a cervical screening invitation for a period of time. This will help tackle deeply entrenched barriers that keep some away from life-saving screening.

The World Health Organisation’s cervical cancer elimination targets will be used as the basis for ongoing monitoring, along with the regular assessment of cervical cancer rates.

NHS England will be monitoring and evaluating the success of all the individual activities included within its elimination plan, as well as new initiatives as they are developed and implemented.

NHS England works to ensure that core public information on screening is easily accessible and understandable to the public, and it regularly and systematically reviews this information.

For example, earlier this year, NHS England updated its cervical screening guidance to include that cervical screening is not a check for other cancers of the reproductive system, such as ovary, womb, vulval, or vaginal cancer. This guidance is available at the following link:

https://www.gov.uk/government/publications/cervical-screening-description-in-brief/cervical-screening-helping-you-decide--2

While uptake rates in England remain high by international standards, in recent years adolescent vaccine coverage for the human papillomavirus (HPV) has fallen due to the challenges posed by the COVID-19 pandemic. National Health Service commissioned School Aged Immunisation Service providers have robust catch-up plans in place for the adolescent vaccination programme based on population need, to offer vaccination to those young people who may have missed out during the initial offer.

The UK Health Security Agency (UKHSA) publishes and provides a range of supporting materials to health professionals on both the 12 and 13 year old HPV offer, and the vaccine programme for those at higher risk. The UKHSA also works closely with charities and academics to develop resources that can be used to raise awareness of HPV and the importance of vaccination, including for boys.

NHS England has improved digital communications on vaccinations, including by expanding the NHS App, and has improved access to the HPV vaccine outside of schools through community clinics at convenient times and locations.

In March 2025, NHS England published the Cervical cancer elimination by 2040 – plan for England, setting out how the NHS will improve equitable uptake and coverage across HPV vaccination and cervical screening to meet the goal to eliminate cervical cancer by 2040. Further information on the Cervical cancer elimination by 2040 – plan for England is available at the following link:

https://www.england.nhs.uk/publication/cervical-cancer-elimination-by-2040-plan-for-england/

In June 2025, NHS England launched the cervical cancer elimination campaign and toolkit for stakeholders, to increase awareness of the elimination target by 2040, educate the public about HPV, and build confidence in the HPV vaccine and cervical screening.

The 10-Year Health Plan for England: Fit for the Future, restates the National Health Service’s aim to eliminate cervical cancer by 2040 through improved uptake of cervical screening and human papillomavirus (HPV) vaccination. Delivering the plan and making progress towards committed targets is a key priority for NHS England, working with the Department, providers, and wider health system partners.

NHS England continues to develop its strategy, building on the strong foundations of both school-based programmes, ensuring as many young people as possible take up the offer of HPV vaccination, and cervical screening offered by local general practices (GPs) and other venues. Key activities to increase equitable HPV vaccine and screening uptake include:

- all children, both boys and girls aged 12 to 13 years old, or those in Year 8, being offered the HPV vaccine. Vaccinating boys not only helps to protect girls, it also directly benefits them, as HPV vaccination helps to protect boys from HPV related cancers, such as head, neck, and genital cancers. NHS England is taking a multi-pronged approach to improving HPV vaccine uptake. This includes improvements in School Age Immunisations Service provider delivery, investing in better digital services and data, improving access to vaccination services in supplementary settings, and continuing to deliver clear public health messaging;

- ensuring appropriate follow-up for those who have not yet been vaccinated, as NHS England has launched the GP HPV campaign, which went live from July 2025. GPs have been asked to invite unvaccinated individuals aged 16 to 24 years old for their HPV vaccine as a requirement of the GP Contract. The campaign runs until 31 March 2026;

- NHS England working with the Department and the UK Health Security Agency to develop options for HPV catch-up vaccination through community pharmacies from 2026;

- improving confidence in vaccinations, by working with Government partners to deliver improved campaigns that raise awareness of vaccination;

- indicating our intention to transform our approach to cervical screening for under-screened women or people with a cervix in July 2025. From early 2026, they will receive home testing kits, starting with those that are the most overdue for screening. This will help to tackle deeply entrenched barriers that keep some away from life-saving screening;

- the Digital Transformation of Screening programme, which is leading an ambitious, end-to-end transformation of screening services, and which is being rolled out in a test and learn way. New digital services will support screening participants to manage their screening appointments via the NHS App as well as delivering new, artificial intelligence ready services for staff, freeing up their time to focus on care;

- taking insight driven approaches to addressing inequalities using both data and behavioural insights to target communications and activities to increase uptake and coverage;

- sharing good practice among regions, integrated care boards, and providers, with NHS England having developed a central online resource which includes information on reducing inequalities and supporting equalities, and where all information can be readily accessed by NHS organisations and providers;

- NHS England launching our first ever cervical cancer elimination creative campaign and communications toolkit for Cervical Screening Awareness Week, from 16 to 24 June 2025. This will continue to be developed;

- engaging and maintaining relationships with stakeholders, which will be central to the ongoing delivery of the Cervical Cancer Elimination plan, and ultimately the elimination of cervical cancer in England; and

- carrying out screening in any primary care setting, including sexual health clinics, rather than just at GPs. This includes evenings and on weekends.

The 10-Year Health Plan for England: Fit for the Future, restates the National Health Service’s aim to eliminate cervical cancer by 2040 through improved uptake of cervical screening and human papillomavirus (HPV) vaccination. Delivering the plan and making progress towards committed targets is a key priority for NHS England, working with the Department, providers, and wider health system partners.

NHS England continues to develop its strategy, building on the strong foundations of both school-based programmes, ensuring as many young people as possible take up the offer of HPV vaccination, and cervical screening offered by local general practices (GPs) and other venues. Key activities to increase equitable HPV vaccine and screening uptake include:

- all children, both boys and girls aged 12 to 13 years old, or those in Year 8, being offered the HPV vaccine. Vaccinating boys not only helps to protect girls, it also directly benefits them, as HPV vaccination helps to protect boys from HPV related cancers, such as head, neck, and genital cancers. NHS England is taking a multi-pronged approach to improving HPV vaccine uptake. This includes improvements in School Age Immunisations Service provider delivery, investing in better digital services and data, improving access to vaccination services in supplementary settings, and continuing to deliver clear public health messaging;

- ensuring appropriate follow-up for those who have not yet been vaccinated, as NHS England has launched the GP HPV campaign, which went live from July 2025. GPs have been asked to invite unvaccinated individuals aged 16 to 24 years old for their HPV vaccine as a requirement of the GP Contract. The campaign runs until 31 March 2026;

- NHS England working with the Department and the UK Health Security Agency to develop options for HPV catch-up vaccination through community pharmacies from 2026;

- improving confidence in vaccinations, by working with Government partners to deliver improved campaigns that raise awareness of vaccination;

- indicating our intention to transform our approach to cervical screening for under-screened women or people with a cervix in July 2025. From early 2026, they will receive home testing kits, starting with those that are the most overdue for screening. This will help to tackle deeply entrenched barriers that keep some away from life-saving screening;

- the Digital Transformation of Screening programme, which is leading an ambitious, end-to-end transformation of screening services, and which is being rolled out in a test and learn way. New digital services will support screening participants to manage their screening appointments via the NHS App as well as delivering new, artificial intelligence ready services for staff, freeing up their time to focus on care;

- taking insight driven approaches to addressing inequalities using both data and behavioural insights to target communications and activities to increase uptake and coverage;

- sharing good practice among regions, integrated care boards, and providers, with NHS England having developed a central online resource which includes information on reducing inequalities and supporting equalities, and where all information can be readily accessed by NHS organisations and providers;

- NHS England launching our first ever cervical cancer elimination creative campaign and communications toolkit for Cervical Screening Awareness Week, from 16 to 24 June 2025. This will continue to be developed;

- engaging and maintaining relationships with stakeholders, which will be central to the ongoing delivery of the Cervical Cancer Elimination plan, and ultimately the elimination of cervical cancer in England; and

- carrying out screening in any primary care setting, including sexual health clinics, rather than just at GPs. This includes evenings and on weekends.