Thousands of women face an extended wait for what could be life-saving results from CervicalCheck smears, due to the HSE cyberattack.The attack was described by Nóirín Russell, the director in charge of CervicalCheck, as having a worse effect on services than that caused by Covid-19.While GPs are continuing to conduct smear tests, and most slides are being sent to an American lab for processing, the impact of the cyberattack means results are not being sent back to GPs and their patients.
Dr Russell said CervicalCheck is operating a workaround to get results as soon as possible for women considered high risk, but that results are being delayed for all other women.
Risks due to ransomware attack
CervicalCheck is one of a host of essential health services still badly impacted by the ransomware attack, which crippled the HSEs IT systems on May 14.
The HSE has said that, despite a limited recovery of some systems, there is still a significant risk of harm to patients and that risk increases as the incident becomes prolonged and recovery is deferred.
It said the risks to patients are as a result of:

• Severe restriction of GP access to diagnostic laboratory and radiology tests;
• Reduced access and delayed diagnosis and treatment due to generalised slowing of all internal processes;
• Possible clinical errors related to lack of access to clinical notes;
• Reliance on telephone and written ordering of tests and communication of results, with risk of lost results;
• Manual reporting, with transcription errors in handwritten results.

Dr Russell said the sharing of CervicalCheck results is delayed as a result of the cyberattack, and that some colposcopy clinics, attended by women whose initial test showed an abnormality, have been cancelled.
‘Workaround’ for high-risk patients
Dr Russell, who is also an obstetrician at Cork University Maternity Hospital, said: The women we are most worried about are the ones with high-grade disease; we need to make sure they get detected and referred onwards.
‘The good news is we are still screening,’ said Dr Nóirín Russell, clinical director of CervicalCheck but the consultant obstetrician and gynaecologist at CUMH says the ransomware attack is causing some delays. 
She predicted that there will be a really long tail to the attack.
The good news is we are still screening, despite the problems, she said. We have delays in getting the results out to women and their GPs. We can get the samples to the lab we have a workaround for the women who are more high risk.
Laboratories are printing results for high-risk women, she said, rather than wait, but only very very urgent cases are being seen in colposcopy clinics.
Our colposcopy clinics are all in the hospitals, Dr Russell said. They are sending their biopsy samples to the histology labs and they are backed up. So a lot of the labs have said we can only take the very, very urgent ones.
Cyberattack ‘worse than Covid’
Looking at the long-term impact, Dr Russell said: I think the cyberattack is probably worse for our services than Covid thats how bad it is.
The HSE is not yet sure when normal service can be resumed, and Dr Russell said that, even then, that will only be the start.
It is really really stressful not having patient information, not having their history, she said.
And not knowing when you can go ahead and do normal biopsies in a normal way, even when it comes back and the systems are up and running.
CervicalCheck numbers had been improving
This latest crisis for the CervicalCheck programme comes as numbers attending for smear tests had started to rise after the pandemic slowdown. The number of women attending for screening last year, when services were interrupted by Covid-19, was more than 100,000 lower than expected.
In 2018, confidence in the screening programme was badly shaken after it emerged that hundreds of women were not informed that smear test results showing them to be in the clear were in fact inaccurate and the revised test results were kept from them for years.