The vaginal speculum is an instrument used during gynaecological examination to facilitate the visualization of the vagina and cervix. The speculum is introduced via the vagina and its cylinder (with a rounded end) allows easy passage. Once in situ, the speculum is opened, holding the vagina open and allowing the health professional to have access to the cervix and perform the cervical smear. Most speculums are now made of plastic and are single use, replacing those formerly made of metal and requiring sterilization after use. There are two categories of speculum: virgin and non‐virgin. The latter is available in four sizes: small, medium, large and long. Special attention should be paid when selecting a speculum for use in women previously treated with pelvic radiotherapy or who are postmenopausal (Singh et al. [230]).

The cervical broom is a plastic broom‐shaped tool with a pyramidal arrangement of flexible flat ‘teeth’. The longer ‘central’ tuft fits into the cervical os and must be rotated clockwise through a full circle five times. When used to take a conventional smear, this brush is an adequate and effective sampling device (NHSCSP [160]). The brush should be inserted into the cervical os with the lower bristles remaining visible and rotated between a half and a whole turn to reduce trauma (NHSCSP [161]).

The brush should be inserted into the cervical os with the lower bristles remaining visible and rotated between half and a whole turn to minimise trauma (Insinga et al. [105]).

LBC is the current standard method of screening in the NHS cervical screening programme (NHSCSP [160]). The National Institute for Health and Care Excellence ([162]) has recommended that LBC is used as the primary means of processing samples in the cervical screening program in England and Wales. It achieves ‘cleaner’ preparations, which are generally easier to read. Its advantage is a reduction in inadequate samples and there may be gains in reducing borderline results and increasing sensitivity (PHE [193]).

Once the sample has been taken, it is vital that the cells collected are transferred onto a glass slide and preserved immediately or placed into the correct vial containing liquid preservative and fixative. Slides must not be placed in a refrigerator (Higgins [84], NHSCSP [161]).

The environment is also important, with the following equipment required:

Explain the procedure to the patient prior to commencing. It is good practice to offer the patient a demonstration of the speculum and to explain what part will be inserted into the vagina. Possible side‐effects, such as spotting post‐examination, should also be discussed prior to commencing the examination (RCN [201]).