Will a breast screening programme change the workload and referral practice of general practitioners?

This article has been made available through the Brunel Open Access Publishing Fund and is available from the specified link - Copyright © 1990 BMJ Publishing Group.STUDY OBJECTIVE--The aim of the study was to consider possible changes in the clinical activities of general practitioners whose patients are registered in a breast cancer screening programme. DESIGN--The study was a survey based on completion of forms recording breast consultations carried out by participating general practitioners during a four week period. SETTING--One of three intervention centres and one of three comparison centres in the national trial of early detection of breast cancer was selected. The intervention centre was in Guildford; the comparison centre in Stoke on Trent. PARTICIPANTS--The participants were general practitioners in the selected centres. In Guildford, 64 of 99 general practitioners approached took part (65%); in Stoke on Trent, 81 of 177 took part (46%). The proportion of male and female participants in the two centres was similar. Doctors in Stoke on Trent were older and worked in smaller practices than in Guildford. RESULTS--A comparison of workloads showed that in the screening centre there was less demand for doctor consultations from those in the screened age group, but those excluded from screening made more use of the general practitioners' services. A difference in referral practice was also apparent, with doctors in the screening centre referring more frequently for specialist advice. CONCLUSIONS--The evidence suggests that no significant change in the overall use of general practice resources can be expected with the introduction of national screening, but there may be greater pressure on assessment services

'Biomedical nemesis? Critical deliberations with regard health and social care integration for social work with older people’

This document is the Accepted Manuscript version of a published work that appeared in final form in International Social Work. To access the final edited and published work see http://dx.doi.org/10.1177/0020872816651698.This paper questions ongoing moves towards integration into health care for social work with older people in the UK. Whilst potentially constructing clearer pathways to support integration risks reducing welfare provisions for a traditional low priority user group, while further extending privatisation. Integration models also understate the ideological impact of biomedical perspectives within health and social care domains, conflate roles and undermine the potential positive role of ‘holistic’ multi-agency care. Constructive social work for older people is likely to further dilute within aggressive integrated models of welfare: which will be detrimental for meeting many of the complex needs of ageing populations