THE CURRENT STATE OF SCREENING IN GENERAL-PRACTICE

Background The aim of this study was to describe the range of screenin g services offered by general practitioners (GPs). Methods A postal qu estionnaire survey was sent to a random sample of one in four GPs in g eneral practices within the geographical boundaries of North (East) Th ames Region. The questionnaire was divided into five sections, the fir st covering practice details and the other four covering screening dir ected at different groups of patients. Each GP in the sample was sent the general section and two other sections. Results The overall respon se rate was 67.7 per cent. There was inter-practitioner variability in screening practice in all four patient groups. A number of GPs did no t undertake all screening tests required by the national GP contract o r recommended by national or local policy, and some had introduced scr eening programmes of uncertain benefit. There was little evidence of s ystematic audit of screening programmes. Differences in screening obse rved between GPs in Greater London metropolitan areas, but there was l ittle difference between single-handed and group practices, or between fundholding and non-fundholding GPs, except in the provision of child health surveillance. Conclusion Primary care teams carry out screenin g for a wide range of conditions but the lack of uniformity of practic e and of evaluation makes it unclear to what extent the population ben efits from these activities. The importance of national and internatio nal screening policies is obvious, but there is a need to go beyond pu blication and dissemination of guidelines to develop implementation st rategies which take account of the variations in the way GPs actually address screening in their practices.