The British journal of general practice : the journal of the Royal College of General Practitioners
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Poor mental health and high stress levels have been reported in staff working in general practice. Little is known about how practices are tackling these and other issues of health at work in the absence of an established occupational healthcare service. ⋯ The study revealed substantial neglect of workplace health issues with many practices falling foul of health and safety legislation. This report should help general practices identify issues to tackle to improve their workplace health, and the Health at Work in the NHS project to focus on areas where their targeted help will be most worthwhile.
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The United Kingdom (UK) cervical screening programme has been successful in securing participation of a high proportion of targeted women, and has seen a fall in mortality rates of those suffering from cervical cancer. There remains, however, a significant proportion of unscreened women and, of women in whom an abnormality is detected, many will not attend for colposcopy. The present work reviews the psychological consequences of receiving an abnormal cervical smear result and of secondary screening and treatment, and examines reasons for women's non-participation in the screening programme. ⋯ The receipt of an abnormal result and referral for colposcopy cause high levels of distress owing to limited understanding of the meaning of the smear test; many women believe the test aims to detect existing cervical cancer. The quality of the cervical screening service can be enhanced by the provision of additional information, by improved quality of communication, and by consideration of women's health beliefs. This may result in increased participation in, and satisfaction with, the service.
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Although reduction in the use of secondary care mental health services is a suggested benefit of counselling in general practice, there has been little empirical investigation of this relationship. ⋯ Provision of practice counselling in the study was associated with higher referral rates to clinical psychology and no difference in referral rates to outpatient psychiatry. This is in contrast to the hypothesis that counselling reduces the use of secondary care mental health services.