Changes in patient experience associated with growth and collaboration in general practice: observational study using data from the UK GP Patient Survey.

Background: For the last few years, English general practices - which are, traditionally, small - have been encouraged to serve larger populations of registered patients by merging or collaborating with each other. Meanwhile, patient surveys have suggested that continuity of care and access to care are worsening.

Aim: To explore whether increasing the size of the practice population and working collaboratively are linked to changes in continuity of care or access to care.

How widespread is working at scale in English general practice? An observational study.

Background: Over the last 5 years, national policy has encouraged general practices to serve populations of >30 000 people (called 'working at scale') by collaborating with other practices.

Aim: To describe the number of English general practices working at scale, and their patient populations.

Design And Setting: Observational study of general practices in England.

The role of the Quality and Outcomes Framework in the care of long-term conditions: a systematic review.

Background: Improving care for people with long-term conditions is central to NHS policy. It has been suggested that the Quality and Outcomes Framework (QOF), a primary care pay-for-performance scheme that rewards practices for delivering effective interventions in long-term conditions, does not encourage high-quality care for this group of patients.

Aim: To examine the evidence that the QOF has improved quality of care for patients with long-term conditions.

"Promoting Early Presentation" intervention sustains increased breast cancer awareness in older women for three years: A randomized controlled trial.

Objective In a randomized controlled trial, the Promoting Early Presentation intervention increased older women's breast cancer awareness after two years. We investigated whether this increase was sustained at three years, and the effect on breast screening self-referral. Methods We randomly allocated 867 women attending their final invited breast screening appointment to the Promoting Early Presentation intervention or usual care.

Is cancer survival associated with cancer symptom awareness and barriers to seeking medical help in England? An ecological study.

Background: Campaigns aimed at raising cancer awareness and encouraging early presentation have been implemented in England. However, little is known about whether people with low cancer awareness and increased barriers to seeking medical help have worse cancer survival, and whether there is a geographical variation in cancer awareness and barriers in England.

Methods: From population-based surveys (n=35 308), using the Cancer Research UK Cancer Awareness Measure, we calculated the age- and sex-standardised symptom awareness and barriers scores for 52 primary care trusts (PCTs).

Delays in diagnosis of young females with symptomatic cervical cancer in England: an interview-based study.

Background: Diagnosis may be delayed in young females with cervical cancer because of a failure to recognise symptoms.

Aim: To examine the extent and determinants of delays in diagnosis of young females with symptomatic cervical cancer.

Design And Setting: A national descriptive study of time from symptoms to diagnosis of cervical cancer and risk factors for delay in diagnosis at all hospitals diagnosing cervical cancer in England.

A systematic review of barriers to early presentation and diagnosis with breast cancer among black women.

Objective: To explore barriers to early presentation and diagnosis with breast cancer among black women.

Design: Systematic review.

Methods: We searched multiple bibliographic databases (January 1991-February 2013) for primary research, published in English, conducted in developed countries and investigating barriers to early presentation and diagnosis with symptomatic breast cancer among black women (≥18 years).