The British journal of general practice : the journal of the Royal College of General Practitioners最新文献

{"title":"Moving on from patient safety incidents: a qualitative study exploring GP perspectives in England.","authors":"James Tawse, Christopher J Armitage, Carolyn A Chew-Graham, Maria Panagioti","doi":"10.3399/BJGP.2026.0190","DOIUrl":"10.3399/BJGP.2026.0190","url":null,"abstract":"<p><strong>Background: </strong>Patient safety incidents (PSIs), defined as unintended or unexpected events that could have or did lead to patient harm, can have profound effects on GPs. Understanding how GPs experience and recover from PSIs is important for workforce wellbeing and patient safety in primary care.</p><p><strong>Aim: </strong>To explore how GPs experience PSIs, how they move on, and how they use available support.</p><p><strong>Design and setting: </strong>Qualitative study with GPs in England.</p><p><strong>Method: </strong>Semi-structured interviews were conducted with 22 GPs. Data were analysed using thematic analysis. Participants were eligible if they had been involved in a PSI in general practice, spanning near misses to events resulting in patient harm. Themes were developed inductively and mapped onto the theoretical domains framework to identify cognitive, social, and environmental influences on learning, help seeking, and recovery.</p><p><strong>Results: </strong>Three themes were generated: personal and professional consequences; recovery and learning processes; and barriers to healing. GPs described emotional responses, including guilt, self-doubt, and fear of reputational or regulatory consequences. Peer support was valued, but access to structured support was limited. Formal investigations were experienced as distressing and compounded the emotional impact. Recovery and learning were facilitated by empathetic, systems-focused cultures, protected time for reflection, and structured opportunities to learn from incidents.</p><p><strong>Conclusion: </strong>GPs rely on informal and self-directed strategies to recover from PSIs, with variable access to formal support. Recovery is shaped by individual and organisational factors. Findings highlight the importance of compassionate, non-punitive support systems and psychologically safe environments to enable recovery and promote learning.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148202017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ruling out acute coronary syndrome in primary care: a diagnostic trial (POB-HELP).","authors":"Simone van den Bulk, Annelieke Hj Petrus, Robert Willemsen, Mattijs E Numans, Mark J Boogers, Maaike Pj Hermans, Joan G Meeder, Braim Rahel, Marcel Janssen, Geertjan Dinant, Christa M Cobbaert, Tobias N Bonten","doi":"10.3399/BJGP.2026.0167","DOIUrl":"https://doi.org/10.3399/BJGP.2026.0167","url":null,"abstract":"<p><p>Background Accurate risk stratification of patients with chest pain in primary care may improve patient safety while reducing unnecessary hospital referrals. Aim To evaluate the diagnostic performance of a clinical decision rule (CDR) combining high-sensitivity tro-ponin I (hs-cTnI) and the Marburg Heart Score (MHS) to rule out acute coronary syndrome (ACS), and specifically myocardial infarction (MI), in primary care patients with chest pain, and to compare referral rates with usual care. Design and setting Cluster-randomised diagnostic trial (2:1 intervention:control) conducted in Dutch primary care practices. Method Patients presenting with acute chest pain were assessed using a CDR applied by general practitioners, combining the MHS with a hs-cTnI point-of-care test. General practitioners in the control group provided usual care. Diagnostic performance was evaluated using sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). Secondary endpoints included evaluation of a modified HEART score and single hs-cTnI rule-out strategy. Results In total, 827 participants were included: 740 intervention and 87 controls. The CDR missed one ACS, yielding a sensitivity of 98.3% (95% CI 90.8-100%) and NPV of 99.7% (95% CI 98.0-100%). Specificity was 49.1% (95% CI 45.3-52.9%) and PPV 14.1% (95% CI 13.2-15.1%). For MI, sensitivity and NPV were both 100% (95% CI 92.6-100% and 95% CI 98.9-100%, respectively). Specificity was 48.6% (95% CI 44.8-52.4%), and PPV 11.9% (95% CI 11.1-12.7%). Referral rates did not differ significantly between groups (54.6% vs 47.1%; p=0.39). Conclusion A CDR combining the MHS with a hs-cTnI point-of-care test safely ruled out ACS and MI in(..).</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommended point-of-care tests in out-of-hours primary care: a modified Delphi study.","authors":"Leon Redek, Rachel Brettell, Rebecca Payne, Linda Huibers, Vesna Homar","doi":"10.3399/BJGP.2025.0757","DOIUrl":"10.3399/BJGP.2025.0757","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care tests (POCTs) are increasingly used to enhance diagnostic accuracy and facilitate rapid clinical decision making in settings with limited laboratory access. However, there is currently no consensus on which POCTs should be routinely available in out-of-hours (OOH) primary care services.</p><p><strong>Aim: </strong>To establish expert consensus on which POCTs should be considered essential or optional in European OOH primary care services.</p><p><strong>Design and setting: </strong>A modified Delphi consensus study involving an international panel of experts from 20 European countries, representing diverse clinical and academic backgrounds in OOH primary care.</p><p><strong>Method: </strong>A three-round Delphi process was conducted. Round one assessed current POCT availability via questionnaire. In round two, panellists rated 28 POCTs as essential, optional, or unnecessary. In round three, results were discussed in a structured in-person workshop, followed by anonymous re-voting. Consensus was predefined as ≥66.6% agreement.</p><p><strong>Results: </strong>Six POCTs achieved consensus as essential: blood glucose, urine dipstick, C-reactive protein, pregnancy testing, electrocardiography, and haemoglobin measurement. Twelve tests were classified as optional, and 10 were deemed unnecessary. Key concerns included inappropriate use, variability in clinician confidence, and patient-driven demand.</p><p><strong>Conclusion: </strong>This study provides, to the authors' knowledge, the first European consensus on POCT prioritisation in OOH primary care. Implementation of essential POCTs, supported by training and governance, may improve diagnostic efficiency, while optional tests should be tailored to local service needs.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of recurrent urinary tract infections on women: a qualitative study.","authors":"Margaret Glogowska, Michael Moore, Alastair D Hay, Christopher Butler, Gail Hayward","doi":"10.3399/BJGP.2025.0699","DOIUrl":"10.3399/BJGP.2025.0699","url":null,"abstract":"<p><strong>Background: </strong>Many women experience recurrent urinary tract infections (rUTIs) yet their significance for the women affected is poorly described and understood.</p><p><strong>Aim: </strong>To explore women's experiences of rUTIs and the impact on their lives.</p><p><strong>Design and setting: </strong>A qualitative study embedded in a randomised controlled trial (RCT) of D-mannose with women with clinically defined rUTIs in England and Wales.</p><p><strong>Method: </strong>We conducted semi-structured telephone interviews with 32 women who participated in the RCT. Interviews were audio-recorded and transcribed verbatim. Data were analysed thematically.</p><p><strong>Results: </strong>Women reported how the experience of rUTIs was burdensome with distressing and debilitating physical symptoms and wider disruptive effects. Women expressed how rUTIs had an impact on different stages of their lives and we identified two types of impact. Internalised impact included the women's emotional response to rUTIs, dread of a recurrence, and maintaining readiness to manage it. Externalised impact encompassed actions in response to rUTIs, including remaining extremely vigilant about recurrences and seeking help as soon as a recurrence was suspected, and the challenges they faced. The women explained how the responses of healthcare professionals (HCPs) when they sought care affected their help-seeking and their self-esteem, and could leave them with a sense of helplessness.</p><p><strong>Conclusion: </strong>Experience of rUTIs has taught women to be vigilant and proactive about the condition but this was not always matched with understanding and validation on the part of HCPs. When women experiencing rUTIs seek care, clinicians could usefully consider the patient's broader experience of rUTIs, including internalised and externalised impacts.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary care quality and secondary healthcare utilisation in patients with multimorbidity: a retrospective cohort study.","authors":"Qian Gao, Benedict Wj Hayhoe, Meryem Cicek, Geva Greenfield, Michaela Otis, Gesthimani Misirli, Ana Luisa Neves, Azeem Majeed, Paul Aylin, Alex Bottle","doi":"10.3399/BJGP.2026.0161","DOIUrl":"https://doi.org/10.3399/BJGP.2026.0161","url":null,"abstract":"<p><p>Background High-quality primary care can improve multimorbidity management but little evidence is available to understand its impact on secondary care use over time. Aim To assess the concurrent and lagged associations between quality of primary care and planned and unplanned secondary care use, examining the modifying role of frailty. Design and Setting A retrospective cohort study included 468,172 patients with multimorbidity in England from the Discover research platform (April 2022-March 2024). Method We used principal component analysis to combine a set of quality indicators (QIs) and assessed the impacts of QIs on both planned and unplanned care using regression models. Results Generally, patients with higher QI attainment also had higher likelihood of outpatient visits, emergency admissions and ED visits. There was a lower lagged odds of elective hospital admissions in the following 12 months among those with higher attainment of multimorbidity-specific QIs. In the complex multimorbidity cohort (≥3 conditions), multimorbidity-specific QIs were longitudinally associated with lower odds of elective admissions and outpatient visits, while generic QIs were related to lower odds of outpatient non-attendance. Conclusion Attainment of generic and multimorbidity QIs was generally associated with slightly increased planned and unplanned care. However, patients for whom we identified higher attainment of multimorbidity-specific QIs had lower odds of elective admissions and outpatient visits, especially for those with complex multimorbidity. Our research suggests that the quality of primary care may influence patients' use of secondary care, with the potential to improve care for people with multimorbidity and warrant further investigation into management strategies.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Suicide through Coroners' Narratives: implications for primary care from a mixed‑methods study of 157 Coroners' reports.","authors":"Phillip Oliver, Emily Reed, Joe Hulin, Brigitte Delaney, Jack Marshall, Caroline Mitchell","doi":"10.3399/BJGP.2026.0207","DOIUrl":"https://doi.org/10.3399/BJGP.2026.0207","url":null,"abstract":"<p><p>Suicide is a major public health concern, and general practice is often a recent point of contact before death. While mental illness is well recognised, the broader social and contextual factors influencing suicide risk remain under-reported in primary care and epidemiological research Aim To describe the demographic, clinical, and psychosocial characteristics of individuals who died by suicide, integrating coronial quantitative data with qualitative narrative accounts to identify implications for primary/ secondary care and public health. Design and setting Explanatory sequential mixed‑methods study of 157 consecutive deaths by suicide recorded by coroners (2018-19) across five English local authorities. Method Demographic, clinical, and social data were extracted from coroners' records and summarised descriptively. Narrative case summaries were coded and analysed thematically to identify contextual, relational, and service factors preceding death. Results Of 157 individuals: 79% were male; 65% lived in the most deprived IMD quintile; 85% had a diagnosed mental health condition; 62% had a long‑term physical illness; 41% had a previous suicide attempt. About half consulted a GP in the preceding three months; mental health featured in about half of those consultations. Common stressors were relationship breakdown (37.2%), housing instability (22.1%), and work pressures (18.2%). Seven interlinked themes were identified: Mental health; Alcohol/Substance use, Physical health; Social connectedness; Life course trauma, Socioeconomic and Structural Vulnerability; Healthcare access. Service transitions were key vulnerability points Conclusion Coroners' records offer important insights into the complex circumstances preceding suicide and highlight opportunities for GPs to recognise intersectional complexity and support integrated, cross-sector suicide prevention approaches.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GP survivors' experiences working with family violence survivors: a qualitative study.","authors":"Jennifer Neil, Clare Delany, Elizabeth McLindon, Kelsey Hegarty","doi":"10.3399/BJGP.2026.0032","DOIUrl":"10.3399/BJGP.2026.0032","url":null,"abstract":"<p><strong>Background: </strong>Domestic and family violence (DFV) is common worldwide and GPs are not immune. DFV survivors frequently present to primary care where GP DFV survivors often encounter them. Little literature and no qualitative studies, to the authors' knowledge, have looked at the emotional and professional effects that these encounters have on survivor GPs, including how it affects their ability to care for survivor patients.</p><p><strong>Aim: </strong>To answer the question: what are the experiences of survivor GPs when working with patient survivors of DFV?</p><p><strong>Design and setting: </strong>A phenomenological qualitative study, to gain a deep understanding of Australian GP DFV survivors' experiences when working with survivor patients.</p><p><strong>Method: </strong>Participants were Australian GPs self-identifying as survivors of all forms of DFV. Participants were recruited from two Australian GP online groups using purposive sampling. Semi-structured interviews took place and were audio-recorded and transcribed verbatim. Reflexive thematic analysis was undertaken.</p><p><strong>Results: </strong>Participants (<i>n</i> = 20) were women and worked in a range of locations throughout Australia. Four themes were identified: 'my experiences can be my superpower' (encompassing the subthemes: 'having a sixth sense' and 'going above and beyond'); 'connecting with survivors' stories'; 'wearing a cloak'; and 'my experiences give me a sense of purpose'.</p><p><strong>Conclusion: </strong>Although GP DFV survivors commonly experienced difficult emotions when working with survivor patients they had a commitment to this work that stemmed from personal DFV experiences. This increased their empathy for survivors and gave them a deep understanding of their circumstances, allowing them to work powerfully with survivors, aiming to improve their situation.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":"e704-e711"},"PeriodicalIF":5.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does ethnicity affect primary palliative care identification and coding? An observational retrospective cohort study.","authors":"Gemma Clarke, Farag Shuweihdi, Samuel D Relton, Sophie Anne Trotter, Jamilla Akhter Hussain, Matthew Allsop, Jonathan Koffman, Michael I Bennett, Sarah Mitchell, Lucy Ziegler","doi":"10.3399/BJGP.2025.0602","DOIUrl":"10.3399/BJGP.2025.0602","url":null,"abstract":"<p><strong>Background: </strong>Primary palliative care is symptom support and care for people with life-limiting illnesses incorporated within standard primary care. Early identification of needs is recommended best practice. There is limited research concerning ethnicity and primary palliative care identification and coding.</p><p><strong>Aim: </strong>To explore associations between ethnicity and primary palliative care identification and coding.</p><p><strong>Design and setting: </strong>A retrospective cohort study of deceased patients in England utilising anonymised primary care data extracted in February 2022.</p><p><strong>Method: </strong>Multilevel logistic regression was used to examine associations between ethnicity and primary palliative care records. Cox regression was used to assess time from first record to death. Differences between first palliative care codes were examined using χ² tests.</p><p><strong>Results: </strong>A total of 200 876 patients were included; 32.30% (<i>n</i> = 64 887) had a primary palliative care record. Multilevel logistic regression (<i>n</i> = 64 887) showed no statistically significant association between ethnicity and identification after adjustment for age, sex, frailty, deprivation, and diagnosis. After adjustment, a mixed-effects Cox proportional hazards model (<i>n</i> = 58 681) indicated: compared with patients from White groups, patients from Asian (hazard ratio [HR] 0.944, 95% confidence interval [CI] = 0.891 to 0.999, <i>P</i> = 0.040) and Black, African, and Caribbean groups (HR 0.925, 95% CI = 0.862 to 0.992, <i>P</i> = 0.028) survived significantly longer; and patients from 'Other' groups had significantly shorter survival (HR 1.136, 95% CI = 1.046 to 1.234, <i>P</i> = 0.002). Patients from ethnic minority groups were significantly (<i>P</i><0.001) more likely to have a first record of specialist palliative care compared with White groups.</p><p><strong>Conclusion: </strong>This study found no statistically significant association between ethnicity and primary palliative care identification after adjustment. However, differences were observed in survival and first palliative care activity. To ensure and monitor equitable access, ongoing improvements in palliative care identification and audits of data quality are required.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":"e712-e723"},"PeriodicalIF":5.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships of actual and expected levels of income with GP job satisfaction: repeated cross-sectional study.","authors":"Benjamin Walker, Michael Anderson, Ravi Ganepola, Joseph Hutchinson, Jonathan Gibson, Sean Urwin, Katherine Checkland, Matt Sutton","doi":"10.3399/BJGP.2025.0683","DOIUrl":"10.3399/BJGP.2025.0683","url":null,"abstract":"<p><strong>Background: </strong>Income is known to be a key driver of job satisfaction, especially when compared with expected income. The pertinence of this for GPs is not fully understood.</p><p><strong>Aim: </strong>To examine whether GP job satisfaction and intentions to quit are affected by actual and expected levels of income.</p><p><strong>Design & setting: </strong>Repeated cross-sectional study involving GPs in England. The authors analysed responses to four waves of the GP Worklife Survey (a survey of GPs in England), between 2015 and 2021.</p><p><strong>Method: </strong>Linear regression models were used to examine the associations of actual income with 10 domains of job satisfaction and three aspects of intentions to quit, adjusted for potential confounders; responders' self-reported expected incomes were then added to these models. These analyses were repeated, stratifying by contract status and age.</p><p><strong>Results: </strong>Higher actual income had a statistically significant association with increased satisfaction across most job satisfaction domains except for 'Amount of variety in your job', 'Your colleagues and fellow workers', and 'Physical working conditions'. There was little evidence of a relationship between actual income and intentions to quit. Higher expected income, conditional on actual income, had a statistically significant association with reduced job satisfaction across all domains and increased intentions to quit. The relationship between expected income and intentions to work abroad in the next 5 years was stronger for GPs aged <40 years, and the relationship between actual income and job satisfaction was stronger for GP partners and for GPs aged >50 years.</p><p><strong>Conclusion: </strong>Higher incomes were associated with higher job satisfaction, but lower than expected levels of income were important sources of dissatisfaction and intentions to quit.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":"e771-e780"},"PeriodicalIF":5.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148153163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning disability register enrolment in young people in England: a cohort study using primary care data.","authors":"Rakhee Shah, Karen Horridge, Sonia Saxena, Dougal S Hargreaves, Irene Petersen","doi":"10.3399/BJGP.2026.0160","DOIUrl":"10.3399/BJGP.2026.0160","url":null,"abstract":"<p><strong>Background: </strong>Learning disability registers in UK primary care support proactive care, but under-identification remains substantial. The 2019 NHS Long Term Plan introduced targets to increase enrolment.</p><p><strong>Aim: </strong>To estimate prevalence and rates of new registration to learning disability registers among young people aged 14-24 years in England and examine changes following the introduction of national targets.</p><p><strong>Design and setting: </strong>Population-based open cohort study using routinely collected primary care data from general practices in England contributing to the Clinical Practice Research Datalink Aurum database, 2015-2023.</p><p><strong>Method: </strong>Young people aged 14-24 years who had been registered ≥6 months were included. Annual rates of new registration per 10 000 person-years at risk (PYAR) and recorded prevalence were calculated, stratified by age, sex, region, and year.</p><p><strong>Results: </strong>Between 2015 and 2023, 11 776 young people were first recorded on a learning disability register. Rates of new registration increased in 2020-2021 across ages and sexes, peaking at 15.8 per 10 000 PYAR in males aged 14-17 years and 8.4 per 10 000 in females before returning to pre-2019 levels by 2023. Recorded prevalence remained low overall (0.03-0.5%; 3.6-52.7 per 10 000) but increased among those aged 18-24 years, with eight-to-10-fold rises between 2015 and 2023. Prevalence was higher in males (rate ratios 1.7-1.8, 95% confidence interval = 1.6 to 1.9).</p><p><strong>Conclusion: </strong>National targets coincided with a temporary rise in enrolment, but identification remains below expected prevalence. Sustained policy focus and systematic identification and coding by practices are needed to ensure equitable access to preventive care during the transition to adulthood.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":"e742-e750"},"PeriodicalIF":5.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}