Search tips
Search criteria 


Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
Br J Gen Pract. 1994 December; 44(389): 567–570.
PMCID: PMC1239080

Annual assessments of patients aged 75 years and over: views and experiences of elderly people.


BACKGROUND. The 1990 contract requires general practitioners to offer all their patients aged 75 years and over an annual health check. Increasing importance is being placed on consumers' views of service provision. AIM. A study was undertaken in June 1992 to investigate elderly patients' views and experiences of the annual health check, and to compare these with the previously reported views of general practitioners and practice nurses who had also been surveyed as part of the study. METHOD. Twenty family health services authorities wrote to a sample of 1500 elderly patients asking if the patient's name could be passed to researchers. Patients who agreed were then interviewed. RESULTS. A total of 664 elderly patients (44%) were interviewed. Only 64% of respondents were aware of their entitlement to a health check. Vulnerable patients, such as those in poor health or who lived alone, were less likely to know about the health checks than other patients. Only 31% of respondents thought they had had a health check. Of these, fewer than half recalled the doctor or nurse discussing the findings with them, although 80% of doctors reported that they always or mostly discussed results with patients. Elderly patients were more likely to recall the physical aspects of the health check rather than discussion about particular health aspects. However, doctors and nurses felt that routine checks were useful for giving advice rather than detecting medical problems. Of those who had had a health check, 82% reported no improvement in their health as a result, but 93% thought that they were a good idea. Only 7% of doctors thought they were of value, compared with the majority of nurses. CONCLUSION. It appeared that the inverse care law was operating, with those more in need of the service being less likely to have known about it. Discrepancies were found between general practitioners' and practice nurses' reports of service provision and those of elderly patients. Evidence about the cost-effectiveness of regular health checks may help the conflict between professional scepticism and consumer enthusiasm for these assessments.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (874K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Perkins ER. Screening elderly people: a review of the literature in the light of the new general practitioner contract. Br J Gen Pract. 1991 Sep;41(350):382–385. [PMC free article] [PubMed]
  • Barber JH, Wallis JB. The effects of a system of geriatric screening and assessment on general practice workload. Health Bull (Edinb) 1982 May;40(3):125–132. [PubMed]
  • Hendriksen C, Lund E, Strømgård E. Consequences of assessment and intervention among elderly people: a three year randomised controlled trial. Br Med J (Clin Res Ed) 1984 Dec 1;289(6457):1522–1524. [PMC free article] [PubMed]
  • Tulloch AJ, Moore V. A randomized controlled trial of geriatric screening and surveillance in general practice. J R Coll Gen Pract. 1979 Dec;29(209):733–740. [PMC free article] [PubMed]
  • McEwan RT, Davison N, Forster DP, Pearson P, Stirling E. Screening elderly people in primary care: a randomized controlled trial. Br J Gen Pract. 1990 Mar;40(332):94–97. [PMC free article] [PubMed]
  • Freer CB. Geriatric screening: a reappraisal of preventive strategies in the care of the elderly. J R Coll Gen Pract. 1985 Jun;35(275):288–290. [PMC free article] [PubMed]
  • Iliffe S, Haines A, Gallivan S, Booroff A, Goldenberg E, Morgan P. Assessment of elderly people in general practice. 2. Functional abilities and medical problems. Br J Gen Pract. 1991 Jan;41(342):13–15. [PMC free article] [PubMed]
  • Brown K, Williams EI, Groom L. Health checks on patients 75 years and over in Nottinghamshire after the new GP contract. BMJ. 1992 Sep 12;305(6854):619–621. [PMC free article] [PubMed]
  • Chew CA, Wilkin D, Glendenning C. Annual assessment of patients aged 75 years and over: general practitioners' and practice nurses' views and experiences. Br J Gen Pract. 1994 Jun;44(383):263–267. [PMC free article] [PubMed]
  • Tremellen J. Assessment of patients aged over 75 in general practice. BMJ. 1992 Sep 12;305(6854):621–624. [PMC free article] [PubMed]
  • McIntosh IB, Power KG. Elderly people's views of an annual screening assessment. Br J Gen Pract. 1993 May;43(370):189–192. [PMC free article] [PubMed]
  • Hart JT. The inverse care law. Lancet. 1971 Feb 27;1(7696):405–412. [PubMed]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners