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Background  Menstruation appears to be problematic for women with learning disabilities, yet there has been little quantitative research on their experiences, or comparisons with other groups of women. This paper considers the nature and extent of menstrual problems experienced by women with learning disabilities.Methods  The data reported here come from a cross‐sectional postal questionnaire survey conducted with carers of 452 women, aged 14–55 years, who had learning disabilities.Results  Women with learning disabilities appear to be as likely to experience menstrual problems as other women. However, such problems may be experienced differently and more negatively and may not always be recognized appropriately.Conclusions  More attention needs to be given to menstrual problems experienced by women with learning disabilities, both in research and in practice. It is particularly important that women with learning disabilities be supported to play a central role in recognizing and defining the problems they experience.

BACKGROUND: Growing demand from an increasingly ageing population with multimorbidity has resulted in complex health and social care needs requiring more integrated services. Integrating primary care with social services could utilise resources more efficiently, and improve experiences for patients, their families, and carers. There is limited evidence on progress including key barriers to and drivers of integration to inform large-scale national change. AIM: To elicit stakeholder views on drivers and barriers of integrated primary care and social services, and highlight opportunities for successful implementation. DESIGN AND SETTING: A qualitative interview study. METHOD: Semi-structured interviews with maximum variation sampling to capture stakeholder views across services and professions. RESULTS: Thirty-seven interviews were conducted across England with people including GPs, nurses, social care staff, commissioners, local government officials, voluntary and private sector workers, patients, and carers. Drivers of integration included groups of like-minded individuals supported by good leadership, expanded interface roles to bridge gaps between systems, and co-location of services. Barriers included structural and interdisciplinary tension between professions, organisational self-interest, and challenges in record sharing. CONCLUSION: Drivers and barriers to integration identified in other contexts are also present in primary care and social services. Benefits of integration are unlikely to be realised if these are not addressed in the design and execution of new initiatives. Efforts should go beyond local- and professional-level change to include wider systems- and policy-level initiatives. This will support a more systems-wide approach to integrated care reform, which is necessary to meet the complex and growing needs of an ageing multimorbid population.

BACKGROUND: Growing demand from an increasingly ageing population with multimorbidity has resulted in complex health and social care needs requiring more integrated services. Integrating primary care with social services could utilise resources more efficiently, and improve experiences for patients, their families, and carers. There is limited evidence on progress including key barriers to and drivers of integration to inform large-scale national change. AIM: To elicit stakeholder views on drivers and barriers of integrated primary care and social services, and highlight opportunities for successful implementation. DESIGN AND SETTING: A qualitative interview study. METHOD: Semi-structured interviews with maximum variation sampling to capture stakeholder views across services and professions. RESULTS: Thirty-seven interviews were conducted across England with people including GPs, nurses, social care staff, commissioners, local government officials, voluntary and private sector workers, patients, and carers. Drivers of integration included groups of like-minded individuals supported by good leadership, expanded interface roles to bridge gaps between systems, and co-location of services. Barriers included structural and interdisciplinary tension between professions, organisational self-interest, and challenges in record sharing. CONCLUSION: Drivers and barriers to integration identified in other contexts are also present in primary care and social services. Benefits of integration are unlikely to be realised if these are not addressed in the design and execution of new initiatives. Efforts should go beyond local- and professional-level change to include wider systems- and policy-level initiatives. This will support a more systems-wide approach to integrated care reform, which is necessary to meet the complex and growing needs of an ageing multimorbid population.