Pulse articles from April 2003

Pulse archives from April 2003

Judge the deal not us, plead negotiators.
April 7, 2003... GPC negotiators have urged GPs to take a `cold, hard look' at the contract before they commit to a No vote in an effort to reverse the slide towards rejection of the deal. The plea to judge the merits of the contract and not the...

GP's alarm as MMR uptake plummets.(measles-mumps-rubella vaccines)(Brief Article)
April 7, 2003... Dr Tony Grewal has expressed alarm at the news that MMR uptake has plummeted to its lowest-ever level. He said GPs would be swamped by worried parents in the event of a large-scale measles outbreak. `We would not cope,' said Dr Grewal....

GP overspends punished.(Brief Article)
April 7, 2003... The GPC has condemned as `blackmail' a move to deny GPs primary care development money as punishment for breaking their prescribing budgets, writes Rob Gough. West Gloucestershire PCT, which has overspent its #25.4 million prescribing...

Lowest ever MMR uptake offers hope in pay deals.(measles-mumps-rubella vaccine)
April 7, 2003... MMR vaccine uptake has plunged by 2 per cent in just three months, falling to its lowest-ever level, according to official data. New quarterly figures released by the Health Protection Agency, formerly the Public Health Laboratory Service,...

GP is carjacked with meat cleaver.(Brief Article)
April 7, 2003... Dr Alan Gilman was carjacked on a home visit after he stopped in a supermarket car park to check the address. Two men - one wielding a 10- inch meat cleaver - forced him out of his two-year-old Subaru Imprezza. Dr Gilman, a GP in Stockport,...

GPs fear the hated pay pool remains.(Brief Article)
April 7, 2003... Grassroots GPs are claiming the new contract raises the spectre of a GMS pay pool under a different name. They claim the process of `normalisation' - under which notional practice populations are adjusted to ensure they total the UK...

Enhanced services cash pledge `will prove to be hollow promise'.(Brief Article)
April 7, 2003... The new contract's pledge of a guaranteed minimum cash fund to pay GPs for enhanced services will prove a hollow promise because primary care organisations have already allocated the money elsewhere, GPC members fear. The contract promises...

Funding for IT in doubt if GPs vote No.(Brief Article)
April 7, 2003... GPs may not get 100 per cent reimbursement of IT costs if they reject the contract. The uncertainty means GPs should not commit to IT upgrades, even those funded by their PCO, until the ballot result is known, the GPC said last week. ...

Frustration over final pricing delay.(Brief Article)
April 7, 2003... GP negotiators have expressed growing frustration at continuing delays in the pricing of enhanced services. Negotiators are blaming Government red tape because any deal has to be signed off by ministers from each of the four health...

Million more outpatients heading for primary care.
April 7, 2003... One million more outpatients will be seen in primary care when the new GP contract is implemented, according to a Government dossier on future NHS funding. In the expenditure report, ministers vowed to increase the level of funding into...

Crashes and lost records blight vision for GP computers.
April 7, 2003... GPs trialling the type of IT system predicted to be rolled out to all practices under the contract are enduring lost patient records and constantly crashing computers. Under the Emis migration project in Lambeth, Southwark and Lewisham in...

Scots get #7.6m to aid access.(Scottish Executive, Scottish Primary Care Collaborative)(Brief Article)
April 7, 2003... The Scottish Executive has earmarked #7.6 million to tempt practices in Scotland to use the advanced-access appointments system. The funding was announced at the launch of the Scottish Primary Care Collaborative last week. The cash will...

PMS GPs in the dark over quality pay.(Brief Article)
April 7, 2003... Dr David Edmondson is angry at the lack of clarity over whether PMS GPs will be eligible for quality framework preparation payments. The GPC and NHS Confederation have said it is up to the Department of Health to decide, but it is refusing to...

Negotiators get time to road-test the contract.
April 7, 2003... Ministers have given contract negotiators until the autumn to clear up the contract chaos in a sign of both sides' desperation to resurrect the deal. The GPC said last week they had been given `flexibility' to spend time road-testing the...

Vote hinges on principals.(Brief Article)
April 7, 2003... The votes of non-principal GPs on the contract will follow the prevailing mood of principals in their area, the National Association of Non-Principals has said. Association chair Dr Richard Fieldhouse said the effect of the contract on...

GP is cleared of frying pan attack.(Brief Article)
April 7, 2003... A GP accused of attacking a manic depressive patient with a frying pan and a wine bottle has been cleared of serious professional misconduct by the GMC. Dr Charles Gould, a GP in Newtonabbey, Co. Antrim, was alleged to have made the attack...

GPC dissenters condemn `flaws' in minimum practice income guarantee.
April 7, 2003... Disgruntled GPC members have condemned the minimum practice income guarantee as `fundamentally flawed'. The guarantee (MPIG) has been heralded a `win-win' deal by GP negotiators, who are pinning their hopes on it to bring a Yes vote back from...

GPC caved in over cancer.(Brief Article)
April 7, 2003... The GPC has admitted it was forced to cave in on the inclusion of cancer in the quality and outcomes framework to get concessions elsewhere in the contract. Dr Simon Fradd, GPC joint-deputy chair, said: `There is no evidence that GPs...

Fraud pledge for PMS GPs.(Brief Article)
April 7, 2003... The NHS counter fraud directorate has reassured PMS GPs they will not be under greater scrutiny than their GMS colleagues if the contract is accepted. Fears were prompted by NHS accounts for 2001/2 that suggested PMS practices might be...

Refugee GPs threat.(Brief Article)
April 7, 2003... Dr Patrick Kiernan's work to train refugee doctors to take up GP registrar posts in the UK is under threat because funding for the pilot project is coming to an end. Eight refugee doctors are taking part in the scheme, run in partnership with...

More teen pregnancies in practices where GPs won't see under-16s alone.
April 7, 2003... GP practices that refuse to give contraceptive advice to under-16s without an adult present have teenage pregnancy rates almost 40 per cent higher than those that do, according to Government-ordered research. The research - which aimed to...

GP clinic cuts hospital wait.(Brief Article)
April 7, 2003... Dr Pauline Brimblecombe has cut unnecessary hospital gynaecology appointments by setting up a clinic in her surgery. Dr Brimblecombe, a GP in Cambridge with a special interest in women's health, has been given PCT funding to take...

Government to tackle postcode prescribing.(Brief Article)
April 7, 2003... The Government plans to tackle postcode prescribing with new guidelines on a range of treatments including those for cancer, coronary heart disease and obesity. Guidance on statins for the primary and secondary prevention of CHD, the...

Colorectal cancer screening must cover iron test.
April 7, 2003... The national colorectal cancer screening programme planned by the Government should include testing for iron deficiency alongside the faecal occult blood test (FOB), a new study suggests. The researchers said GPs were well placed to test...

Endoscopy better than digital rectal examinations.(Brief Article)
April 7, 2003... Giving patients with symptoms of bowel cancer a digital rectal examination (DRE) is unpopular and does not alter management, according to an Australian study. The researchers said GPs would be better off referring patients for endoscopy....

GPs facing upsurge in complaints via e-mail.
April 7, 2003... GPs have predicted a barrage of extra complaints as a result of Government plans to allow patients to file their grievances via e-mail and NHS Direct. The Department of Health has recommended the overhaul in `NHS Complaints Reform - Making...

Performance indicators shake-up.(Brief Article)
April 7, 2003... The Department of Health has amended performance indicators for primary care trusts after pressure from GPs to remove categories they could not influence. The indicators will be used to decide trusts' star ratings this year. ...

GP premises are failing deaf patients.(Brief Article)
April 7, 2003... Deaf patients have seen little or no improvements in access to GP services in the past 30 years, research has concluded. The study of 98 practices found deaf patients still find difficulties making appointments, knowing when they are called...

Golden hellos tempt 500 GPs to apply to join armed forces.(Brief Article)
April 7, 2003... More than 500 GPs have expressed an interest taking up medical posts with the armed forces as a result of the #50,000 golden-hello incentive, latest figures show. The royal navy said it had received 101 expressions of interest so far, more...

19 GPs will seek seats on slimmer GMC.(Brief Article)
April 7, 2003... A total of 19 GPs have put themselves forward as candidates to sit on the new streamlined GMC council. The council will be reduced from 104 to 35 members from July in a bid to make the GMC more efficient and responsive. Overall, 86...

GP sorts out rural issues with Charles.(Prince Charles)(Brief Article)
April 7, 2003... Dr John Wynn Jones met with the Prince of Wales last week to discuss health issues affecting rural communities. The meeting at the Prince's Highgrove residence examined the results of projects in North Yorkshire, Cumbria and Cornwall...

GPs' chance to air views on future of PMS.(Brief Article)
April 7, 2003... The National PMS Development Team has invited GPs to give their views on the future of PMS at a series of meetings this month. The meetings will take place on April 9 in London, April 10 in Bristol, April 14 in Leeds and April 16 in...

GMC in #5m compensation fight.(Brief Article)
April 7, 2003... A GMC member is to claim #5 million compensation from the council for loss of earnings after she was barred from sitting on professional conduct committee hearings. Dr Jennifer Colman was prevented from sitting on PCC cases after she asked...

NICE error means diabetes targets are `unfair to GPs'.(National Institute for Clinical Excellence)
April 7, 2003... Government targets for blood pressure and glycaemic control in type 2 diabetes are neither evidence based nor achievable and must be relaxed, diabetes experts claim. The landmark UK Prospective Diabetes Study suggested an individual target...

Opportunistic random blood glucose best.(Brief Article)
April 7, 2003... Opportunistic random glucose testing for type 2 diabetes in obese patients is more worthwhile than fasting measurements, according to research in Tayside where diagnosed cases have soared by over 50 per cent in five years. In the year-long...

GPs told `lower blood pressure in steps'.
April 7, 2003... The British Hypertension Society has told GPs to adopt a step-wise approach to lowering blood pressure. Its new guidance said hypertensives under 55 should be prescribed either an ACE inhibitor, angiotensin receptor blocker or a Beta-...

PCT inaction makes mockery of anti-violence campaign.(primary care trusts)
April 7, 2003... Many primary care trusts have ignored the Government's February deadline to draw up action plans to protect GPs from violent and abusive patients, a BMA survey has found. The inaction threatens to make a mockery of a new Department of...

Talking POINTS.
April 7, 2003... Dr Fred MacSorley, a GP for 21 years, practises in Lurgan, County Armagh. Jo Carlowe spoke to him about the current hot topics in his practice. New contract The GPC negotiators are standing by the Carr-Hill formula. Is this wise? ...

EDITORIAL COMMENT: Now GPs need space to refocus.(Editorial)
April 7, 2003... GPs are angry, disillusioned and above all confused by recent events relating to the contract. Too many shocks, especially unpleasant ones, can have a profoundly disorientating effect. Now under the minimum practice income guarantee -...

Letter: Undervaluing core work is big mistake.(Letter to the Editor)
April 7, 2003... I believe our negotiators, well-intentioned and hard working as they might be, have misjudged the mood of GPs. The vast majority already deliver a high quality of care to an increasingly demanding public and have felt undervalued for many years...

Letter: Does GPC represent us or the Government?(Letter to the Editor)
April 7, 2003... The new deal will not change my mind from voting a resounding No. After the results of more than a year's so-called negotiations we have ended up with a monumental dog's dinner. I have no confidence at all that the GPC, allegedly...

Letter: Concentrate on a pay rise.(Letter to the Editor)
April 7, 2003... We are losing sight of the wood for the trees. What we need is a large salary increase right now to prevent general practice withering on the vine. Giving us an immediate pay rise will encourage new doctors to enter general practice. We...

Letter: Funding all staff pay is a serious disincentive.(Letter to the Editor)
April 7, 2003... The Carr-Hill formula is being blamed for the financial fiasco of the new contract, but I believe there is another factor that might be more significant - the shift of funding for practice staff. GPs used to contribute 30 per cent or so and...

Letter: We value ourselves far too cheaply.(Letter to the Editor)
April 7, 2003... When it all boils down to it the new contract is basically the following simple formula: activity guess + bean counting = income. When viewed like this it is hardly surprising there has been trouble. What is worse is that the `activity...

Letter: Centralising records is too risky.(Letter to the Editor)
April 7, 2003... The comments by Dr Paul Steventon, chair of the Doctors' Independent Network, on PCOs holding patient records centrally (News, March 31), have exposed the dangers that lie in having total access to the most intimate details of our lives. ...

Letter: Electronic records have huge benefits.(Letter to the Editor)
April 7, 2003... The implication behind the suggestion that GPs would keep separate records under the new contract is rather sad (News, March 31). The worst-case scenario I can draw from your report is that GPs would manipulate the data they enter into the...

Letter: Keep your ballot papers!(Letter to the Editor)
April 7, 2003... After virtually two years of contract negotiations and the promise of a better-structured system, with improved remuneration, we end up with a fiasco like this. How can that happen? How can so many presumably intelligent people make such...

Letter: Treat GP staff wages separately.(Letter to the Editor)
April 7, 2003... It does not take a genius to count what would be left in the pocket if we get a global sum based on weighted list minus staff wages, practice expenses and out-of-hours money. We have the right to survive financially if we treat those who...

Letter: Let the PCOs deal with solicitors to sweeten pill!(Letter to the Editor)
April 7, 2003... If primary care organisations are to hold all records centrally (News report, March 31) would it be too much to hope that the responsibility for answering the increasing number of record requests from solicitors for a derisory fee would become...

Letter: Try them out on MPs first.(Letter to the Editor)
April 7, 2003... I would not be happy for primary care organisations to hold patients' records (News, March 31). First there should be a two-year trial where the medical records of the royal family and every MP and their families could be shown to be...

Letter: GPs left high and dry on forced allocations.(Letter to the Editor)
April 7, 2003... Dr Brian Balmer, chief executive of Essex LMCs, is correct in highlighting the failure of the contract to meet GPs' aspirations on forced allocations (March 31). GPs facing excessive workload feel as if they are walking along a cliff with...

Letter: We seem to be heading same way as dentists.(Letter to the Editor)
April 7, 2003... The Carr-Hill formula for calculating weighted list size means the majority of practices will lose out. One may therefore assume that most parts of the UK are not so deprived and the obsession with deprivation has rather to do with political...

Letter: Astounding message in consultant's letter.(Letter to the Editor)
April 7, 2003... Recently one of my patients with severe osteoarthritis was referred to an orthopaedic specialist, who advised her he would write to her GP with some suggestions and that she should return to her GP in two weeks. She attended after two weeks...

Letter: `Cock-up' looks suspiciously like a conspiracy.(Letter to the Editor)
April 7, 2003... I am no great believer of the cock-up theory over the mess the negotiators have made over the contract. They had 18 months to deliberate and claim to be shocked to have got it so wrong, but it took me less than a day to realise the figures just...

Letter: Why does the GMC serve patients better than doctors?(Letter to the Editor)
April 7, 2003... One of my consultant colleagues appeared at a GMC hearing recently. I obviously cannot divulge the details, because of patient confidentiality, but suffice it to say that the case was thrown out on the third day after the chief witness for the...

Letter: Why does LMC membership indicate a locum's suitability?(Letter to the Editor)
April 7, 2003... On your `Checklist for hiring a locum' (February 17) an indicator of a locum's suitability is listed as having joined the LMC. It is not clear to me why membership of the LMC has a bearing on a locum's suitability. Given that by...

Scots GPs fed up with the dreaded formulae.(Scotland)
April 7, 2003... Dr Stuart Scott explains why the contract has been a nightmare north of the border Investing in general practice! It was a title that held out so much hope, especially as we were reassured the price would be right. Then the Carr-Hill...

Why we made practice nurse into a partner.
April 7, 2003... Dr Sam Everington explains why be believes making your practice nurse a full partner should be a future model for all primary care Our practice nurse is a full profit-sharing partner. The idea began when we took the unusual step of taking...

When a patient tries to force you to give an unnecessary referral.
April 7, 2003... Case history Jane is a 30-year-old Caucasian housewife with two children registered with one of your partners. She attends as an extra one morning saying she gets chest pains when she is stressed, and regular palpitations. She is slim and...

Sorting myths from reality in genetics.
April 7, 2003... Dr Mary Porteous answers GPs' common questions on genetic testing Genetics has moved from the ivory towers of academia to the mainstream of modern medicine. Extravagant claims have been made about the future role for genetics in the...

TOP TIPS: Childhood eczema.
April 7, 2003... An experienced GP passes on practical advice 1 Parents should be encouraged to use as much emollient as possible. They may feel guilty about asking for more, so placing creams on a repeat prescription may improve compliance. 2 The...

Growth problems in children.
April 7, 2003... GP Dr Stefan Cembrowicz discusses the varied causes of child growth problems with specialist Dr Liz Crowne What's in this article * Causes of short stature * Effects of long-term steroids * Determining staging of puberty ...

How concealment can kill in skin cancer.
April 7, 2003... Many factors can complicate diagnosis and treatment of skin cancer. GPs should have a low index of suspicion for referral of pigmented lesions. Dr Toby Chave explains. Amelanotic melanoma Although uncommon, malignant melanoma may...

Your guide to a hassle-free MRCGP.
April 7, 2003... Be organised and avoid being swamped by minutiae, says Dr Prashini Naidoo There are four modules to the MRCGP exam * Written paper (paper 1) nine modified essay questions (EMQs) and three critical appraisal questions * Factual...

Take action now to banish mental health prejudices.
April 7, 2003... Stigma about mental illness can undermine GP consultations, explains Dr David Smart Stigma of mental illness adversely affects the consultation between GP and patient. The shame a patient feels with mental illness is burden enough without...

ANSWER BACK: When is adult glue ear sinister?(Brief Article)
April 7, 2003... Q: What are the chances of an adult with persistent unilateral glue ear actually having nasopharyngeal carcinoma? A: Glue ear, properly called otitis media with effusion (OME), is much less common in adults than children. In a patient with...

ANSWER BACK: Can emigrants get free NHS treatment?(National Health Service)(Brief Article)
April 7, 2003... Q: I have several patients who have emigrated or retired to France and Spain. Some still have property in the UK, which they let out. When they return to my surgery as temporary residents they are annoyed when they find they cannot receive...

Quality pay `unfair and intolerable'.
April 14, 2003... Disgruntled GPC members have turned their venom on the quality framework, branding it `unacceptable and unfair'. The `intolerable' payment system penalises GPs working in high- morbidity areas as well as any practice that ditches the...

GP runs hotel clinic for men.(Brief Article)
April 14, 2003... Dr Anita Sharma ran a men's health awareness session at a hotel to encourage men aged 35 to 55 to overcome their reluctance to visit a GP. `Men have always been like that,' said Dr Sharma, a GP in Oldham, Greater Manchester. `They only...

Hib campaign date set, but no pay deal yet.(Brief Article)
April 14, 2003... The Government has set a date of May 12 to launch the national Hib vaccine booster catch-up campaign - but a deal has yet to be struck on how much GPs will be paid. The GPC criticised ministers for setting the date before hammering out the...

U-turn as GPs are offered return ticket from Carr-Hill.(Brief Article)
April 14, 2003... GPs would be able to switch between the Carr-Hill formula and the minimum practice income guarantee (MPIG) if they accept the contract, GPC negotiators have revealed. The surprise decision marks another U-turn by the GPC as it strives to...

Innocent GP in police quiz over deaths data.(Brief Article)
April 14, 2003... A GP has been mistakenly hauled in for police questioning after a PCO passed on data from a secret post-Shipman study of mortality rates. The study by the Eastern health and social services board in Northern Ireland also led police to...

GPC negotiators facing vote of no confidence from LMCs.
April 14, 2003... GPC negotiators are set to face a vote of no confidence at next month's emergency LMC conference amid strong evidence they are losing the battle for the hearts and minds of GPs. Manchester LMC said it would table a motion calling for the...

GP does ward round to free beds.(Brief Article)
April 14, 2003... Dr Peter Gough has taken on a twice-weekly ward round to speed hospital discharges and free up acute beds. Every Monday he is e-mailed a list of patients at Addenbrookes Hospital, Cambridge, who live in the Royston, Buntingford and...

CHI demands checks on GP criminal records.(Commission for Health Improvement)(Brief Article)
April 14, 2003... PCOs are failing to ensure new GPs have had criminal record checks before they are recruited, a Commission for Health Improvement report has concluded. The finding came as nine doctors, mostly GPs, were reported to have been suspended by...

PMS `safety net' attracts GPs.
April 14, 2003... GPs are applying in droves for PMS as an insurance policy against the potential collapse of the new GMS contract, with GPC members leading the way. LMCs have reported many more GPs registering interest in the PMS 5b wave due to begin in...

Global sum rises to meet practice staff expenditure.(Brief Article)
April 14, 2003... GPs would get significantly more than #53 per patient in their global sum payments next year in order to cover increases in their practice staff costs, the GPC says. GPC joint-deputy chair Dr Simon Fradd said the global sum figure for the...

GPs fail to make impact on quality of care.
April 14, 2003... GPs have made significant progress in improving patient access and organisation of care. But this has had little impact on the quality of clinical care practices provide, a major Government-commissioned study has revealed. Practices failed...

Hypertension result leaves GP stunned.(Brief Article)
April 14, 2003... Dr Tom Coffey was stunned when 120 patients turned out for a session to raise awareness of hypertension among the African-Caribbean community. Dr Coffey, a GP in Tooting, south London, said only one in 20 of the crowd had a normal blood...

PCOs can use out-of-hours cash for debts.
April 14, 2003... PCOs will be free to spend the #100 million Government out-of-hours cash to pay off debts after the Department of Health admitted the money is not ring-fenced. The investment, announced by health minister John Hutton last month, is...

GPs force change in consent to care law.(Brief Article)
April 14, 2003... GPs in Scotland have won their battle to change new laws that force them to conduct half-hour assessments of all patients who may not be able to consent to treatment. The Scottish Executive last week agreed to amend the code of practice in...

PCTs face exodus of GPs.(primary care trusts)(Brief Article)
April 14, 2003... More than half of GPs and other primary care staff will resign from PCT posts in the next two years because of stifling bureaucracy and workload pressures. And one in five is promising to resign within a year, a survey by the NHS Alliance...

GPs must use echo to diagnose heart failure.
April 14, 2003... GPs will be told they must confirm every diagnosis of heart failure with an echocardiogram under forthcoming Government guidance. But the GPC warned that `patchy' access to echocardiography services could leave many patients with suspected...

Government advisers consider shingles vaccine for elderly.
April 14, 2003... The Government's vaccine advisers are considering the implications of asking GPs to vaccinate the elderly against shingles. The Joint Committee on Vaccination and Immunisation is awaiting more research on the efficacy and costs of the newly...