Pulse articles from April 2004

Pulse archives from April 2004

Ministers want GP market.(general practitioners)(ban on sale of goodwill)
April 5, 2004... A drive to make GPs compete for their livelihoods against commercial providers is behind ministers' controversial decision to end the ban on sale of goodwill. A senior Department of Health official has told Pulse the Government changed the...

GP tells colleagues to get on their bikes.(General Practitioners)(Brief Article)
April 5, 2004... Dr Penny Rother says GPs could combat high stress levels by taking more exercise after a Pulse survey on GP health revealed soaring levels of anxiety. Dr Rother, a part-time GP in Edinburgh, is arguably the fittest GP in the UK as she completes...

High Court blow to self-regulation.(Brief Article)
April 5, 2004... Self-regulation has been dealt a crushing blow by a High Court ruling that means GPs who are acquitted by the GMC can still be struck off, writes Susan McNulty. A new super-regulator, the Council for the Regulation of Healthcare...

New inspectors set to scrap star ratings and close PCTs.(Healthcare Commission's bitter criticism of the priamry care trusts rankings)(Brief Article)
April 5, 2004... The `blunderbuss' approach to inspecting GPs' performance will be abandoned and PCT star ratings are likely to be scrapped within two years in an overhaul of the Government's controversial NHS inspection regime. Senior officials at the new...

GPs offered #100 bribe to help win extra stars.(General Practitioners)
April 5, 2004... GPs are being offered a #100 reward for every smoker who quits in a desperate bid by a primary care trust to improve its star rating. Brent Teaching PCT in north London told GPs they could claim #100 for every patient who quit for four...

Vaccines ruined in burglary.(Brief Article)
April 5, 2004... Dr Nick Silcock's practice lost #3,000-worth of vaccine stock after burglars cut through monitor cabling, power was lost and the fridges warmed up. Staff only discovered the burglary - the fourth this year at the practice in Nottingham -...

0870 practice phone lines will not be banned.(general practitioners allowed to provide assistance through telephone services and levy charges too)(Brief Article)
April 5, 2004... Practices have the right to instal telephone systems that charge patients extra to call the surgery, say ministers. Health minister John Hutton said telephone costs had to be covered by overall practice income `like all other businesses' in...

GPs are praised for major turnround in MMR uptake.(General Practitioners)(measles-mumps-rubella vaccines)(Brief Article)
April 5, 2004... GPs have won praise for their part in achieving the biggest quarterly rise in MMR uptake since the safety scare began. UK coverage of the vaccine among two-year-olds soared 1.3 per cent to reach 81.1 per cent in the three months to December...

GPs face chaos over enhanced services.(General Practitioners)(Brief Article)
April 5, 2004... Enhanced services negotiations have descended into chaos during the first week of the new contract. One PCT in Lancashire confirmed it was still seeking clarification from the Government on definitions before commissioning some local...

More patients will get free scripts.(Brief Article)
April 5, 2004... More patients will get free prescriptions after the Government raised the income cut-off point for eligibility. RCGP spokesperson Dr Jim Kennedy said the move could cut GP workload. `There is evidence that patients who can't afford the...

GPs urged to advise on breast-feeding.(General Practitioners)(Brief Article)
April 5, 2004... Dr Morag Martindale is urging GPs to take an evidence-based approach to helping new mothers overcome breast-feeding problems. Her survey of 300 Tayside GPs found a large majority preferred to refer to midwives rather than deal with the issue...

GP's charity vies for peace prize.(General Practitioners)(Brief Article)
April 5, 2004... Dr Saddaf Alam chairs a charity that has been nominated for the Seoul Peace Prize. The $200,000 prize is awarded by the South Korean government to recognise `great contributions to the harmony of mankind'. Stockport-based Doctors...

GPs `won't cash in on goodwill profits'.(General Practitioners)
April 5, 2004... Medical accountants believe GPs will be cautious about taking advantage of new rules that could allow them to raise the price of a share in their practice. The regulations passed last week end a 56-year ban on the sale of goodwill. ...

GPs cleared in pneumonia antibiotic prescribing row.(General Practitioners)
April 5, 2004... GP curbs on antibiotic prescribing are not to blame for an increase in pneumonia deaths, a Government investigation has concluded. Members of the specialist advisory committee on antimicrobial resistance (SACAR) have decided that evidence...

GPs risk claims on decontamination.(General Practitioners)(Brief Article)
April 5, 2004... GPs may be risking negligence suits because of poor decontamination practice, warns a senior Government adviser. Dr Geoffrey Ridgway, consultant microbiologist at UCL hospitals and chair of the Department of Health's microbiology advisory...

Patients' on-call confusion.(Brief Article)
April 5, 2004... More than a third of GPs - 36 per cent - believe patients will be even more confused about what to do out-of-hours under the new contract. Research by the charity Developing Patient Partnerships revealed that 91 per cent of GPs said some...

Postcode lottery is `forcing GPs to overuse SSRIs'.(General Practitioners)(selective serotonin reuptake inhibitors )
April 5, 2004... Postcode rationing of psychological services is forcing GPs to overprescribe antidepressants to patients with mild depression and anxiety, according to a new report. A survey of 250 GPs showed 81 per cent admitted overprescribing selective...

Nurses urged to challenge GPs' power base.(General Practitioners)(Brief Article)
April 5, 2004... Nurses are being encouraged to be more aggressive in taking over practices and challenging GPs' power base. At a recent Government conference for PCT managers, one of the first nurses to take over a practice said her contemporaries had to...

No access cash for small GP practices.(General Practitioners)(Brief Article)
April 5, 2004... Small practices are being denied #5,000 Government payments for improving patient access, despite meeting 24- and 48-hour targets. The Small Practices Association said GPs were being denied the cash because they were running open-access...

NICE advice on asthma steroid choice.(National Institute for Clinical Excellence )(Brief Article)
April 5, 2004... The National Institute for Clinical Excellence will be appraising the use of steroids for chronic asthma as part of its 10th wave of appraisals, which should be completed in 2006. It will look at the clinical and cost-effectiveness of...

Complaints plans are condemned.(primary care trusts respond to patient complaints,physicians in dark)(Brief Article)
April 5, 2004... Medical defence bodies are attacking Government plans to let primary care trusts respond to complaints about GPs without telling the doctor. Under regulations due to come into force on June 1, PCTs can keep GPs in the dark if they believe...

IT move to prevent prescribing errors.(Brief Article)
April 5, 2004... The National Patient Safety Agency has teamed up with primary care IT providers to help reduce medication errors from incorrect prescribing. The agency has incorporated specific warning prompts within clinical systems to protect patients...

GPs getting no support as more confess to `finding life difficult'.(general practitioners survey)(Brief Article)
April 5, 2004... GPs say they are stressed but trying to cope - Nerys Hairon takes a look at the results of a Pulse survey More than half of GPs still do not have access to occupational health services, a Pulse survey reveals. The finding came as one...

We put our patients' health first.(general practitioners survey)(Brief Article)
April 5, 2004... GPs put the health of patients before their own well-being. Almost three GPs in four admitted that they always or usually carried on working when they were too ill to hold surgeries, Pulse's survey revealed. In addition, some 74 per...

Most GPs leading a healthy life.(General Practitioner)(Brief Article)
April 5, 2004... Most GPs practise what they preach by eating healthily, taking regular exercise, drinking in moderation and not smoking. Pulse's health and stress survey revealed only 3 per cent of GPs smoked. Some 80 per cent eat at least three portions...

Journal watch: Abortion not linked to breast cancer.(Brief Article)(Excerpt)
April 5, 2004... Women who have pregnancies ending in abortion or miscarriage are at no greater risk of breast cancer than other women, according to new research. Data from 56 studies involving 39,000 women from 16 countries showed relative risk of breast...

Journal watch: CBT effective in hypochondriasis.(Cognitive behavioural therapy )(Brief Article)(Excerpt)
April 5, 2004... Cognitive behavioural therapy could be effective in tackling hypochondriasis, according to new research. A randomised trial of 102 patients given the therapy and 85 patients given usual care in primary care found significant reductions in...

Journal watch: Lower anticoagulant targets better.(Brief Article)(Excerpt)
April 5, 2004... Reducing the target range for INR monitoring of patients taking oral anticoagulants leads to fewer untoward events. A US study of 2,341 patients treated with anticoagulants compared untoward events before and after a reduction in the INR...

Journal watch: Alcohol benefits hypertensive men.(Brief Article)(Excerpt)
April 5, 2004... Hypertensive men who are otherwise healthy can take heart from a new study that suggests daily alcohol consumption reduces mortality from all causes and cardiovascular disease. Researchers followed-up 14,125 men with a past or current...

Journal watch: Supplement interactions `not serious'.(Brief Article)(Excerpt)
April 5, 2004... According to US researchers the use of dietary supplements alongside prescription medications is very common, but most interactions are not serious. In a study of 458 patients in primary care, 43 per cent were found to be taking at least...

Journal watch: GPs are `rounding' BP readings.(General Practitioner )(Brief Article)
April 5, 2004... English GPs' hypertension treatment decisions could be unreliable according to researchers checking records of blood pressure measurements. A statistical analysis of the end digits from 85,000 blood pressure readings from patients with...

`Patients stared at my biscuits'.(Gill Jenkins)(Brief Article)
April 5, 2004... Dr Gill Jenkins says she feels under pressure from her patients to eat healthily and has encountered at least one uncomfortable moment in her supermarket. Dr Jenkins, a GP in Bristol with a special interest in obesity and weight...

How US-style proactive care will drive Blair's dream for NHS.(National Health Services)
April 5, 2004... US-style schemes aimed at cutting emergency admissions through `proactive' management of elderly patients with multiple chronic diseases are a key plank of the Government's strategy for primary care - Emma Wilkinson reports Writing in...

Six US principles that will influence new UK projects.(United Kingdom)(Kaiser Permanente-health management organisation )(Brief Article)
April 5, 2004... Kaiser Permanente is a US health management organisation that the Government has approached to help improve chronic disease management in the UK. In February 2003, after a visit to Kaiser, Department of Health officials identified six...

GP expects change for better.(United States health management organisation Kaiser Permanente)(Brief Article)
April 5, 2004... Dr Elizabeth Gonzalez is confident that the way patients with chronic diseases are managed will change for the better. Dr Gonzalez, a Birmingham GP involved in one of 10 pilot schemes modelled on the values of US health management organisation...

Recruit gives GP a break at last.(general practitioners)(Brief Article)
April 5, 2004... Dr Keith Tattum has had his first time off for nearly a year after he finally managed to recruit a GP. His practice in Stoke-on-Trent has opened its list and resumed minor surgery after salaried GP Dr Brenda Gorrie joined last month. ...

GPs shy away from `irrelevant and pointless' PCO role.(general practitioners have no say in health policy formulation)(primary care organizations accuse physicians,deny seeking apology)(Brief Article)
April 5, 2004... A high-profile dispute between two GPs and local NHS managers will make doctors even more reluctant to work for primary care organisations. GPs say the row between Dr Les Glass and Dr Roger Ford and Sunderland Teaching PCT shows the lack of...

Trust sorry - but not that sorry.(Sunderland Teaching Primary Care Trust accuses physicians but denies offering apology)(Brief Article)
April 5, 2004... Sunderland Teaching Primary Care Trust is insisting it has not apologised to Dr Lesley Glass and Dr Roger Ford, despite withdrawing its accusations and expressing `regret' at the distress it had caused. In a letter to the GPs, seen by...

No plans to scrap GPs' IT systems.(general practitioners information technology systems)(National Health Services' information technology modernisation program)(Brief Article)
April 5, 2004... Ministers have moved to reassure GPs the Government's NHS IT modernisation program will not mean some practice computer systems will be scrapped. The move comes after the biggest supplier of GPs' systems, EMIS, pulled out of negotiations...

EDITORIAL COMMENT: GPC must resist sale of goodwill.(general practitioners councils)(Brief Article)
April 5, 2004... In the early years of NHS general practice the sale of goodwill was largely achieved by making incoming prospective partners work for many years as `assistants with a view' or at a financial disadvantage to the senior partner. Over time general...

Letter: Snub out-of-hours until disputes settle.(Letter to the Editor)
April 5, 2004... We may feel we have a gun pointed at our heads (Comment, March 22) but let us not forget we still have control of an arsenal we could deliver up the Government's pompous rectum. Any failure to sort out this complete and utter shambles to...

Letter: Primary care is suited to managing epilepsy.(Letter to the Editor)
April 5, 2004... We were dismayed to read the disparaging comments about GPs and practice nurses made in the article about reviewing patients with epilepsy (News, March 15). What is the status of the relevant evidence of any benefit of specialist review of...

Letter: Contract stresses practice staff too!(Letter to the Editor)
April 5, 2004... Much has been said and is being said about the levels of stress that the new contract will place in GPs (News, March 29). However, I note there is little or nothing said about the levels of stress that practice managers and indeed practice...

Letter: Time for BMA to live up to its trade union role.(Letter to the Editor)
April 5, 2004... As a profession we have reached a turning point in history. The new contracts for primary and secondary carers have not only angered but also deeply divided the grassroots. Perhaps the biggest issue for doctors in the NHS today is their...

Letter: Protecting overseas doctors.(Letter to the Editor)
April 5, 2004... More than 11,000 overseas doctors registered to practise in the UK last year, the highest number ever, according to the regulatory body for the medical profession. The GMC, which registers and regulates doctors, said 11,106 overseas doctors had...

Letters: NICE proves itself to be far from infallible.
April 5, 2004... Clinicians have long realised NICE is anything but infallible when it comes to advising on clinical matters, and to blame the BMA for the MMR disaster, as Sir Michael Rawlins does (News, March 22), quite takes one's breath away. The BMA is...

Letter: Tony Blair is full of patronising rubbish.(Letter to the Editor)
April 5, 2004... Four years ago the Government set itself the target of recruiting an extra 2,000 GPs by 2004. This paltry figure remember was set against the RCGP and BMA's assertion that the country needed a minimum of an extra 10,000. The Government has...

Letter: When asylum seekers must get free care.(Letter to the Editor)
April 5, 2004... I am writing in connection with your resource guide regarding overseas visitors' eligibility to receive free primary care which stated only refugees with leave to stay in the country were eligible to receive free primary health care. In...

Letter: Deteriorating trust to blame for public's MMR scepticism.(Letter to the Editor)
April 5, 2004... The public scepticism on MMR is not surprising. Society has always had a love/hate relationship with science and scientists and in recent years the deterioration of trust has become more apparent. Incidents such as Three Mile Island, Bhopal and...

Letter: Does the statin dose matter?(Letter to the Editor)
April 5, 2004... It was fascinating to read the statin letter from Hull (March 22) and well done for some general practice research. The results, however, must be tempered by Bandolier 121 which seemed to show `the cholesterol-lowering capacity of statins...

Dr Fradd moves to real war zone.(General Medical Councils)(Interview)
April 5, 2004... The flak GPC joint-deputy chair Dr Simon Fradd endured during new contract negotiations will pale into insignificance when he starts his new job in wartorn Iraq, as he explains to Nerys Hairon Many comparisons have been made between the...

Why GPs must try to understand PCOs.(general practitioners)(primary care organizations)
April 5, 2004... Dr Peter Saul is both a GP and a member of his local health board and so sees the contract from both sides of the fence Most GPs in practice have seen the implementation of the new contract as a bit of a headache with impossible deadlines...

Will your partnership agreement need to be altered for GMS2?(general medical services contracts)
April 5, 2004... GMS2 has brought into focus the need to have a robust partnership agreement - Daphne Robertson identifies areas of your agreement you may need to review GMS2 is about capitalising on the `skill mix' in your practice but with this comes...

Get on top of your time management.(general practitioners)
April 5, 2004... GPs have a duty to patients, colleagues and to themselves to manage time well, says Dr Melanie Wynne-Jones If you are feeling pressured, take control. Take control by reflecting on your situation and working out what is going wrong. A...

QUALITY AND OUTCOMES FRAMEWORK: Practice management.(health care industry)
April 5, 2004... Dr John Couch continues our series by looking at the requirements needed to earn points from practice management Total points available 20 2004/5 2005/6 ...

Is undertaking an MSc midlife madness?(academic talk )
April 5, 2004... Dr Abayomi McEwen found doing a distance learning MSc hard work and nerve racking but ultimately very valuable indeed Sitting on the shores of a lake in a distant land is not the time to agree to undertake a life-changing course of action....

GP's referral quandary over unexplained tiredness and abdomen pain.(case study analysis)
April 5, 2004... Case history There is something the matter with Mr Smith and you can't find out what it is. He presented two months ago with vague abdominal pains and tiredness, joking that he was falling apart at the age of 45. Routine bloods,...

PracticeQ&As: What about seniority pay for part-timers?(general practitioners)(Brief Article)
April 5, 2004... Q: What is the position of part-time GPs with regard to seniority in the new contract? A: Part-time and full-time work contribute equally to `reckonable service' calculations. The full rate of seniority payments is payable in respect...

PracticeQ&As: If we can't charge for travel medicine must we do it free.(general practitioners)
April 5, 2004... Q: Is travel medicine a core service that GPs have to do? If it isn't, but we are not allowed to charge for the service, are we obliged to do it for nothing? A: Primary medical services for NHS patients remain free at the point of delivery...

PracticeQ&As: Who's responsible for school leaver vaccinations?(diphtheria and tetanus immunisation)(Brief Article)
April 5, 2004... Q: Some schools no longer carry out the diphtheria and tetanus immunisation of 14- to 15-year-old school leavers. Who has responsibility for these immunisations? A: This is a service that must be paid for if the GP is to assume...

PracticeQ&As: Why are there two seniority pay options for PMS?(primary medical services)(Brief Article)
April 5, 2004... Q: I gather there are two options for seniority pay for PMS practices after April to reflect the arrangements under GMS2. Can you explain? A: It is intended seniority pay should increase in parallel with increases in GMS2. The choices are...

PracticeQ&As: Do we get appraisal costs?(health care industry)(Brief Article)
April 5, 2004... Will we still receive appraisal costs under GMS2? The following clear statement concerning funding streams for appraisal is made on page 4 of the Primary Medical Services Allocations 2004/5 - HSC 2004/003: `This allocation covers funding...

Pitfalls in communicating risk.(risk management for general practitioners)
April 5, 2004... Dr Mike Campbell offers tips on conveying medical risks to the patient If an average 40-year-old buys one Lottery ticket twice per week for a year their chances of dying each week before the draw are greater than their chances of winning...

10 TOP TIPS: Topical pimecrolimus and tacrolimus.
April 5, 2004... Bite-sized advice for busy GPs 1. A new group of topical compounds has become available for treating the inflammation associated with atopic eczema. These are the calcineurin inhibitors, otherwise known as topical immunomodulators or...

Quick wins for the new contract.(general practitioners' contract)
April 5, 2004... GPs are working hard to make the most of the quality points available under the new contract. Rather than every GP reinventing the wheel, Pulse invites readers to send in their thoughts on aspects of the contract they think would be of interest...

What you need to know about controlled drugs.
April 5, 2004... Dr Clare Gerada explains the traps for the unwary GP Dame Janet Smith, chair of the Shipman Inquiry, will shortly make her final recommendations. She will almost certainly pick up on the confusion around the regulation of controlled drugs...

What works to improve depression outcomes?(care and treatment of depression disorder)
April 5, 2004... Brief, low-intensity methods can improve depression management in primary care - Dr Simon Gilbody reviews the evidence There is clear evidence that pharmacological and psychological treatments are effective for depression in primary care....

DOCTOR'S COMMENT: A raw deal for patients.(depression care under the new general medical services contract)
April 5, 2004... The new contract should measure depression care, says Dr Phillip Bland One of the many disastrous failings of the new contract is its relegation of the fourth most significant cause of suffering and disability worldwide to `enhanced...

Are anxiety and depression really separate disorders?
April 5, 2004... Dr Simone Forlee and Dr Lynne Drummond examine diagnosis and treatment There may be considerable overlap in the presentation of anxiety and depressive disorders. People suffering a depressive episode may have both physical and cognitive...

End-stage care in COPD and heart failure.
April 5, 2004... It's time the lessons of cancer were applied to people dying from other conditions, says Dr Louise Gibbs The physical, psychological and social needs of people with end-stage chronic disease are rarely recognised and relieved, despite...

How to sail through the MRCGP orals without stress.(Member of the Royal College of General Practitioners)
April 5, 2004... With the MRCGP oral exams looming, Pulse is launching its new `Four Minute Conversation' series this week to help you sail through with maximum marks and minimum stress. The oral module - two 20-minute exams covering around five topics...

YOUR FIRST: Consultation with an unhappy teenager.(do's and dont's for a general practitioner on managing depressed teenage patients)
April 5, 2004... Does a depressed teenager present an even more challenging consultation than usual? Dr Lionel Jacobson outlines what to expect GPs often see unhappy patients. As a registrar you will see adults with stress symptoms who report unhappiness,...

CLINICAL CASEBOOK: An early request for medication.(management of patient care)
April 5, 2004... Case history S.J. is a 44-year-old patient who has requested a prescription for her usual diazepam and dihydrocodeine but was asked to see the doctor as the request was a week early. Her summary tells you she suffers from chronic anxiety...

ANSWER BACK: Screening neonates for heart problems.(Brief Article)
April 5, 2004... Q: I am sometimes requested to carry out a `day three heart check' on a new baby. Is this an effective screening tool? A: Modern obstetric practice allows discharge from the maternity unit on the first day after birth, often at six hours....

ANSWER BACK: What are limits on ESR for diagnoses?(erythrocyte sedimentation rate)(Brief Article)
April 5, 2004... Q: What are the limitations on using ESR as a marker for undiagnosed/active illness? A: The erythrocyte sedimentation rate (ESR) measures the distance that red cells have fallen after one hour in a vertical column of anticoagulated blood...

GP out-of-hours bonanza.(general practitioners' contracts providing more them with more income)
April 12, 2004... GPs are cashing in on the new contract's lucrative out-of-hours market by earning up to #105 an hour for on-call shifts. LMCs have warned that rates could spiral further with GPs beginning to demand as much as #150 an hour to work nights...

But most wait to opt out.
April 12, 2004... GPs in some areas suffered crushing disappointment last week when plans to allow them to ditch out-of-hours responsibilities fell through at the last minute. In some places GP co-operatives were forced to pick up the pieces, but in other...

GPs `too busy' to learn from near-misses and mistakes.(general practitioners)(Brief Article)
April 12, 2004... Time pressures and lack of awareness prevent `worrying' numbers of GPs learning lessons from practice errors that are serious enough to jeopardise patient safety, a Government-funded study suggests. The quality of review of `significant...

GP initiative streamlines referrals.(general practitioners)(Brief Article)
April 12, 2004... Dr Katherine Burn's practice has cut waiting times for urgent referrals to a rapid-access chest pain clinic by two days by streamlining paperwork. The initiative was singled out by the NHS Modernisation Agency as an example of how services...

Government cracks down on 48-hr access loophole.(new rule for physicians' appointments, to be made prior two days)(Brief Article)
April 12, 2004... GP practices are to be monitored to make sure they offer advance appointments as well as 48-hour access. New Department of Health guidance to PCTs makes clear practices cannot meet the access target by simply preventing patients from making...

Annual review plans `breach light-touch contract pledge'.(general practitioners services under check)
April 12, 2004... GPs face `bureaucratic' and `disruptive' visits by large teams of assessors as part of the annual review of quality and outcomes measures. Under new Government guidance issued to PCTs, all practices will have an annual review visit of at...

Patient choice `won't add to GP workload'.(general practitioners)(patients who choose hospital services take less consultation time)
April 12, 2004... GPs have cast doubt on a Government-funded study that found offering patients a choice over hospital referrals added just 36 seconds to consultations. Ministers want all GPs to offer patients a choice of hospital for elective surgery at...

GP will treat while waiting for PCT deal.(primary care trusts)(general practitioners)(Brief Article)
April 12, 2004... Dr Thomas Bloch believes even the most militant GPs will find it difficult to turn patients away instead of providing enhanced services on an unpaid basis. Dr Bloch's practice in Broadway, Worcestershire, is providing a wide range of...

GPs work for free to protect patients' care.(Brief Article)
April 12, 2004... The vast majority of GPs are doing unpaid work under the new contract to ensure patients do not suffer as a result of PCTs' failure to commission many national enhanced services, Pulse has learned. A Pulse investigation involving GPs in 75...