Pulse articles from April 2006

Pulse archives from April 2006

GPs fight to stave off spending cuts.(General practitioners)
April 6, 2006... Enhanced services and appraisal funding under threat as desperate trusts look for savings By Helen Crump and Anna Hodgekiss GPs are fighting to stave off swingeing cuts in funding by PCTs trying desperately to find savings. ...

Appraisals' cash anger.(General Practitioners appraisal funding)(Brief article)
April 6, 2006... GPs in Gloucestershire have condemned a decision by three PCTs to axe funding for appraisals. Cotswold and Vale, West Gloucestershire and Cheltenham and Tewkesbury PCTs told practices this week that appraisers would only be paid if GPs met...

#50,000 boost as quality scores rise.(general practitioners quality score)(Brief article)
April 6, 2006... GPs have scored around 5 per cent higher on the quality framework this year, taking the average practice over the 1,000-point mark, GPC negotiators believe. The achievement, coupled with the increase in quality rewards from #75 to #125 per...

DoH leaves GPs in vacuum over flu vaccine supplies.(Department of Health)(General Practitioners)
April 6, 2006... GPs hit out over lack of advice on how much they should order this year By Daniel Cressey The Government has failed to complete its `urgent review' of flu vaccine supplies in time to inform this year's orders, Pulse has learned. ...

GPSI move could lead to deskilling.(General Practitioners with a Special Interest)(Brief article)
April 6, 2006... The growing workforce of GPSIs in mental health could deskill GPs, warns the RCGP. A higher level of GPSI services could have the `unintended effect' of threatening the `interest and core skills' of GPs, the college warned in a position...

GP's 800 jabs in pandemic flu dry-run.(General Practitioners training on emergency medical services)(Brief article)
April 6, 2006... Dr Gillian Rink helped to carry out 800 dummy vaccinations during a pandemic flu simulation exercise at Bolton Arena. Among the scenarios dreamt up to test medical staff were a girl who'd recently been hospitalised in intensive care, a man...

Work pressure a factor in GP suicide.(General Practitioners)
April 6, 2006... Pressure of work and an inability to switch off after seeing patients were major factors in the suicide of a GP who `cared more about others than herself', an inquest has heard. Dr Jane Hext had a heavy workload, including numerous patients...

PBC `the Achilles heel of reforms'.(Practice-based commissioning)(Brief article)
April 6, 2006... Practice-based commissioning is the `Achilles heel' of current NHS reforms, a leading academic and former Department of Health adviser has claimed. Professor Chris Ham, professor of health policy at the University of Birmingham, told a BMA...

Reassurance on childhood vaccine cash.(fund allocation of childhood vaccine)(Brief article)
April 6, 2006... GPs are being assured that funding for new childhood vaccines is not under threat, following reports in the national press last week. The Department of Health has denied that a #2 billion NHS funding hole would lead to cuts in money for new...

Pledge on laboratory eGFR reports.(Epidermal growth factor receptor )(Brief article)
April 6, 2006... All laboratories should be routinely reporting eGFR calculations from this week, the Department of Health has said. Although the QOF now requires eGFR reporting to identify patients with chronic kidney disease, many GPs are not receiving...

InBrief: #27m for Scottish premises.(General Practitioner premises)(Brief article)
April 6, 2006... The Scottish Executive is to invest #27 million in GP premises. The cash will fund 21 projects in deprived areas, ranging from #400,000 for the Airth Health Clinic in the Forth Valley to #2.55 million for a `health and community campus' in West...

InBrief: Data migration confusion.(General Practitioners should pay to migrate data from one system to another)(Brief article)
April 6, 2006... A new deal to give practices a free choice of clinical system may breach GPs' contracts. Practices must pay to migrate data from one approved system to another - unless the new system is from a local preferred provider. Dr Paul Cundy,...

InBrief: NHS managers' pay rises.(National Health Services)(Brief article)
April 6, 2006... Senior NHS managers are to get pay rises equal to doctors'. Very senior managers get a 1 per cent uplift this month, with another 1.2 per cent in November. PCT chairs and non-executive directors' pay is frozen until re- appointed once...

InBrief: Treatment centres `mess'.(medicare contracts of independent sector rises financial burden for primary care trusts)(Brief article)
April 6, 2006... Independent sector treatment centres are `a mess', benefit few patients and saddle PCTs with enormous financial burdens, a parliamentary inquiry will be told. NHS Alliance evidence to the health select committee said ISTCs' long- term...

InBrief: GPASS action demanded.(General Practice Administration System for Scotland)(Brief article)
April 6, 2006... The BMA and RCGP are demanding the Scottish Executive take immediate action to remedy fears about the safety of the GPASS IT system. Dr Paul Cundy, joint chair of the joint GPC/RCGP IT committee, said: `The system is not fit for purpose.'...

InBrief: GPs' efforts cut CV events.(General Practitioners)(cardiovascular)(Brief article)(Statistical data)
April 6, 2006... More than 8,700 cardiovascular events in England will be prevented over the next five years by the QOF, the GPC has said. High GP achievement in the hypertension indicators - 94.4 per cent of practices delivered top-quality care - means 8,740...

InBrief: Ca diagnosis in women.
April 6, 2006... GPs are less likely to take action when women initially present with symptoms of bowel cancer, a survey by charity Bowel Cancer UK reveals. The survey also found only 25 per cent of patients had their treatment choices explained to them by...

InBrief: TV asthma ad complaint.(false advertising by Channel 4 )(Brief article)
April 6, 2006... Respiratory experts have condemned Channel 4 for an advert featuring a child using an inhaler below the headline `sucker'. The General Practice Airways Group is supporting Asthma UK in a complaint to the Advertising Standards Agency over...

Waist better than BMI.(Body Mass Index)(cardiovascular disease risk diagnosis)
April 6, 2006... Doubts over the value of BMI checks surfaced at the Diabetes UK meeting By Daniel Cressey Focus on body mass index rather than waist measurement is leaving a vast swath of cardiovascular risk undiagnosed, research suggests. Waist...

Metformin advice flouted.(adverse drug reactions report)(Brief article)(Clinical report)
April 6, 2006... NICE guidance on discontinuing treatment with metformin in diabetic patients with renal impairment is being widely flouted, an audit reveals. Of 694 patients prescribed the drug, 42 were found to have creatinine levels above 130 mol/l...

Solutions to GP premises problems.(General practitioners)(Brief article)
April 6, 2006... GPs wanting to develop new premises or extend their existing building will find the answers they need at a new Pulse seminar launched today. A line-up of experts will lead GPs through the minefield of regulations, red tape and financial...

Kids serve up what the Dr ordered.(Dr Mike Hearne practice serves elderly)(Brief article)
April 6, 2006... Dr Mike Hearne is Pulse's latest Proud of Our Practice winner for his scheme which involves inviting elderly patients to a local school for lunch. Dr Hearne, a GP in rural Fownhope, Herefordshire, came up with the idea as a way of tackling...

Scottish GPs' pay falls further behind English.(General Practitioners)
April 6, 2006... Profits up more than 20 per cent everywhere, but English stretch away By Ian Cameron The pay gap between GPs in England and Scotland is widening, new figures indicate. Data from medical accountants Dodd & Co showed GPs in England...

MediaWatch: `New Pill could cure PMT'.(Premenstrual syndrome treatment drug)(Brief article)
April 6, 2006... The story A new `wonder Pill' could cut the risk of breast cancer and cure PMT, all newspapers claim. The source A new class of oral contraceptive, based on RU486, which blocks production of the progesterone hormone, is being...

MediaWatch: `Cancer jabs for girls'.(Human Papillomavirus vaccine for girls)(Brief article)
April 6, 2006... The story A cervical cancer jab will soon be available for girls as young as 10, the Daily Mail and Daily Express report. The source Professor Henry Kitchener, chair of gynaecological oncology at the University of Manchester, told...

MediaWatch: `Pill cures fear of spiders'.(glucocorticoids for phobia disease)(Report)(Brief article)
April 6, 2006... The story Phobias, such as fear of spiders or public speaking, can be cured with a pill, the Daily Mail reports. The source A study published in the Proceedings of National Academy of Sciences, assessed treatment with...

Depression fight boost.(health campaigns need to be addressed by the government)(Brief article)
April 6, 2006... MPs demand action from Government on Pulse depression campaign By Nerys Hairon Pressure is mounting on the Government to act on the Pulse `Action on Depression' campaign demands. This week the shadow health secretary, Conservative...

#26,000 on offer for DESs.(Directed Enhanced Services)(Conference news)
April 6, 2006... Northern Ireland LMCs conference By Ian Cameron New directed enhanced services for access and chronic conditions in Northern Ireland could earn an average practice up to #26,000 next year. The potential income from the #4 million...

Move on referrals.(referral management centre endorsed by General Practitioners)(Brief article)
April 6, 2006... GPs in Northern Ireland have endorsed the creation of a referral management centre for the province. But they have warned it must not undermine clinical autonomy and patients' right to a second opinion, and must be adequately funded. ...

GPs to quiz adults on exercising.(General Practitioners)
April 6, 2006... GPs should quiz all adult patients about their levels of physical activity and offer advice to inactive people, under new NICE recommendations published this week. In its first public health guidance, NICE said GPs should take the...

Top 10 Side-effects of inhaled steroids.(Table)
April 6, 2006... Top 10 Side-effects of inhaled steroids Patients affected % 1 Coughing up phlegm 59 2 Tiredness 49 3 Easy bruising ...

GP screening pay urged for chlamydia.(General Practitioners)(Brief article)
April 6, 2006... GPs should be paid to carry out chlamydia screening, suggests a NICE review, which found little or no evidence that opportunistic screening is effective, writes Joanna Clarke-Jones. Currently, fewer than half of young people under 25 years...

Smoker chats work.(smoking cessation consultation at primary care nursing)(Brief article)
April 6, 2006... Offering smoking cessation advice to all smokers in primary care is cost-effective even though every 10 hours of GP consultation time only results in two smokers quitting, according to an evaluation from NICE . New smoking cessation...

JournalWatch: Hyperglycaemia in COPD.(Chronic Obstructive Pulmonary Disease)(Brief article)(Clinical report)
April 6, 2006... Rising blood glucose concentrations can increase mortality in patients with acute exacerbations of COPD independent of age, sex, severity of COPD or a previous diabetes diagnosis, a UK study reports. Researchers examined electronic records...

JournalWatch: Vitamin link to birthweight.(antioxidants uptake does not prevent pre-eclampsia )(Brief article)
April 6, 2006... High-dose antioxidants do not prevent pre-eclampsia in pregnant women and may actually increase the risk of having a low birthweight baby. A randomised, placebo-controlled trial in 2,410 women with clinical risk factors for pre-eclampsia...

JournalWatch: Adrenal function caution.(corticosteroids usage associated with adrenal malfunction)(Brief article)(Clinical report)
April 6, 2006... Adrenal function needs to be closely monitored in patients on long-term treatment with high-dose corticosteroids, a US study suggests. Researchers measured adrenal function in 103 asthma patients treated with either inhaled or oral...

JournalWatch: Type 1 diabetes CVD risk.
April 6, 2006... Patients with type 1 diabetes have a greatly increased risk of major cardiovascular events compared with the general population, despite advances in care. A UK cohort study of 7,479 patients with type 1 diabetes and 38,116 controls found...

JournalWatch: Heart failure in diabetes.(Hypertensive patients treatment results)(Brief article)(Clinical report)
April 6, 2006... Hypertensive patients with diabetes have less regression of left ventricular hypertrophy in response to hypertensive therapy than patients without diabetes. A study of 9,193 hypertensive patients - 1,195 with diabetes - treated with...

PBC unviable in places.(Practice-based commissioning)(budget cuts for primary care nursing)
April 6, 2006... Up to 5 per cut in budgets plus clash with choice - Rob Finch reports Practice-based commissioning is being made `unviable' in many areas because of a decision to top-slice practices' indicative budgets, GPs warn. The Department of...

Patient choice and PBC incompatible.(practice-based commissioning)(Brief article)
April 6, 2006... Patient choice and practice-based commissioning are not compatible, says a new report. Conflict between the two flagship Government policies will arise because patients will often ignore GPs' decisions on how or where they should be...

No incentive to increase savings.(practice-based commissioning has little incentive for general practitioners)(Brief article)
April 6, 2006... Practices that have already made savings through practice-based commissioning are complaining they have little incentive to make further improve- ments this year. GPs involved in the early stages of commissioning made savings by validating...

GP pay awards `just peanuts'.(General Practitioners)
April 6, 2006... Salaried GPs, GP trainers and GP registrars have condemned the decision to award them only a 2.2 per cent pay rise this year, writes Ian Cameron. The award, recommended by the Doctors and Dentists Review Body and described by the...

Accenture's loss on NHS IT.(National Health Service Information Technology)(Financial report)(Brief article)
April 6, 2006... Accenture, the giant US financial services and consulting firm, has blamed a near half- billion dollar loss on its involvement in the NHS IT modernisation programme. The company, which is a local service provider for Connecting for...

Doctors need US-style pact.(patient care trends)(Brief article)
April 6, 2006... GPs should seek closer links with hospital doctors to help to change care pathways through practice-based commissioning, the NHS Confederation is advising. Nigel Edwards, the confederation's director of policy, said closer collaboration...

Thrombophilia test confusion.(imappropriate referrals for testing services)
April 6, 2006... GPs call for more guidance on thrombophilia screening after audit warns of overreferral By Daniel Cressey GPs are flooding thrombophilia testing services with inappropriate referrals because of lack of guidance, new research suggests....

Infection DVT risk.
April 6, 2006... The risk of developing a venous thromboembolism is significantly increased after infection, new UK general practice research suggests. A large study of 11,000 patients found risk of deep vein thrombosis and pulmonary embolism was doubled...

Hardcore smokers.(General practitioners should find ways for smoking cessation consultation)(Survey)(Brief article)
April 6, 2006... A substantial subgroup of smokers is very resistant to the notion of stopping smoking, new research finds. Around 16 per cent of 1,170 smokers registered with 73 GPs were `hardcore', a study found. The researchers said hardcore smokers...

GP dementia referral threat.(General Practitioners medical referral regulations)
April 6, 2006... Major progress in referring Alzheimer's patients at an earlier stage of their disease is under threat from a proposed NICE ruling, leaders of new research have warned. Existing NICE guidance on Alzheimer's disease means GPs now refer...

GP's offer to save lives is snubbed.(General Practitioners cancer screening service rejected)(Brief article)
April 6, 2006... Dr Jeff Featherstone, a GP in Liverpool, was so determined to get bowel cancer screening up and running in his area, he offered to run a free colonoscopy service. But his local hospital and PCT rejected the offer, despite his 20- years'...

MMR catch-up campaign spreads.(Measles-mumps-rubella vaccination)(Brief article)
April 6, 2006... The Department of Health is planning to roll out MMR catch-up programmes around the country in the wake of the successful programme in London. The news came as the latest figures from the Health Protection Agency showed uptake of MMR...

Bid to back GPs identifying carers.(General Practitioners)
April 6, 2006... MPs consider plan to make registers of carers part of core GMS and PMS contracts - and pay GPs extra to do it By Rob Finch GPs would be given more money for identifying and supporting carers under plans being considered by MPs. A...

Registering early.(General Practitioners registration for certification)(Brief article)
April 6, 2006... The RCGP is urging GP registrars to register early for certification to avoid predicted delays stemming from a huge increase in applications. Between October and February, the college dealt with 1,766 applications for certificates of...

Triggers trouble.(primary care nursing contract)(Brief article)
April 6, 2006... Planned poor-performance `trig- gers' which could compel PCTs to contract out services must be discussed with the GPC before they are put into practice, GPs have warned. A `local trigger' system to force PCTs to respond to public...

Letter: We should be a bit nicer to NICE.(Letter to the editor)
April 6, 2006... From Dr Rubin Minhas Primary care CHD clinical lead Medway PCT When NIHCE (to use its correct acronym) developed a hypertension guideline reflective of broad medical consensus it came in for criticism, and now having closely developed a...

Letter: Obesity: a job for GPs or the Government?(Letter to the editor)
April 6, 2006... From Dr James Mather Malvern, Worcestershire Thank you for printing Dr Fisher's letter (30 March). He is of course absolutely correct in his two-component answer to the obesity public health disaster. Behaviour change is the...

Letter: From choices to a tall story.(Letter to the editor)
April 6, 2006... From Dr Paul Salomon London N11 A computer search of the White Paper `Your Health, Your Care, Your Say' reveals a grand total of 233 words based on the concept of `choice'. These are: choice (141), choices (31), choose (33), choosing...

Letter: Diagnosis of Kawasaki.(Letter to the editor)
April 6, 2006... From Dr GB Winstock London SW18 I was perplexed by the case of the child who had a fever for four days and other symptoms (Clinical, 23 March). Kawasaki disease, according to the article, requires a fever of more than five days and yet...

Letter: Going online with records.(Letter to the editor)
April 6, 2006... From Dr David Stables Co-founder and clinical director EMIS With reference to your story about the trial of online patient access to medical records at a practice in Derbyshire (News, March 23), I would like to point out that this project...

Letter: Budgeting for a poor pay deal.(Letter to the editor)
April 6, 2006... From Dr Kailash Chand Ashton-under-Lyne, Lancashire The Budget was a huge disappointment for the NHS. The total cash deficit in the NHS is growing to more than #1 billion by the end of this year and we are braced for much worse news to come...

Letter: Capital booster for GP premises.(Letter to the editor)
April 6, 2006... From Norman Warner Health minister It is misleading to claim GP premises in London are in crisis (News, 23 March). The Government has been rectifying a legacy of neglect of London's primary care facilities. The NHS in London has never...

Crime and punishment.(recidivist personal narratives)(Column)
April 6, 2006... Our recidivist columnist admits to serial speeding and assorted sartorial misdemeanours I am a criminal. I sit, head bowed, silent in a room full of other felons. We await our summons. There is no conversation; we avoid each other's eyes....

Patient choice will not work.
April 6, 2006... SecondOpinion Andy Jones Question: what do the patient-led NHS and the Diana Memorial Fountain in London's Hyde Park have in common? Answer: both are lovely ideas but neither works. The public accounts committee has criticised the...

PulseFinancial: Predict your cash-flow to avoid nasty surprises.(general practice management)
April 6, 2006... General practice is likely to be more business orientated in future - to compete successfully practices must be able to forecast income and expenditure, writes Dr John Couch More and more practices are using cash-flow spreadsheets to...

PulseFinancial: Unexpected benefit from helping the homeless.
April 6, 2006... Dr Peter Moore's practice runs a clinic for homeless people which generates a profit as well as providing a valuable service to the community As a rule, altruism does not pay the bills. But our PMS project to help the homeless has achieved...

PulseClinical: Does the Coc cause weight gain?(hormonal contraceptives related to weight gain research report)(Disease/Disorder overview)
April 6, 2006... Weight gain is often considered a side-effect of combination hormonal contraceptives, and many women and clinicians believe that an association exists. Concern about weight gain can limit the use of this highly effective method of contraception...

PulseClinical: Does diacerein work for oa?(Osteoarthritis)(Drug overview)
April 6, 2006... Diacerein acts differently from traditional NSAIDs which inhibit prostaglandin syn-thesis, leading to adverse gastrointestinal effects. It is not clear whether diacerein works and whether it is safer than other drugs used to treat OA. ...

PulseClinical: Need to know iron deficiency anaemia.(Disease/Disorder overview)
April 6, 2006... Dr Mark Follows answers questions from GP Dr Stefan Cembrowicz about the latest thinking on supplements and other therapies 1. What haemoglobin levels are considered to be abnormal for children and adults? WHO defines anaemia as a...

PulseClinical: Learning from illness Transsexualism.(Disease/Disorder overview)(Column)
April 6, 2006... Dr Richard Curtis gives a poignant account of his transition from woman to man I have always behaved like a man. Unfortunately for me, I was born a girl. I have led a very busy life but didn't really know myself and many things about...

Answerback: Is HPV screening a major advance?(human papillomavirus)
April 6, 2006... Cervical cancer: eradication in the future is certainly possible Does screening for human papillomavirus (HPV) and the possibility of vaccine development represent a major step forward in the battle against cervical cancer? Studies...

Answerback: Are allergy tests useful in eczema?(Disease/Disorder overview)
April 6, 2006... Is there a role for skin testing or any other form of allergy testing such as RAST in eczema patients? There are three main types of eczema: * allergic contact dermatitis * irritant dermatitis * atopic dermatitis. ...

PulseRegister: A Diabetes patient dodging her review.(Disease/Disorder overview)
April 6, 2006... Case history Jenny is 32 and has been diagnosed with type 1 diabetes for 16 years. You have not seen her for three years and her last blood pressure was 165/89mmHg with a HbA1C of 10.3 per cent. She requests insulin regularly. She has...

PulseCareers: Why I'm quitting general practice.(Interview)
April 6, 2006... Dr Sheila Montgomery needed counselling before deciding to leave her happy and successful partnership after 15 years - she explains why she made the move Well, that's it, I have only weeks to go before leaving my supportive partnership...

PulseComment: Flu vaccine blame game.(procurement management by general practitioners)(Brief article)
April 6, 2006... So GPs are to be trusted with the task of ordering their own flu vaccine supplies again this year. News that the procurement system will remain unchanged, at least for now, emerged from the Department of Health with barely a whimper - in...

GPs opt for special interests to exploit PBC opportunity.(General Practitioners)(Practice based commissioning)
April 13, 2006... Course providers report huge interest in GPs wanting to specialise, but RCGP urges caution By Rob Finch GPs are applying in droves to take on a specialism in order to exploit the shift in work from secondary to primary care. ...

PBC must have GPSIs.(Practice based commissioning)(General Practitioners with Special Interest)(Brief article)
April 13, 2006... Dr Peter Stott is about to start an online diploma in dermatology which will eventually give him dual GPSI status. Dr Stott, a GP in Tadworth, Surrey, already has a special interest in diabetes and is doing an insulin initiation course to...

But trusts misuse GPSIs says report.(General Practitioners with Special Interest)(Brief article)
April 13, 2006... PCTs have rushed to implement GPSI services as a cost-cutting measure without planning to ensure they work effectively, a new report warns. Researchers at the Centre for Health Economics in York uncovered a series of concerns over GPSI...

NICE attacks QOF for promoting poor COPD care.(National Institute for Clinical Excellence)(Quality of Framework)(Chronic Obstructive Pulmonary Disease)
April 13, 2006... Institute criticises failure to bring indicators in line with its guidance By Daniel Cressey NICE has launched a stinging attack on the QOF review for compromising patient care by failing to overhaul indicators on COPD. The...

GP vows to fight mental health cuts.(General Practitioners)(Brief article)
April 13, 2006... Pulse Action on depression Dr Peter Graves has pledged to fight `outrageous' plans to cut mental health services in Hertfordshire. Watford and Three Rivers PCT is consulting on plans to cut 5 per cent from mental health budgets across...

GPs to take campaign to MP meeting.
April 13, 2006... Pulse Action on depression GPs will have the opportunity to put their grievances over services for depression directly to politicians after Pulse secured a high-level meeting at the House of Commons. The meeting will focus on the...

Workforce policy may spark sex discrimination challenge.
April 13, 2006... The RCGP and BMA are considering a legal challenge against the Government's workforce policies on the grounds they discriminate against female GPs, writes Rob Finch. The action will focus on cuts to the flexible career and GP returner...

GPs ridicule `#1bn for premises' claim.(General Practitioners permises capital funding)(Brief article)
April 13, 2006... GPs have scoffed at Government claims that more than #1 billion capital funding for premises developments will be available this year. Lord Warner, health minister, told an NHS Confederation conference that more new GP surgeries and primary...

InBrief: Appraisal for QOF.(Quality of Framework)(Brief article)
April 13, 2006... Public spending watchdogs are to investigate the quality framework for data quality, accuracy of payments, `consistency of approach' and whether quality payments are good value. Plans from four organisations including the Audit and...

InBrief: Strontium ranelate fears.(osteoporosis drug therapy)(Brief article)
April 13, 2006... A Drug and Therapeutics Bulletin review has warned that strontium ranelate should only be used to treat osteoporosis in patients intolerant of bisphosphonates. It questioned evidence for claims that the drug stimulates bone formation and...

InBrief: Transport not core service.(non-emergency patient transport services regulations )(Brief article)
April 13, 2006... Practices can legally stop arranging non-emergency patient transport services because they are not part of `core' services, the GPC has advised. New guidance states it is only obligatory in acute conditions. The GPC advises practices to give...