Pulse articles from April 2007

Pulse archives from April 2007

Days of GMS contract.(General Medical Services)
April 5, 2007... Negotiators condemn ex-health minister's comments as an attempt to undermine the BMA Exclusive By our political correspondent The days of the GMS contract may be numbered, with a push to replace it with locally negotiated deals,...

Rejected deal offered 2.5% pay rise.(General Practitioner Committee )(Brief article)
April 5, 2007... The pay deal rejected by the GPC was worth a 2.5 per cent rise in income for the average practice, the Department of Health's negotiating arm has claimed. NHS Employers said more than #200m had potentially been available UK- wide for...

JBS2 guidelines `not independent or fit for purpose'.(Joint British Societies)
April 5, 2007... UK's leading CVD guidance judged as `poor' against international criteria By Daniel Cressey The UK's leading guidelines for cardiovascular disease are so flawed they should not be recommended for clinical use, an analysis concludes....

Rules change for end-of-life decisions.(Brief article)
April 5, 2007... GPs are to be expected to defer to patient representatives when making end-of-life decisions about withholding or withdrawing treatment. Guidance from the BMA recommends doctors consult with new Independent Mental Capacity Advocates,...

Choose and Book top of LMC hit list for pay freeze protest.(Local Medical Committee )
April 5, 2007... Choose and Book should be top of the list of things that GPs are encouraged to boycott in protest at the zero per cent pay award, LMCs believe. The GPC's protest action plan is due to be published this week and was being pored over by...

GPs `under no DES obligation'.(Directed Enhanced Services)(General Practitioner Committee )(Brief article)
April 5, 2007... The GPC has advised GPs they are under `no obligation' to continue with unfunded Directed Enhanced Services as funding for most lapsed on 31 March. The DESs have now been left in disarray because negotiations in many areas have broken...

Fractures warning for rosiglitazone.(Brief article)
April 5, 2007... Drug regulators have issued an official warning on the safety of a major diabetes drug after concerns it raises the risk of fractures. GPs are being alerted to the increased fracture risk with use of rosiglitazone following reports of...

Beefed-up PEC role for clinicians.(professional executive committees)(Brief article)
April 5, 2007... The role of clinicians on PCTs' professional executive committees will be beefed up under new guidance from the Department of Health. The guidance emphasises PECs should be at the heart of PCTs' decision- making and clinicians should make...

InBrief: Pulse hits reader record.
April 5, 2007... Pulse is still the best-read weekly medical publication, with our readership up five percentage points in thepast year. In the six months up to February, 79 per cent of GPs read Pulse every week - three points ahead of GPand 19 ahead of...

InBrief: Patient survey response.
April 5, 2007... Two million patients have answered the GP Patient Survey on access in what the Department of Health claims is the greatest ever response to a Government survey. Another 200,000 responses are anticipated before the survey closes on 5 April....

InBrief: Staff lack faith in NHS.
April 5, 2007... NHS staff lack confidence in the health service, a new survey reveals. The Healthcare Commission found only 39 per cent would be happy with the care provided by their own trust. Only 45 per cent of nearly 130,000 NHS staff polled thought...

InBrief: Chlamydia diagnoses up.(Brief article)
April 5, 2007... New data from the Health Protection Agency show `marked increases' in the number of uncomplicated chlamydia diagnoses since 1995. Between 2004 and 2005 cases rose by 5 per centto 10,995, with the rise highest among males, in whom there was...

InBrief: Interviews for juniors.
April 5, 2007... All eligible junior doctors who applied for jobs in Scotland and Wales are to be interviewed as part of the Modernising Medical Careers initiative, it was announced last week. This marks a break with current policy in England, where doctors are...

InBrief: GPs to take vCJD lead.(Brief article)
April 5, 2007... GPs will be expected to `take the lead' in commissioning care for variant Creutzfeldt-Jakob disease. A report commissioned for the Department of Health recommends care for patients with vCJD should be standardised across the country - led...

InBrief: Faked ambulance data.
April 5, 2007... Another ambulance service has been found out for faking key performance data. The Audit Commission said the former Wiltshire Ambulance Service NHS Trust had `routinely' altered response times of more than 600 calls. Copyright: CMP...

InBrief: New patient help courses.
April 5, 2007... The Department of Health has taken the unusual step of setting up a social enterprise organisation to improve patient care. PCTs will now be able to commission the Expert Patient Programme company to run courses in self-management for...

NHS risk score picks up cancers missed by NICE.(National Health Service)
April 5, 2007... Six-item colorectal cancer algorithm feasible for use in general practice By Lilian Anekwe Patients with suspected colorectal cancer who are missed by NICE guidance may now be picked up using an algorithm under development by the...

Overseas patients fee fears.(Brief article)
April 5, 2007... Government plans to make GPs charge overseas patients would be unethical and disruptive to the doctor-patient relationship, researchers have warned. The Department of Health last week announced a review of policy in general practice, which...

Pay `should be docked' for QOF failure.(quality and outcomes framework)(Brief article)
April 5, 2007... GPs should actually lose cash for not meeting QOF targets, a health economist is suggesting. Professor Alan Maynard, professor of health economics at the University of York, said the threat of money being taken away was likely to be a...

MediaWatch: `Neuroleptics death risk'.(Brief article)
April 5, 2007... Copyright: CMP Information Ltd. The story Drugs prescribed for people with dementia are causing thousands of premature deaths, report The Guardian, The Times and Daily Express. The source A group of 165 Alzheimer's patients were...

MediaWatch: `MRIs for second breast'.(Brief article)
April 5, 2007... The story Women diagnosed with cancer in one breast should have an MRI scan of the other, according to the Financial Times and various other media outlets. The source An international research team found MRIs detected cancer in the...

MediaWatch: `Burning away asthma'.(Brief article)
April 5, 2007... The story The biggest advance in asthma treatment in years has arrived, with a new treatment that involves `burning' the lungs of sufferers, report The Daily Telegraph, The Independent, The Sun, Daily Mail, Daily Express and The Times. The...

QOF cuts admissions.(quality and outcomes framework)
April 5, 2007... Admission rates are markedly lower in areas achieving high QOF points By Daniel Cressey Hospital admissions for a range of conditions are significantly lower in areas with high achievement in the quality and outcomes framework, data...

Nurse scripts double in a year.
April 5, 2007... Experts fear for patient safety as non-medical prescribing soars despite unmet educational needs By Daniel Cressey The number of prescriptions issued by nurses and pharmacists has soared by more than 100 per cent in a year despite...

Inhaled steroids only of short-term benefit in COPD.(chronic obstructive pulmonary disease )(Brief article)
April 5, 2007... Inhaled steroids have no effect on the long-term course of COPD, with their benefits restricted to short-term symptom relief, a meta-analysis reveals. Steroid treatment increased FEV1 by the equivalent of 42ml in men and 29ml in women over...

DH `repeating fundholding errors'.(Department of Health )
April 5, 2007... Former policy chief warns Government that practice-based commissioning will struggle to engage GPs By Helen Crump The Government has failed to learn the lessons of fundholding and risks making the same mistakes with practice-based...

GPs in discharge summaries plea.(general practitioners)(Brief article)
April 5, 2007... GPs must tell their PCT to get tough on discharge summaries, the NHS Alliance says. Dr Mike Dixon, NHS Alliance chair, said the issue had become the `cause celebre' of practice-based commissioning and urged GPs and practices to push trusts...

A safety check before warfarin repeat scripts.(Report)
April 5, 2007... Safety agency wants GPs to ensure patients are controlled and reviewed By Lilian Anekwe GPs should only issue repeat prescriptions for anticoagulation after a series of rigorous safety checks, a new report warns. The National...

Improving medication safety in the NHS.
April 5, 2007... * A redesign of the `yellow book' issued to patients prescribed anticoagulants * Asking patients to share INR results with GPs and community pharmacists when requesting a repeat prescription * Safer labelling of products to minimise...

Doubts on review by pharmacists.(Brief article)
April 5, 2007... Medication reviews by pharmacists do not appear to bring any clinical benefits, although they do cut costs, new research concludes. The study appears to question the widespread use of pharmacist reviews, which previous studies have...

Is GP contract really more for less?
April 5, 2007... Government claims that the GMS contract has reduced productivity provoke fierce debate among GPs By Steve Nowottny Ask Dr Karen Blades her view on Government claims that the GMS contract has made GPs less productive, and her response...

JournalWatch: Bipolar disorder failure.(Brief article)
April 5, 2007... Adjunctive treatment with antidepressants does not benefit patients with bipolar disorder, according to a US study. The researchers randomly assigned 366 patients to receive a mood- stabilising drug plus an antidepressant or mood stabiliser...

JournalWatch: Aspirin's long-term effects.(Brief article)
April 5, 2007... Use of low to moderate doses of aspirin has short-term benefits for reducing cardiovascular disease and longer-term benefits for cancer, a US study reports. The research followed 79,439 women enrolled in the Nurses' Health study, 9,477 of...

JournalWatch: Rosuvastatin success.(Brief article)
April 5, 2007... Rosuvastatin slows the progression of atherosclerosis in low-risk patients, a US trial reveals. The METEOR study randomised 984 middle-aged people with a Framingham risk score of less than 10 per cent to 40mg/day rosuvastatin or placebo....

JournalWatch: Steroids prevent wheeze.(Brief article)
April 5, 2007... Steroids protect some infants from recurrent wheeze if given after their first episode, Finnish researchers report. Their study assessed the effectiveness of prednisolone against placebo in 118 children who had been hospitalised for a first...

JournalWatch: PPIs safe in children.(proton pump inhibitors)(Brief article)
April 5, 2007... Proton pump inhibitors are safe and effective for long-term use in children, a Canadian study has found. The retrospective cohort study examined records for 166 children, with an average age of 7.8 years, who had received treatment with a...

SOAPBOX: Not costly and not unsafe.
April 5, 2007... Dr Neil McNeil is a GP in Stalybridge, Cheshire, and a GPSI in minor surgery. He is angry over a recent NHS report that warned against assuming that shifting care into community settings will always be cheaper and safe. After reading your...

Letter: Shifting work requires proper infrastructure.
April 5, 2007... A recent report on care close to home provoked a strong response From Dr Raj Dhumale, Probus, Cornwall As a primary care surgeon, I think it is wrong to make a general statement that care closer to home is costly and unsafe. I note from...

Letter: How Passover affects Jewish patients.
April 5, 2007... From Dr Steven Livingston, Barnet, north London Anyone with a large Jewish population in their practice may have noticed the increase in attendance of women suffering from stress and lack of sleep over the last few weeks. What is this all...

Letter: Show us evidence of Muslim breach.(Brief article)
April 5, 2007... From Dr Alam Ara Khan, chair, Muslim Doctors and Dentists Association Open letter to Health Secretary Patricia Hewitt We are deeply distressed by the remarks attributed to you, the Health Secretary, regarding confidentiality by Muslim...

Letter: Challenging contraception advice.
April 5, 2007... Professor John Guillebaud responds to readers' questions about issues raised in his series on contraception From Dr R Yadava, Stoke-on-Trent Further to Professor John Guillebaud's article `Contraception update: long-acting reversible...

Blink and you'll see me.
April 5, 2007... Phil reveals he is the world record holder for access to a GP - 48 seconds, never mind hours This afternoon I had one of those consultations that made me stop and think about the way we run our practice. It was an `urgent extra' patient,...

Dinah's Diary: Mental health - solace in Easter eggs.(Diary entry)
April 5, 2007... Dinah is concerned by mental health care - but finds solace in Easter eggs Monday Surgery. Thank goodness March is over, it's always such a rush - last- minute QOF figures; everyone wanting appraisals; claims and travel forms to get...

Opinion: Regulation plans are a wake-up call to GPs.(general practitioners)
April 5, 2007... The white paper on medical regulation does not make pretty reading, says Dr Patrick McEvoy - but GPs must dust off their wounded pride and act to safeguard their professional identity Regulation, Regulation, Regulation - could this be a New...

PulseFinance: Gilt comes off the pensions gingerbread.
April 5, 2007... Your NHS pension should still be the centrepiece of your retirement planning, but in the light of recent events it would be unwise to rely upon it alone for a comfortable retirement, says Dr John Couch A year ago the prospects for GP NHS...

PulseFinance: How they calculate your NHS pension.
April 5, 2007... All GPs should keep a close and careful eye on their pension and to do this they must understand exactly how it is calculated. Here Andy Blake of the BMA explains the facts, the figures and the intricacies of the NHS scheme GPs' pensions...

PulseFinance: How to prepare for your retirement.
April 5, 2007... It is never too early to start preparing for your retirement, and it is important too to make extra pension provision, says Dr Andrew Dearden It is almost impossible to cover this topic in a single article so I'll have to ruthlessly...

PulseFinance: The proposed changes for 2008.
April 5, 2007... Dr Andrew Dearden looks at the 2008 proposals for existing doctors, both salaried and self-employed, and at the changes that will - or will not - happen to their pensions The NHS pensions review has taken around three years, and the...

PulseFinance: Why NHS scheme is still superb value.(National Health Service)
April 5, 2007... Despite recent vicissitudes and possible threats, the NHS pension scheme is still superb value, says pensions expert Tom McPhail It is hard to overestimate the value of the NHS pension scheme to its members. As a member you are required to...

PulseClinical: Fracture management and complications.
April 5, 2007... Take-home points * Cracking noise is not diagnostic of fracture - many joints produce sounds from vacuum effects and tendons around joints may click, especially if tense. * For any fracture, gentle attempts at realignment of the limb...

PulseClinical: Reasoning training slows age-related functional decline.(Clinical report)
April 5, 2007... Q Can cognitive training for older adults slow functional decline resulting in less difficulty with activities of daily living? Synopsis These investigators enrolled 2,832 people into their study, aged 64 or older, living independently...

PulseClinical: Cancer in primary care.
April 5, 2007... Screening and early diagnosis: Ovarian, lung and bladder cancer Dr Alison Round and Professor David Weller discuss potential screening options Ovarian cancer Ovarian cancer is relatively rare, with a low five-year survival rate of...

PulseClinical: Journal shortcuts recent papers on mental health.
April 5, 2007... GP Dr John Hague looks at interesting papers that have recently caught his eye Is telephone cognitive behavioural therapy as good as face-to-face CBT? THE PAPER Telephone administered cognitive behaviour therapy for treatment of...

PulseClinical: Management of dipstick haematuria.(Disease/Disorder overview)
April 5, 2007... How should GPs identify and manage dispstick haematuria? Dr Jon Rees, a GPSI in urology, distils the lastest guidelines KEY POINTS * There is no need to confirm dipstick haematuria with microscopy * Routine screening for dipstick...

Geoff Tipper's Registrar diary: Smile for the video nasty.
April 5, 2007... Dr Geoff Tipper, our new registrar diarist, will be sharing the highs and lows of life as a trainee GP through his regular dispatches. This week he launches with a look at the bane of the registrar's life - the video. The camera slowly...

PulseRegistrar: nMRCGP hot topics hepatitis C.(Disease/Disorder overview)
April 5, 2007... Dr Priya Joshi gives a round-up of the latest thinking on another key nMRCGP subject What is hepatitis C? The hepatitis C virus (HCV) is a blood-borne RNA virus that causes liver disease. There are both acute and chronic forms. The...

PulseRegistrar: Your first...home delivery.
April 5, 2007... Home deliveries have better outcomes than hospital births and are a low- risk option for women with uncomplicated pregnancies, advises Dr Stefan Cembrowicz Home deliveries comprise a small minority of obstetric care; rates range from 0.3...

PulseRegistrar: Clinical casebook - Endometriosis.(Clinical report)
April 5, 2007... A teenager's complaint of chronic pelvic pain could point to this diagnosis - Dr Melanie Wynne-Jones discusses CASE HISTORY Lucy is 19 and has consulted several times about lower abdominal/pelvic pains and dyspareunia. Urine testing is...

PulseCareers: On the job - life as a prison doctor.
April 5, 2007... Working in a prison is an immensely challenging and rewarding job that gives you the opportunity to learn a vast array of clinical skills very quickly, writes Dr Redmond Walsh Why work in a prison? Prison healthcare has a negative...

PulseCareers: CareerCoach - Having the perfect interview.
April 5, 2007... Visit the surgery before your interview to suss out the staff, dress code and whether you'd actually want to work there, advises Dr Peter Graves. Every contact you make with the practice is part of the two-way assessment. At the very...

PulseComment: It's time for action over pay freeze.(General Practitioner Committee )(Brief article)
April 5, 2007... When the GPC called its emergency summit on the pay debacle last week, it seemed to be an acknowledgement that the committee had initially underestimated the degree of anger among GPs on the ground. GPs are angry not so much at the pay...

Last word: Dr Adam Pringle.
April 5, 2007... Dr Adam Pringle... on erupting, tractors and bureaucracy The best thing about my practice is the people. The worst thing about my practice is the paper. My greatest fear is being a patient. If I was Health Secretary I would...

GPs face evening work to keep MPIG.(maximum practice income guaranteed )
April 12, 2007... New health minister reveals plan to use MPIG cash as incentive to offer flexible opening hours EXCLUSIVE By Helen Crump GPs may have to open up surgeries in the evening or at weekends to preserve their current income, Pulse can reveal....

Long hours `impossible' for parents.(Brief article)
April 12, 2007... Plans to link GP pay to extended opening hours would cause problems for those juggling work and family commitments, GPs have warned. `I would be very much against it,' said Dr Claire Bailey, a locum GP in Devon. `There's no provision,...

GPC under fire for `toothless' action.(Brief article)
April 12, 2007... The GPC has come under fire from some grassroots GPs after it backed away from a formal protest over the zero per cent pay award, writes Steve Nowottny. GPC guidance published last week suggested a range of measures GPs could take to...

Over half of trusts cutting GP cover on out-of-hours shifts.
April 12, 2007... Pulse investigation finds PCTs are cutting GP numbers by up to 50 per cent Exclusive By Christian Duffin and Joanna Clarke-Jones PCTs are cutting the number of GPs covering out-of-hours shifts by up to 50 per cent and replacing them...

GP views of OOH cuts.(out of hours )(Brief article)
April 12, 2007... West Hampshire PCT has reduced the number of GP visiting sessions from four to three. Dr Stephen Linton, a GP in Farnborough, said: `In terms of the overall costs, nurses work more slowly and admit more patients. `If you run a service...

Fresh doubt over chlamydia screening.(Brief article)
April 12, 2007... The national chlamydia screening programme is not underpinned by sound clinical evidence, a leading public health expert has claimed. Dr Nicola Low, a member of the Government-funded Chlamydia Screening Studies evaluation group, warned...

Two-thirds of GPs see services cut.
April 12, 2007... Two-thirds of GPs have seen local services cut back over the past year as NHS deficits bite deep, a Pulse investigation reveals. Maternity services and district nursing are among the hardest hit, writes Daniel Cressey. The analysis of...

Researchers demand statins data.(Brief article)
April 12, 2007... Researchers are demanding the release of data from a meta-analysis of statin use amid claims the drugs are causing `serious unrecognised harm'. A research team at the University of British Colombia in Canada warned statins may adversely...

Maternity cuts hit Hewitt's pledge on birthing choice.(Patricia Hewitt)(Brief article)
April 12, 2007... A Government pledge to provide expectant mothers with `a full range of birthing choices' has provoked uproar after reports emerged of swingeing cuts in maternity services. Pulse has discovered cash-strapped trusts across the country are...

InBrief: Ban on dating ex-patients.(Brief article)
April 12, 2007... New regulations are likely to propose a ban on health professionals dating or having sexual relationships with former patients, unless patient-professional contact has been minimal. The regulations, drafted by the Council for Healthcare...

InBrief: No flu vaccine guarantees.(Brief article)
April 12, 2007... The Government has warned GPs not to assume there will be contingency stock of flu vaccines this year. A letter from the Chief Medical Officer also suggests PCTs offer local enhanced services to vaccinate patients with chronic liver...

InBrief: Graduate entrant choices.(Brief article)
April 12, 2007... Graduate entrants to medical school are only marginally more likely to opt for a career in general practice than non-graduates, but less likely to choose surgery or paediatrics, a survey by researchers at the University of Oxford reveals. ...

InBrief: QMAS causes QOF chaos.(quality management and analysis system )(Brief article)
April 12, 2007... Technical difficulties with the QMAS system created problems for many GPs trying to agree their end-of-year final QOF achievement report on 2 April. A spokesperson for Connecting for Health said the matter had been investigated and by 3 April...

InBrief: Patient choice `supersite'.(Brief article)
April 12, 2007... Health Secretary Patricia Hewitt has pushed ahead with the next step of the Government's choice agenda. This week she promised that a `new flagship super website' would allow patients to book hospital appointments from their local library, in...

InBrief: Appointment reminders.(Brief article)
April 12, 2007... GPs are being urged to include up-to-date telephone numbers for patients on all referral letters so patients can receive routine outpatient appointment reminders. Researchers in London found patients who were called between 9am and 5pm in...

InBrief: Drug distribution probe.(Brief article)
April 12, 2007... The Office of Fair Trading is to look into the introduction of the `direct to pharmacy' distribution models and the likely impact of exclusive distribution agreements, where a single distributor is appointed. The investigation follows...

Steroids are `overused and risky' in COPD.(chronic obstructive lung disease)
April 12, 2007... Inhaled steroids raise risk of pneumonia by 70 per cent, study reveals By Daniel Cressey Patients with COPD who use inhaled steroids are at substantially increased risk of dying from pneumonia, a large-scale analysis reveals. The...

Studies question steroid use.(Brief article)
April 12, 2007... February 2007 * TORCH study of 6,000 patients found inhaled steroids on their own had no effect on mortality in patients with COPD * Combination of salmeterol and fluticasone propionate reduced risk of dying 17.5 per cent, but not...

GMC to collect ethnicity data.(Brief article)
April 12, 2007... The GMC will collect ethnicity and other equalities data on all registered doctors by the end of the year so it can monitor whether certain groups of doctors are subject to more complaints. The move comes just weeks after Health Secretary...

Call for physio funding for back pain.(Brief article)
April 12, 2007... Physiotherapy is cost-effective for treating back pain but continues to face `horrendous' underinvestment, researchers warn. Their new study found a programme of physical therapy had a cost per quality-adjusted life-year of only #2,362,...

MediaWatch: `Depression triggers birth'.(Brief article)
April 12, 2007... The story Depression is causing thousands of mums to give birth dangerously early, warns The Sun. The source Dr Veronica O'Keane, head of perinatal psychiatry at the Institute of Psychiatry in London, told a conference that the hormone...

MediaWatch: `Name test for autism'.(Brief article)
April 12, 2007... The story Babies who do not respond to their name when they are one year old may be showing early signs of autism, reports the Daily Mail. The source Researchers at the University of California Davis in Sacramento, US, tested children by...