Pulse articles from April 2008

Pulse archives from April 2008

Most GPs face third successive pay freeze.
April 9, 2008... 0% on MPIG means nine practices in 10 will miss out on global sum rise By Steve Nowottny The vast majority of practices will see their income frozen for a third successive year under the official Government pay award. The...

2008 GP pay award.
April 9, 2008... * Average increase of just 0.2% in practice funding - global sum increased by 2.7%, but no increase in MPIG funding * Most practices see no increase in funding - only practices with a global sum above or close to their MPIG benefit *...

Call to give OOH care back to GPs.
April 9, 2008... GPs would be given back responsibility for out-of-hours care, under proposals released this week by the NHS Alliance. The alliance, which represents PCTs, GPs and patients in primary care, said current out-of-hours care was `madness', with...

NICE in U-turn over advice on bisphosphonates.
April 9, 2008... NICE has backed down over its controversial decision to recommend alendronate as the sole option for secondary prevention of fractures in post-menopausal women. In a draft appraisal released last week, NICE recommends risedronate and...

Concern over GP diagnosis of Parkinson's.
April 9, 2008... One patient in five with Parkinson's disease is not referred by their GP for a specialist diagnosis, according to a new survey. The Parkinson's Disease Society found the number of patients diagnosed by GPs had reduced by 40%, compared with...

GP2GP record transfers top the 100,000 mark.(General Practitioners)(Report)(Brief article)
April 9, 2008... More than 100,000 electronic health records have been transferred using the GP2GP system, Connecting for Health has announced. It claimed the landmark meant many practices were not `flying blind' when treating new patients while they waited...

Care record pilot hit by GP pull-outs, chaos and delays.
April 9, 2008... Connecting for Health admits rollout is behind schedule amid fresh fears over patient confidentiality EXCLUSIVE By Steve Nowottny The rollout of the Summary Care Record has been hit by massive delays and fresh controversy over...

Pharmacists to take on GP work.
April 9, 2008... GPs have urged caution over Government plans to extend the role of pharmacists, despite claims they will free up time in general practice. Pharmacists will have a greater role in treating minor ailments, monitoring and prescribing for...

GPs resigned to the end of the NHS within a decade.
April 9, 2008... EXCLUSIVE By Lilian Anekwe GPs are resigned to the end of the NHS within a decade, with many reluctantly prepared to work directly for the private sector, a Pulse survey reveals. The poll of more than 500 GPs reveals the dramatic...

Save Our Surgeries: GPs cry foul over polyclinic threat.
April 9, 2008... Polyclinic plans threaten viability of local practices as GPs rush to support Pulse's Save Our Surgeries campaign By Steve Nowottny PCTs across the country plan to set up polyclinics in areas with no shortage of capacity in a way that...

Save Our Surgeries: Latest flashpoints in battle over polyclinics.
April 9, 2008... Sunderland: Plan for one polyclinic and three `underdoctored' surgeries opposed by LMC, which fears they will be run by private companies Scarborough: Local GPs have written to MP over fears existing practices will have to compete with a...

Save Our Surgeries: Pulse campaign wins major support.
April 9, 2008... The Family Doctor Association has thrown its weight behind Pulse's Save Our Surgeries campaign as opposition builds to the polyclinic rollout. More than 200 GPs have now signed up to the campaign via the Pulse website, with more than 180...

Save Our Surgeries: GPs team up to bid for new polyclinics.
April 9, 2008... GP practices across the country are teaming up to bid for the new breed of polyclinics, in a bid to stop private companies dominating the future face of general practice. Pulse understands hundreds of practices across the country are...

GPs line up behind Pulse's campaign.
April 9, 2008... Dr Paul Rankin, Woking, Surrey `I support this campaign completely. This Government is hellbent on destroying primary care. It is forcibly introducing unpiloted models and imposing a London solution on the broader population.' Dr Karen...

Row blows up over CVD screening.
April 9, 2008... The BMA says systematic screening will swamp GPs, as the heart tsar admits it will double the statins bill By Nigel Praities The Government's plans to screen for cardiovascular disease in general practice from next year have sparked a...

Welsh Assembly set to abolish internal market.(Brief article)
April 9, 2008... Welsh ministers have signalled a bold break with England over health policy, by proposing to scrap the NHS internal market. The Welsh Assembly Government is consulting on plans to remove local health boards' role in commissioning hospital...

BMA prepares PR campaign.
April 9, 2008... GP leaders set to open multimillion-pound war chest in campaign to win patients' hearts and minds By Lilian Anekwe The BMA is considering using a 100-year-old fighting fund to launch a major PR campaign against anti-GP Government spin,...

How to win the PR war.
April 9, 2008... * Make the most of the perception that the BMA is David versus the Government Goliath * Emphasise GPs are fighting to protect their one-to-one patient relationship by having more time to do their job properly * Call it the `One Voice'...

IN BRIEF: Care budgets criticised.
April 9, 2008... The BMA has attacked the Government's plans to give patients with long- term conditions individual care budgets in an attempt to increase choice as part of the NHS Next Stage Review. Dr Laurence Buckman, GPC chair, said: `Devolving funding...

IN BRIEF: CBI talks tough on GPs.
April 9, 2008... Business chiefs say reforms to GP contracts should not stop at extending GP working hours. Dr Neil Bentley, director of public services for the Confederation of British Industry, said last week that `contracts for life' should be removed if GPs...

IN BRIEF: All GPs face regulation.
April 9, 2008... All GPs should come under the power of the planned new regulator but dentists should be excluded, the Healthcare Commission proposes. The commission, which will be replaced by the Care Quality Commission, says it would not be `realistic or...

IN BRIEF: Shock over GP's death.
April 9, 2008... Colleagues have described their shock at the death of a GP in a motorbike accident in Florida last week. Dr Kathy Phipps, a GP at Woodgrove Surgery in Wath-Upon-Dearne, South Yorkshire, and her husband, Dr Walter Rhoden, a heart specialist at...

Civil standard set to be applied retrospectively.
April 9, 2008... GMC comes under fire after opting to apply new rule to backlog of cases By Steve Nowottny The GMC plans to retrospectively apply the new civil standard of proof to outstanding fitness-to-practise cases, in a move that has prompted...

How the switch will work.
April 9, 2008... * Criminal standard of proof Fitness-to-practise panels and GMC investigations with hearings up to 30 May * Civil standard of proof Fitness-to-practise panels and GMC investigations with hearings beginning from 31 May - even if...

GPs face more CKD work for no pay.
April 9, 2008... GPs will have to do extra work for no extra money under changes to the chronic kidney disease domain of the 2008/9 QOF. Under changes revealed by the GPC, GPs must test all patients with CKD for proteinuria, as part of the process of...

Transport delays cause blood test errors.
April 9, 2008... GPs may be faced with huge numbers of inaccurate blood test results as samples are transported longer distances to centralised pathology services, researchers are warning. A four-year audit of GP-requested potassium tests found as many as...

Media Watch: This week's top... Miracle cure.
April 9, 2008... Ancient Chinese martial arts could help patients create a Zen-like control over mind, body and... blood sugar, says the Daily Mirror. According to a study by Taiwanese researchers, after a 12-week programme of Tai Chi, those with type 2...

Media Watch: This week's top... Scare story.
April 9, 2008... A sausage a day won't keep the doctor away, claim the Daily Mail and the Mirror this week. In fact, in a blow to Britain's cultural answer to Tai Chi - the daily morning fry-up - an expert says eating one sausage or three rashers of bacon a day...

Media Watch: This week's top... most pointless research.
April 9, 2008... The next time you write a prescription for HRT, it might be helpful to tell your patient the evolutionary reasons behind `the change'. Research in the Proceedings of the National Academy of Sciences claims older women lost the ability to have...

BP drug benefits extend into 80s.
April 9, 2008... Study presented at American College of Cardiology conference `squashes' case for age caps in the QOF By Nigel Praities and Mark Pownell Treating patients for hypertension has significant benefits even in those over 80 years old, a...

Other key findings presented at the ACC conference.(Conference news)
April 9, 2008... * Drug company researchers have failed to show any benefit with angiotensin receptor blockers over ACE inhibitors, despite a five-year study in more than 25,600 hypertensive patients. The ONTARGET study found outcomes were slightly better with...

JournalWatch: Prasugrel offers benefits.(Brief article)
April 9, 2008... Antiplatelet agent prasugrel could offer improved outcomes in patients who have had at least one coronary stent, US researchers report. A comparison of the combination of thienopyridine, prasugrel and aspirin with clopidogrel plus aspirin...

JournalWatch: Diabetes risks match MI.
April 9, 2008... People with diabetes have the same high risk for a heart attack or stroke as people who've already had a heart attack, Danish researchers report. A population study of 3.3 million people aged 30 and older living in Denmark in 1997 found...

JournalWatch: Depression-dementia link.(Brief article)
April 9, 2008... People who have had depression are more likely to develop Alzheimer's disease than those who have not, Dutch research suggests. In a six-year follow-up of 486 people aged 60 to 90 who did not have dementia, 134 had had at least one episode...

JournalWatch: Rimonabant in spotlight.
April 9, 2008... Rimonabant has some benefits at reducing risk factors for heart disease in obese patients, but the overall picture is mixed, international research concludes. A randomised controlled trial comparing rimonabant with placebo in 839 patients...

JournalWatch: Child pneumonia warning.
April 9, 2008... Children admitted to hospital with community-acquired pneumonia have continuing respiratory problems and must be followed up more closely, a UK study suggests. Researchers followed up 103 young patients, aged five years on average, who...

Doubts on antipsychotic use.
April 9, 2008... Antipsychotic treatment has no cognitive or neuropsychiatric benefits for patients with Alzheimer's disease and should only be used as a `last resort', UK researchers conclude. Their trial of 165 patients taking neuroleptic drugs found no...

Focus on: The lure of private firms.
April 9, 2008... As more GPs sign up with private partners to safeguard their careers, we examine the offers on the table By Gareth Iacobucci Where exactly do GPs fit within the complex world of the NHS? Are GPs at the heart of a nationalised health...

March of the private sector: What's on the table:.
April 9, 2008... CIRCLE * Currently largest partnership of doctors in UK. Says services could include telehealth, enhanced diabetes services, urological services, day-case surgery, endoscopy, community-based ENT or ophthalmic services. * GPs continue...

Debate: Should it be a GP's job to issue well notes?
April 9, 2008... YES A well note system would streamline sickness certification and make life easier for GPs, patients and employers, argues Professor Sayeed Khan The sick note is on its last legs. We know GPs don't like sickness certification and...

Letter: I just don't understand how polyclinic figures add up.(Letter to the editor)
April 9, 2008... From Dr Ron White Peacehaven, East Sussex I understand that PCTs, often against their better judgment, are being forced to each set up a polyclinic for 6,000 registered patients including a walk-in centre. They will operate from 8am to...

Letter: Don't just complain, do something.(Letter to the editor)
April 9, 2008... From Spleen Name and address supplied I wish to thank all those who responded to my Speaker's Corner piece calling for GPs to form an alternative union to champion our cause. I would urge anyone who wants to take control of their own...

Letter: It's time for GPs to put up or shut up.(Letter to the editor)
April 9, 2008... From Dr Minesh Patel East Grinstead, West Sussex Your pages seem to be full of the same cliche-ridden letters. We have GPs who are against extended hours, and argue that polyclinics lack any evidence of need or cost benefit; we have...

Letter: Pay analysis was relevant and unbiased.(Letter to the editor)
April 9, 2008... From Tim Straughan Chief executive, The NHS Information Centre Your article on the GP pay figures quotes a doctor as claiming our analysis was part of a `wilful agenda' against general practice (`GPs condemn analysis showing pay has...

Letter: Sickness does not respect the clock.(Letter to the editor)
April 9, 2008... From Dr J Findlater Silverdale, Lancashire Though I retired from general practice many years ago, I have always been very proud of most GPs in this country. Consequently I have been aghast at the ugly confrontation involving some GPs - and...

Letter: Irresponsible attitude to out-of-hours.(Letter to the editor)
April 9, 2008... From Dr Andy Lindop, Derby I completely disagree with Professor Roger Jones on out-of-hours care and object to his ill-considered use of the words `avarice' and `idleness' when he talks about fellow members of his profession (`Was...

60-second interview: Dr Simon Parkinson.
April 9, 2008... Dr Simon Parkinson, secretary of Worcestershire LMC and a GP in Redditch, this week delivered a petition signed by more than 4,000 patients and practice staff objecting to Government plans for polyclinics and other changes to general practice....

Editorial: Battles still to be won on APMS.(Editorial)
April 9, 2008... Pulse this week publishes a special report, `March of the private sector' - and a march it truly is. Already a quarter of GPs have been approached by private firms with offers to sign up, according to our survey, and the number of PCTs...

PulseSpecial report: MARCH OF THE PRIVATE SECTOR.(Survey)
April 9, 2008... Pulse examines the threats and opportunities arising from private provision of primary care It's little less than a revolution in primary care. Private firms are bidding to run GP surgeries, open state-of-the-art polyclinics and walk- in...

CAN PRIMARY CARE BENEFIT FROM PRIVATE SECTOR INVOLVEMENT?
April 9, 2008... Emma Wilkinson looks at the evidence for claims private involvement will raise NHS standards The NHS and the private sector is one of those volatile combinations on which everyone seems to have a view. On one hand, campaigners take to the...

PulseSpecial report: CASE STUDY - How a GP-led apms scheme can work.
April 9, 2008... Dr James Heath says when his company Aston Healthcare took over one practice in South Knowsley, Liverpool, four years ago, it was in a dire state. `It was a singlehanded practice in a converted council house. It had a list size of 1,600...

March of the private sector: HOW I BEAT A PRIVATE FIRM IN APMS BID.(Interview)
April 9, 2008... Dr Thomas Reichhelm is one of the few GPs to have taken on the private sector in an APMS bid - and won. Here he explains how he did it The doors to primary care have been flung open wide in recent years, with private providers welcomed to...

EXPERT PANEL - PLAYING THE PRIVATE SECTOR GAME.
April 9, 2008... INVOLVE PATIENTS TO HOLD PRIVATE SECTOR AT BAY GPs need to sharpen up their act and involve patients in their care if they are to fend off competition from the private sector. That's the view of Dr James Kingsland Like it or not,...

THE BEGINNING OF THE END?
April 9, 2008... Are NHS reforms a one-off injection of competition or the first step to a US-style system? Gareth Iacobucci asks experts to look into their crystal balls `We predicted it would happen, and it is going to mirror all the excesses and worst...

How healthcare systems work in the UK, continental Europe and the US.
April 9, 2008... * The NHS: Provides healthcare to anyone normally resident in the UK with most services free at the point of use. * Social insurance: Favoured in continental Europe, in countries such as France. Funds are collected from individuals,...

PulseClinical: OSTEOARTHRITIS.
April 9, 2008... A team of experts led by Professor Elaine Hay and GP Dr Mark Porcheret answer GP Dr Pam Brown's questions on exercise, NSAIDs, joint injections and cox-2s Take-home points * NICE recommends topical NSAIDs before considering oral NSAIDs...

PulseClinical: TREATING LIPIDS TO TARGET.
April 9, 2008... Cardiology GPSI Dr Peter Savill gives tips on assessment tools, starting choices and non-statin lipid lowerers 1 Measure lipids in young patients with a strong family history of cardiovascular disease (CVD). Patients under 40 with a family...

PulseClinical: ORTHOPAEDIC PROBLEMS IN TODDLERS.
April 9, 2008... From knock-knees to pulled elbows, paediatrician Dr Benjamin Jacobs and orthopaedic surgeon Ms Deborah Eastwood advise on some common paediatric conditions Delayed walking Most children start to walk with assistance - for example, with...

PulseClinical: MULTIPLE SKIN LESIONS.(Clinical report)
April 9, 2008... Could the bumps be multiple lipomas or is there a genetic cause? Dr Mike Wyndham shares another unusual diagnosis The patient This 28-year-old man greeted me, saying: `I know how you like skin diseases, doctor. This'll interest you.'...

PulseClinical: DO DIETARY EXCLUSIONS WORK IN ATOPIC ECZEMA?
April 9, 2008... Diets excluding foods such as egg and milk are claimed to ease eczema symptoms - this Cochrane review looks at the evidence Atopic eczema is a non-infective chronic inflammatory skin disease characterised by an itchy red rash. In the...

PulseWorking Life: HOW THE BUDGET WILL AFFECT GPS.
April 9, 2008... Practice finance Accountant Ian Tongue looks at the parts of the recent Budget that have particular relevanceto general practice In Alistair Darling's first Budget, many of the proposals from the pre- Budget report were confirmed....

Nonprincipal'sdiary: Dr Ruth Chapman.
April 9, 2008... To be honest, I am not usually the most politically active person. At medical school I was one of the founding members of a green action group - which I have to admit saw very little action apart from a lot of beer drinking, navel contemplating...

AVOIDING RISK OF DISCRIMINATION ACCUSATION.
April 9, 2008... Barristers Michael Salter and Chris Bryden advise on another tricky practice problem THE SITUATION I am aware that I am not allowed to discriminate against certain people, but what does `discriminate' mean? THE ADVICE ...

PulseWorking Life: WHY I WORK AS... A MOUNTAIN RESCUE DOCTOR.
April 9, 2008... Dr Ellerton's team performs a rescue operation On a snowy February day, my wife and I finished a climb on Helvellyn in the Lake District. We were walking down the valley in the fading light thinking of tea and cake when two vehicles came up...

PulseServices: Make the most of new ISA schemes.
April 9, 2008... Don't let a lack of understanding over changes to ISAs make you miss out this financial year, says Stuart Smith When the individual savings account (ISA) was launched in 1999, it was to have an initial shelf life of 10 years, although the...

I'm just not having it.
April 9, 2008... It's Phil's practice and he'll do what he wants to, as a patient seeking homeopathy discovers `You're running very late, Dr Peverley. I've been sitting in that waiting room for half an hour!' I bridled. While it's perfectly true that...

New fears surround out-of-hours care.
April 16, 2008... GPs told to curb home visits and referrals amid fears financial pressures may compromise care EXCLUSIVE By Gareth Iacobucci and Rob Finch GPs working for out-of-hours providers are being placed under pressure to reduce their home...

How out-of-hours providers are managing GP performance.
April 16, 2008... On Call Care GPs performance-managed on triage outcomes, length of telephone calls, referrals to 999 and admissions Seldoc Monitoring number of telephone and face-to-face consultations, and length of calls Harmoni Has...

Patients value personal touch over access.(Brief article)
April 16, 2008... Patients value the quality of their relationship with their GP more than accessibility of appointments, according to new research. The study by the King's Fund found that confidence and trust in a GP was the most important factor in...

More GPs are commissioning services.
April 16, 2008... The number of GPs commissioning services under practice-based commissioning has risen but practices are still being plagued by lack of reliable data, according to a new report. The third wave of a rolling Department of Health survey into...

PCTs flout guidelines on elderly care.
April 16, 2008... Thousands of older people who need care because of chronic illness are being neglected by the NHS, despite the introduction of Government guidelines to make access fairer. Figures obtained by the charity Age Concern show `black-spots'...

Empyema cases show dramatic increase.(Conference news)
April 16, 2008... Cases of a bacterial strain not covered by the pneumococcal vaccine are on the rise, researchers are warning. The number of infections caused by Streptococcus pneumoniae seroptype 1 has risen dramatically, according to research presented...

PCTs sidestep consultation process in rush to polyclinics.
April 16, 2008... LMCs warn of `fait accompli' as PCTs give GPs and patients no say on polyclinic locations EXCLUSIVE By Steve Nowottny PCTs are under such pressure to force through plans for polyclinics that they are sidestepping the normal processes...

Polyclinics protests.
April 16, 2008... Coventry More than 100 GPs and patients hold town meeting, warning new GP-led health centres could `destabilise' existing services York LMC leaders write to health secretary hitting out over `one-size-fits- all' plans for...

BMA and patient group join campaign.
April 16, 2008... The BMA and the Patients Association have both lined up to support Pulse's Save Our Surgeries campaign, as pressure mounts on the Government to rethink its polyclinic plans. The pledges of support from the official doctor and patient bodies...

Pulse campaign continues to build support.
April 16, 2008... SOS Save our Surgeries Dr Richard Poole, Holbrook, Suffolk Many local villages have already lost banks, post offices and shops in the name of progress. This misguided policy will inevitably result in the closure of GP surgeries. It is...

March on Number 10 urged.
April 16, 2008... GPs are being urged to stage a march on Downing Street immediately after the LMCs conference in June, to protest against the Government's plan for general practice. An LMC motion, drawn up by a senior BMA and GPC council member and gaining...

GPs face 8% profit crash in 3 years.
April 16, 2008... Accountants warn latest pay award means it could be a decade before most practices see a rise in income EXCLUSIVE By Emma Wilkinson GPs will see profits tumble for a third successive year after most had their income frozen yet again by...

Why it's a freeze for most GPs.
April 16, 2008... * Previously the MPIG floated on top of the global sum, so any increase in global sum funding would not affect the additional correction factor payments. * This year the DDRB recommended, under changes to the GMS contract made in 2006/7,...

Slump in registrar numbers predicted.
April 16, 2008... General practice faces a manpower crisis with the number of future registrars set to slump following cuts to their pay, the BMA is warning. Supplements paid to GP registrars are to fall from 55% to 50% of basic salary for those entering...

Huge delay for care record evaluation.
April 16, 2008... The Summary Care Record will remain under review for at least two years in a move which casts a shadow over the future of the programme, Pulse can reveal. University College London had been expected to produce its final evaluation next...

Glitazones `not worth the money'.
April 16, 2008... Review finds glitazones no better than cheaper oral drugs, as prescribing committee issues warning to GPs By Lilian Anekwe Glitazones are no better than older, cheaper oral antidiabetic drugs, and are not worth the huge NHS expenditure...

Warning to GPs over cox-2 risks.
April 16, 2008... The risks posed by cox-2 inhibitors outweigh their benefits for many patients in clinical practice, research by the drug regulator reveals. More than 90,000 patients remain on cox-2s in the UK, latest figures from CSD Patient Data show,...

Plan for primary care consultants.
April 16, 2008... Proposals submitted to Darzi review for faster access to specialists draw criticism for being too costly By Nigel Praities A new grade of consultant should be created in primary care to provide faster access to specialist care, mentor...