Pulse articles from April 2009

Pulse archives from April 2009

Regulator plans risk profile for every GP.
April 1, 2009... Care Quality Commission to use new scoring system to spot poor or dangerous practices Exclusive By Gareth Iacobucci The Government's new health and social care regulator is to draw up a risk profile for every practice to allow it...

How the CQC will monitor GPs.
April 1, 2009... * Registration requirements include assessing and monitoring quality of provision, infection control, complaints processes, safety of premises and co-operating with other providers * Information will be gleaned from QOF data, practice...

Salaried GPs `must not be cannon fodder'.
April 1, 2009... Partners are exploiting salaried GPs and putting the independence of the whole profession at risk, according to LMC leaders. Two motions passed at the Welsh LMCs conference in Swansea last weekend called for more partnership opportunities...

DH attacked for patient survey data breach.
April 1, 2009... GPs have attacked the Department of Health for allowing confidential patient information to be transferred from practices to Ipsos MORI as part of the patient survey. GPs at the Northern Ireland LMCs conference expressed concern that...

GPC seeks GPs' views on how to improve care.
April 1, 2009... The GPC has launched a consultation inviting comments from GPs, patients and patient groups on good practice in primary care, in order to build a dossier to `inform discussions with UK governments'. `Once practices have consulted patients,...

NHS bosses plot to prevent PMS GPs getting GMS uplift.
April 1, 2009... PCTs told not to pass on any pay rise to PMS practices unless GPs do extra work to demonstrate value for money Exclusive By Lilian Anekwe NHS managers have drawn up behind-the-scenes plans to stop PMS GPs from getting any pay...

Guidance to PCTs on how to handle PMS negotiations.
April 1, 2009... * Put a positive spin on this to counteract negative messages * There is a risk patients at some practices will be targeted by their GPs with adverse `noise', such as `our funding has been cut, so we have to sack our nurse or stop this...

Pharmacy schemes do not cut GP workload.
April 1, 2009... Schemes encouraging patients to self-care or consult a pharmacist for minor ailments do not ease GP workload, and may even increase it, an evaluation of pilot programmes concludes. The study blows a large hole in Department of Health claims...

LMCs condemn GPC over QOF changes.
April 1, 2009... LMC leaders have condemned the GPC's decision to agree changes to the QOF prevalence formula, which they say have left some practices facing financial ruin. GPs at the Northern Ireland LMCs conference passed a motion attacking the...

CARDIOLOGY CONFERENCE: Five-in-one pill for CVD prevention.(Conference news)
April 1, 2009... Researchers say new polypill could cut the risk of heart disease by a third and stroke by a quarter By Lilian Anekwe A polypill combining five different cardiovascular drugs can act as a potent agent for primary prevention without...

CARDIOLOGY CONFERENCE: Key figures.
April 1, 2009... * The Polycap reduced systolic blood pressure by 7.4mmHg and diastolic blood pressure by 5.6mmHg compared with patients not receiving any antihypertensives * A combination of three antihypertensives lowered systolic blood pressure by...

CARDIOLOGY CONFERENCE: Inflammatory marker predicts statin benefits.(Conference news)
April 1, 2009... Reductions in the inflammatory marker high-sensitivity C-reactive protein predict the benefits of a statin at least as well as falls in cholesterol level, new research reveals. The study may alter perceptions of how statins work and could...

`Report PCTs' over appraisals.
April 1, 2009... The RCGP has told GPs they must report primary care organisations that are not carrying out appraisals to ensure their safe passage to revalidation. Professor Steve Field, chair of the college, warned GPs would be required to do five full...

LMCs set up bidding company.(London Medical Council)(Brief article)
April 1, 2009... The country's largest group of LMCs aims to help GPs to take on the private sector by setting up a new company to provide back-office support for contract bids. Londonwide LMCs, which represents more than 6,000 GPs across the capital, is...

NHS cuts beds by 10% as work moves to GPs.
April 1, 2009... Hospitals reducing capacity as patients are discharged earlier, figures reveal By Nigel Praities NHS hospitals have cut acute beds by 10% in just three years as managers pile pressure on GPs to manage complex cases in the community,...

No cost saving with alternative therapy.
April 1, 2009... Complementary therapies can improve quality of life but there is little evidence they reduce NHS costs, research concludes. The first study to review all the evaluations of NHS complementary therapy services showed positive changes in the...

Number of GPs with PBC budgets falls.
April 1, 2009... The number of GPs receiving an indicative commissioning budget from their PCT has fallen, official figures show. The Department of Health's quarterly practice-based commissioning survey reveals that 69% of practices are receiving...

MEDIA WATCH: THIS WEEK'S TOP... Scare story.
April 1, 2009... Drinking a steaming hot cup of tea fresh from the pot may be an age-old tradition but it could also send you to an early grave, the Times and Daily Mail report. A study of 900 people in Iran - where even more tea is consumed than in...

MEDIA WATCH: THIS WEEK'S TOP... Miracle cure.
April 1, 2009... Soothing music could restore the sight of patients left blind after a stroke, the Daily Mail claims. Three patients with visual neglect - a loss of ability to track objects in the visual field on the opposite side of the brain to that damaged...

MEDIA WATCH: THIS WEEK'S TOP... most pointless research.
April 1, 2009... A study of 140 children aged 11 to 15 found young children have a preference for sweets. The US study, published in the august, lofty journal Proceedings of the National Academy of Sciences, found a direct link between children's ages and their...

DH privately backed GP ratings website.
April 1, 2009... Patient rating of individual GPs enjoys Lord Darzi's `enthusiastic' support By Steve Nowottny A website allowing patients to rate individual doctors was set up with `enthusiastic' support from the Department of Health, Pulse can...

GPSIs in `turf war' with geneticists.
April 1, 2009... A report on the rollout of GP-led genetics services is expected to say that progress is being hampered by a `turf war' between specialists and GPSIs. Pilot GP-led genetics services were established in 2004, offering improved access to...

GPC member leads mass care record opt-out.
April 1, 2009... A senior GPC member is among rebel GPs opting out thousands of patients from the Summary Care Record over confidentiality fears, Pulse can reveal. A string of practices across the country have decided to conduct a blanket opt-out of all...

Opt-out Read codes.
April 1, 2009... * If a patient agrees to having a care record, patient is coded using the 93C2 Read code. * If a patient has concerns but is not sure, they can be advised that they can have a record set up but not share it with anyone until they decide...

PCTs to double patients registered with APMS contracts.
April 1, 2009... PCTs are planning to double use of APMS contracts in the next five years as part of a drive to standardise the list sizes of GPs, a review by NHS managers reveals. A `benchmarking' exercise in 80 PCTs found major variations in the list...

IN BRIEF: UK youth alcohol problem.
April 1, 2009... A European-wide poll has found that the UK has the third-highest proportion of 15- and 16-year-olds with an alcohol problem in Europe. British youths scored higher than average on four of the nine variables. Some 88% had consumed alcohol in...

IN BRIEF: Thyroid overtreatment.
April 1, 2009... Doctors are warning that patients are increasingly being inappropriately diagnosed and treated for underactivity of the thyroid. An editorial published in the BMJ by the British Thyroid Association argued that in recent years increasing...

IN BRIEF: Complaints data fears.
April 1, 2009... Government plans to hold sensitive information about GPs on a national database may undermine confidence in the profession, the Medical Protection Society has warned. It described as `deeply concerning' plans to collect and share so-...

Family doctor group backs federations.
April 1, 2009... The Family Doctor Association has backed a call from GP leaders to establish large-scale practice federations as a way of healing the salaried-partner divide. The support from the FDA - which used to be known as the Small Practice...

Three strikes and you are in at Darzi centre.
April 1, 2009... Patients to be automatically offered registration on third walk-in visit to GP-led health centre, prompting fears of `registering by stealth' By Steve Nowottny Patients who attend a GP-led health centre three times as walk-in cases...

Salaried GPs rise by 10%.
April 1, 2009... Government figures have revealed the full extent of the huge shift towards a salaried GP workforce, writes Gareth Iacobucci. Statistics from the Information Centre show that the number of salaried GPs increased by 10% in 2008 alone, to...

Warning over CVD drugs in over-80s.
April 1, 2009... Cardiovascular drugs have little benefit for patients aged over 80 who have diastolic heart failure, researchers are warning. Their five-year study found that although cardiovascular drugs were commonly used in the over-80s with diastolic...

JOURNAL WATCH: Grip strength link to BMD.
April 1, 2009... Grip strength could be used to identify postmenopausal women at risk of osteoporosis, a Finnish study has found. Researchers enrolled more than 600 older women and looked at a range of physical tests that could be used to identify those who...

JOURNAL WATCH: Two BP drugs better.
April 1, 2009... Adding another blood pressure drug is more effective than doubling the dose of monotherapy, concludes a US meta-analysis. The study looked at 42 trials with 10,968 participants and compared the effect of doubling the dose of one...

JOURNAL WATCH: Lipid-lowering benefit.
April 1, 2009... Intensive lipid-lowering reduces the progression of atherosclerosis, even in those who would not normally be considered for statin treatment. A randomised Dutch study looked at the effect of rosuvastatin 40mg on carotid intima-media...

JOURNAL WATCH: Erratic COPD drug use.
April 1, 2009... Patients with COPD tend to use medications erratically during their last year of life, according to US researchers. They identified 11,300 COPD patients from national records - all of whom had died between 1990 and 2003. Of those on...

15-week window to quit in pregnancy.
April 1, 2009... Pregnant women who quit smoking before 15 weeks' gestation dramatically reduce their risk of complications, a new study shows. Women who stopped before week 15 lowered their risk of having an underweight baby or going into spontaneous...

Domperidone 10mg under consultation to go OTC.(over the counter drugs)(Brief article)
April 1, 2009... The MHRA has launched a consultation on the reclassification of domperidone 10mg from a prescription-only medicine to one available over the counter. The reclassification would make domperidone available for sale in pharmacies for the...

PULSE INTERVIEW: A woman with a mission to root out the mad and bad.
April 1, 2009... As the Care Quality Commission assumes power this week, we ask its chair about her plans for general practice By Gareth Iacobucci Mad, Bad and Dangerous to Know is the title of the recent auto- biography by polar explorer and ex-SAS...

EDITORIAL: DH dreamers refuse to let reality intrude.(Editorial)
April 1, 2009... The Department of Health has a dream - a grand vision for the NHS that has adorned countless Powerpoint presentations to thousands of managers and civil servants. Imagine a gigantic healthcare pyramid, with relatively small numbers of...

VOX POP: Should PMS GPs get the same pay uplift as GMS GPs?
April 1, 2009... Dr Johnny Marshall PMS GP in Wendover, Buckinghamshire `PMS contracts were designed to address local health needs. Where the expectations are the same as on GMS, the contract should be subject to the same uplift. But because PMS contracts...

LETTER: Only a cap on salaried GPs will save profession.(Letter to the editor)
April 1, 2009... From Dr Yealand Kalfayan GP partner, Bristol We need to be reminded that GPs in partnerships have not created this problem (`GP leaders plan overhaul of "unsustainable" general practice', pulsetoday.co.uk/ news). A few years ago there was...

LETTER: New generation must take over the baton.(Letter to the editor)
April 1, 2009... * From Dr KS Pandher GP partner, Kidlington, Oxfordshire I am disappointed that our LMC leaders, representing GPs old and new, have rejected calls for a wholly salaried profession, which would be a significant leap forward (`GPs split over...

LETTER: It's essential patients get SSRI choice.(Letter to the editor)
April 1, 2009... From Dr Chris Manning, UPstream Healthcare Ltd and former GP As someone who has had major depression successfully treated with an SSRI since 1990, I was encouraged to read the paper by Cipriani et al demonstrating variation in SSRIs...

LETTER: QOF losers will be few in fairer system overall.(Letter to the editor)
April 1, 2009... From Dr David Colin-Thome National director for primary care, Department of Health The BMA, based on its mandate from LMCs, agreed to move to a true prevalence weighting for the QOF by April 2011 (with the square root going from this...

LETTER: Still waiting on negotiations over quitting.(Letter to the editor)
April 1, 2009... From Dr Laurence Buckman, GPC chair In our statement responding to the Commons health committee report on health inequalities (`GPs face smoking quit rate targets', pulsetoday.co.uk/news), we said we agreed with the committee's...

LETTER: Co-proxamol ban not the main culprit.(Letter to the editor)
April 1, 2009... From Shirley Norton Deputy director, vigilance and risk management of medicines, Medicines and Healthcare Products Regulatory Agency The withdrawal of co-proxamol in the UK has saved approximately 300 lives per year and there is no evidence...

LETTER: Ministers just not interested in `my GP'.(Letter to the editor)
April 1, 2009... From Dr Thomas McAnea GP registrar, north London I agree with the sentiment of your recent article on continuity of care (`Why being "my GP" to a patient will secure our future', pulsetoday. co.uk/blogs). However, I believe the...

LETTER: Beating the Blues? Where is it then?(Letter to the editor)
April 1, 2009... From Nigel Brabbins Chief executive, Ultrasis Open letter to health secretary Alan Johnson Further to our previous correspondence on the availability of NICE- approved treatments for mental health, I applaud your recent announcement...

Are women being misled about pros and cons of breast screening?
April 1, 2009... In the second of our occasional series of short essays, Dr Margaret McCartney argues that women deserve better information about the risks as well as the benefits of breast screening - and questions whether the programme is cost-effective ...

PULSECLINICAL: Polycystic ovary syndrome.
April 1, 2009... Gynaecologist Miss Lisa Webber answers GP Dr Sabby Kant's questions on diagnosis, which cases to treat and which to refer and how best to induce ovulation 1 What are the diagnostic criteria for PCOS? How does one interpret the blood tests...

PULSECLINICAL: Ambulatory blood pressure monitoring.
April 1, 2009... Cardiology GPSI Dr Chris Arden on when to order an ABPM and what to consider if you decide to bring it in-house 1 Remember clinical endpoints are more closely correlated with ABPM readings than they are with those taken in the clinic ...

LABTEST UPDATE: Uric acid.
April 1, 2009... Chemical pathologist Dr Berenice Lopez uses a primary care case history to discuss the clinical implications of raised uric acid levels The case A 53-year-old man attends in a state of some anxiety. He has attended a private screening...

SNAPSHOT DIAGNOSIS: Burning, reddened face.(Case study)
April 1, 2009... Dr Mike Wyndham on how a patient left out the most crucial piece of diagnostic information The patient The 55-year-old patient coughed heavily as she sat down and said: `It's one thing after the other.' Ten days previously, she...

BUSINESS BRIEFING: Your guide to the QOF coding changes.(Quality and Outcomes Framework )
April 1, 2009... GPs must get to grips with recent QOF coding changes to earn maximum points - Dr Simon Clay advises on how to get your coding right The QOF currently accounts for a sizeable chunk of every practice's income and to maximise your QOF earnings...

Living on the front line.(Personal account)
April 1, 2009... Home visits are not normally Phil's cup of tea - but this one brought a smile to his face I have railed against home visiting in the past. It's not a good thing generally. Homes (patients' homes, not yours or mine obviously) are dusty,...

Pay deal will release thousands from MPIG.
April 8, 2009... Review body's 2.29% award broadly welcomed, but practices face starkly varying fortunes By Gareth Iacobucci Thousands of GPs will no longer be reliant on the MPIG after the Government accepted the pay review body's recommendation of a...

GMC council elects Catto's successor.(General Medical Council)(Graeme Catto)(Brief article)
April 8, 2009... Professor Peter Rubin has been elected as the next chair of the GMC council. He will take up office on 20 April 2009 and succeeds Sir Graeme Catto who has headed the GMC since February 2002. The new chair is professor of therapeutics and...

Fresh furore over care record opt-outs.
April 8, 2009... Patients who do not initially choose to opt out of the Summary Care Record will be unable to have their records subsequently deleted, it emerged this week - despite the claims of some of the first PCTs involved in the national rollout. ...

Scots antenatal care shifts to midwives.
April 8, 2009... The Scottish Government is planning to pass responsibility for antenatal care from GPs to midwives. Under the Keeping Childbirth Natural and Dynamic strategy, all pregnant women will from the end of this year have antenatal appointments...

CVD MANAGEMENT: Sphygmo errors throw doubt on hypertension diagnoses.
April 8, 2009... Up to a quarter of non-mercury sphygmomanometers in widespread use may be inaccurate, study finds Exclusive By Lilian Anekwe Serious errors in many of the sphygmomanometers routinely used in general practice could call into...

CVD MANAGEMENT: Committee guidance.(Brief article)
April 8, 2009... * While mercury sphygmomanometers continue to be used, appropriate health and safety procedures should be maintained including the availability of mercury spillage kits * Where [non-mercury] gauges are used for sphygmomanometry, their...

CVD MANAGEMENT: No need for LFTs with statin.
April 8, 2009... Routine monitoring of liver function in patients taking simvastatin 40mg is `not useful' as there is almost no risk of hepatitis, concludes a UK study. The analysis of five years of data from the Heart Protection Study failed to find any...

CVD MANAGEMENT: Clopidogrel-aspirin an option in AF.
April 8, 2009... Combined therapy with clopidogrel and aspirin can substantially reduce the risk of stroke in patients not suitable for warfarin, say researchers. A randomised trial in over 7,500 patients with atrial fibrillation and at least one risk...

CVD MANAGEMENT: Advice on liver function testing with statins.
April 8, 2009... BNF `There is little information available on a rational approach to liver-function monitoring; however, NICE guidelines say liver enzymes should be measured before treatment, and repeated within three months and at 12 months of starting...

Urgent OOH cases vary 30-fold.
April 8, 2009... Credibility of 20-minute `urgent' target in doubt as PCT analysis finds huge variation in those classed as eligible By Gareth Iacobucci The proportion of out-of-hours cases classified as in need of urgent attention varies by as much as...

Warning over non-NHS vascular screening.(United Kingdom. National Health Service)
April 8, 2009... Using non-NHS providers for vascular screening risks fragmenting the scheme and increasing health inequalities, warn Department of Health and NICE advisers. The claim came a week after the official launch of vascular screening and with...

GPs pushed into extended opening.
April 8, 2009... NHS managers are exploiting the axing of the QOF square root formula to force practices into taking on extended hours, GPs are claiming. In Milton Keynes - where all but one practice will lose under the QOF changes - GPs say the PCT is...

Darzi centre contracts in doubt as bidders rethink.(Brief article)
April 8, 2009... PCTs may be forced to retender some of the new wave of GP-led health centres and practices in underdoctored areas because private firms and GP-led consortiums will struggle to deliver on demanding APMS contracts, academics have warned. ...

Lead GP in QOF review has easy indicators in her sights.
April 8, 2009... QOF indicators with high achievement and low exception reporting will be first to go By Lilian Anekwe QOF indicators with high achievement and low exception reporting will be first to face the axe in the coming review, the GP appointed...

GPs leading the QOF review.
April 8, 2009... Professor Helen Lester, chair of external contractor for QOF review: Deputy director of the National Primary Care Research and Development Centre and former co-chair of the QOF indicator expert advisory panel. A GP in Birmingham since 1991. ...

Child UTI advice questioned.
April 8, 2009... NICE guidance on children's urinary tract infections may lead to incorrect diagnosis in as many as 40% of cases, a new study suggests. Diagnosing children without access to microscopy can lead to many being inappropriately treated and other...

IN BRIEF: CQC infection control call.
April 8, 2009... The Care Quality Commission has issued a warning to all 388 NHS trusts in England to remain vigilant on infection control, after its assessments found that although most met Government requirements for infection control, 21 - including six PCTs...

IN BRIEF: Epilepsy drug warning.
April 8, 2009... Epilepsy drugs may raise the risk of osteoporosis if taken for long periods, says the drugs regulator. The MHRA advised GPs to consider vitamin D supplements for patients on primidone, phenytoin, carbamazepine, phenobarbitol or sodium...

IN BRIEF: HPV tests cut cervical Ca.
April 8, 2009... Deaths from cervical cancer can be cut by half if women are tested for HPV, say Indian researchers in the latest New England Journal of Medicine. Their study used HPV testing in more than 131,700 women, investigating those positive for HPV...

Maternal antibiotics alert.
April 8, 2009... Pregnant women are too commonly being prescribed antibiotics by GPs, despite the potential for long-term effects on the health of the foetus, researchers are warning. The proportion of pregnancies in which antibiotics were prescribed fell...

GPs to run hospital wards under ICO plans.
April 8, 2009... Integrated care pilots will result in some GPs working directly for acute trusts By Nigel Praities GPs will run hospital wards or see their practices subsumed into acute trusts under a series of radical pilots of integrated care. ...

How pilots will aim to bring care together.(Brief article)
April 8, 2009... Principia, Nottingham: 16 practices will work with therapists, nurses and other health professionals to open community wards in hospital and improve discharge planning and community care of patients with COPD Northamptonshire Integrated...

Herpes zoster and cancer warning.
April 8, 2009... GPs should be aware patients diagnosed with herpes zoster may have an underlying undiagnosed cancer, researchers warn. A primary care study found the risk of having cancer diagnosed was more than twice as high for patients with herpes...

Inquest told of GP work pressure.
April 8, 2009... A GP whose death has stunned his practice was struggling to cope with the pressure of work, an inquest has been told. Dr Martin Webster, a partner at the New Springwells Practice, near Grantham, Lincolnshire, had been `in a low mood' before...

MEDIA WATCH: THIS WEEK'S TOP... Scare story.(Brief article)
April 8, 2009... As if the National Programme for IT wasn't enough of a threat to confidentiality, a study suggests it could infect patients with killer bugs too. Researchers from Queen Elizabeth Hospital in King's Lynn, Norfolk, looked at swipe cards...

MEDIA WATCH: THIS WEEK'S TOP... Miracle cure.
April 8, 2009... Deafness could be a thing of the past after scientists succeeded in growing ear cells in the lab, according to reports in the Mirror and Sun. The sensory hair cells, grown from stem cells, could be used to regenerate damaged tissue and...

MEDIA WATCH: THIS WEEK'S TOP... most pointless research.(Report)(Brief article)
April 8, 2009... Riding to the rescue of hard-pressed GPs everywhere, a study in BMC Family Practice has found a sign in the waiting room asking patients to turn off their phones results in a significant reduction in ring-tone interrupted consultations. ...

Warning on OTC antibiotics drive.
April 8, 2009... Researchers raise alarm over resistance as use of chloramphenicol jumps 48% since going over the counter By Lilian Anekwe Selling antibiotics over the counter leads to a huge increase in their use that should cast doubt on further...