Pulse articles from August 2004

Pulse archives from August 2004

Remote GP condemns OOH plans.(general practitioners)(out-of-hours plans)(Brief Article)
August 2, 2004... Dr Susan Bowie is `aghast' that plans for out-of-hours care in rural Scotland could risk patients' lives. Dr Bowie, a GP in Shetland, has warned proposals to reduce GP cover and use the ambulance service could have jeopardised her...

Staff sick leave to hit GPs' pockets.(general practitioners)
August 2, 2004... GPs face seeing their profits and pensions slashed if practice staff go on long-term sickness or maternity leave. The threat comes after primary care organisations issued a blanket ban on using discretionary funds to reimburse practices for...

GPs win #108m premises cash.(general practitioners)(Brief Article)
August 2, 2004... Ministers have bowed to GP pressure and announced a #108 million cash boost for practice premises. The decision, exclusively revealed by Pulse last month, comes after sustained criticism of the Department of Health for failing to invest in...

Meldrum tells GPs to boycott unpaid student MMR drive.(general practitioners)(Measles-mumps-rubella vaccines)
August 2, 2004... The GPC has told GPs to boycott Government recommendations to vaccinate 16- to 24-year-olds with MMR unless they are properly paid for the extra work. The instructions come as GPs face a surge in workload for MMR vaccination, with many...

Pilot aims to end sicknote burden.(sickness certification)(Brief Article)
August 2, 2004... Dr Tony Feltbower has welcomed a pilot project in his area aimed at taking the burden of sickness certification away from GPs. Seven firms, including vehicle manufacturers Peugeot Citroen and London Taxis International based near Dr...

NICE cancer referrals guide under attack.(National Institute for Clinical Excellence )(Brief Article)
August 2, 2004... New draft NICE guidance on urgent cancer referral proposes key changes to rules for cancers such as breast and skin, in response to widespread criticism of the original Department of Health advice. But the new guidance has already run into...

GPC refuses `essential' guide.(general practitioners councils)(Brief Article)
August 2, 2004... The GPC is to disregard a key LMC conference vote and will not issue `unequivocal guidance' on what constitutes essential GP services. Negotiators said defining GPs' core work was too subjective and policies varied massively between...

GPs fear quality visits will be turned into witch-hunts.(general practitioners)
August 2, 2004... Primary care organisations are planning to use visits to check GPs' quality framework performance into exhaustive investigations of practices. GPs warned some PCOs were talking as if the visits were `a witch-hunt' to root out poor...

Singlehanded GPs worry over future as pay gap grows.(general practitioners)(Brief Article)
August 2, 2004... Singlehanded GPs are questioning their future because of a widening pay gap with larger practices. Small practices claim the new contract is not only failing to deliver promised pay rises but has revealed massive income discrepancies. ...

GP hits out at plan over asylum seekers' care.(general practitioners)(Brief Article)
August 2, 2004... Dr Paul Williams has attacked the Government's proposed crackdown on care for failed asylum seekers as `unethical and unworkable'. Dr Williams, who works at a specialist PMS practice dealing with refugees in Stockton-on-Tees, said many refugees...

GPs `sexist over heart treatment'.(general practitoners gender biased treatment)
August 2, 2004... Sharp inequalities emerge in cardiovascular treatment with women and the less affluent missing out - by Rob Finch GPs are treating women less rigorously than men for cardiovascular disease and the gender gap may be widening, according to a...

Simvastatin finally goes on sale.(drug to treat Coronary Heart Disease on sale at the counters)(Brief Article)
August 2, 2004... Simvastatin 10mg finally went on sale in high street pharmacies last Thursday, after a snap announcement from manufacturer Johnson & Johnson. Around 7.4 million people at moderate risk of CHD will be eligible to buy the drug, according to...

Risks for less affluent underestimated too.(less affluent patients at higher health risks)(Brief Article)
August 2, 2004... Less affluent patients are missing out on preventive treatment for cardiovascular disease because assessment charts underestimate their risk, research concludes. The authors have suggested applying a `postcode factor' to the Framingham...

Will IT program be an improvement?(information technology services)(Brief Article)
August 2, 2004... The Government has failed to produce evidence that its IT modernisation program will have a positive impact on the NHS, according to an influential think-tank. A report from the Institute for Public Policy Research said better use of IT...

Topical NSAIDs only work short-term.(Nonsteroidal anti-inflammatory agents)(Brief Article)
August 2, 2004... Topical NSAIDs used to treat osteoarthritis are only effective as a very short-term treatment, a review of the available data shows. The evidence, taken from 13 randomised controlled trials, showed that in trials lasting up to four weeks...

Poor coding hits chronic disease care.(research report)(Brief Article)
August 2, 2004... Poor-quality morbidity coding in general practice may hamper efforts to improve the management of chronic disease, according to a new study. A systematic review of coding practices in primary care found the quality of recording varied for...

BMA condemns `scandal of STI failure'.(British Medical Association)(Brief Article)
August 2, 2004... BMA chair Mr James Johnson has criticised the Government's `scandalous' failure to tackle the epidemic of sexually transmitted infection, after new statistics revealed another sharp rise. The figures, released by the Health Protection...

Civil service purge may hit contract.(general practitioners councils)(Brief Article)
August 2, 2004... GPC negotiators are concerned the planned cull of civil service jobs could further disrupt new contract talks. Negotiators have already attributed `teething' troubles over implementation to job cuts at the Department of Health where many...

New GP guide on medical certificates.(General practitioners)(general practitioners councils)(Brief Article)
August 2, 2004... The GPC has released guidance on medical certificates and reports, with information on GPs' obligations under new contracts. It covers GMS and PMS GPs' statutory obligations, particularly in relation to certificates issued by the Department of...

GP recruits are opting for salaried or part-time posts.(General practitioners)
August 2, 2004... New GPs are shunning full-time principal positions in favour of salaried or part-time roles, Government figures reveal. Statistics released by the Department of Health showed a total headcount increase of 529 GPs in the first three months...

GP fights for more parking.(general practitioners)(Brief Article)
August 2, 2004... Dr Raja Dandapat is battling with his council after it allocated only two secure parking spaces to cover five GPs at his health centre. Dr Dandapat, a GP in west London, said the area was unsafe and GPs could spend half an hour looking for...

Poaching of nurses spreads.(nurses on demand for services)(Brief Article)
August 2, 2004... GPs are poaching practice nurses from other surgeries in a bid to achieve higher scores on the quality and outcomes framework. Newham LMC in Essex said a chronic shortage of nurses and lack of London weighting for the area made it easier...

`Square root' still a conundrum.(mathematical formula-square root for calculating payments)(Brief Article)
August 2, 2004... GPC negotiators have admitted they do not know whether the `square root' formula used to weight quality pay will result in a cut in total payments. Their comments follow claims by Dr Gavin Jamie, a GP in Swindon, that the formula used to...

Journal watch: Adding aspirin raises bleeding risk.(clopidogrel drug)(Brief Article)
August 2, 2004... Adding aspirin to clopidogrel for the secondary prevention of cardiovascular disease increases the risk of major bleeding without significantly reducing vascular events, a new study finds. The Europe-wide MATCH trial compared aspirin with...

Journal watch: Anaemia warning in GI cancer cases.(gastrointestinal cancer)(research report)(Brief Article)
August 2, 2004... GPs risk missing cases of gastrointestinal cancer because they do not adequately investigate iron deficiency anaemia, a new UK study finds. Researchers in Nottingham studied 431 patients, 43 per cent of whom had investigations within three...

Journal watch: Growth monitoring misses adrenal risk.(research report)(Brief Article)
August 2, 2004... Monitoring the growth of children who are taking steroids for asthma does not identify those at risk of serious adrenal suppression, according to a Northern Ireland study. Researchers studied 35 prepubertal children aged four to 10 who were...

Journal watch: Breast-feeding cuts BRCA1 cancers.(Brief Article)
August 2, 2004... The protective effect of breast-feeding extends to some hereditary forms of breast cancer but not others, a new study finds. US researchers conducted a case-control study of women with BRCA1 and BRCA2 mutations, surveying the past...

Journal watch: High mortality in south Asian diabetics.(Brief Article)
August 2, 2004... South Asians with diabetes have a significantly worse mortality than other ethnic groups, according to a new study. Researchers conducted a prospective cohort study of 828 south Asians and 27,962 non-south Asian patients with insulin-treated...

Journal watch: `Silent' strokes mar cognitive function.(research report)(Brief Article)
August 2, 2004... A significant proportion of elderly people suffer from `silent' strokes, which impair cognitive function but are never diagnosed, new research suggests. The community-based study in Germany screened 267 men and women aged 65- 83. Silent...

Nurses less effective than GPs at patients' reviews.(general practitioners)
August 2, 2004... Diabetes is under the spotlight with new research questioning nurse reviews and diet-only management, while the obesity threat grows - by Cato Pedder Nurses may be less effective than GPs at carrying out patient reviews, new research...

Obesity may stop GPs hitting diabetes targets.(geenral practitioners)(Brief Article)
August 2, 2004... Rising levels of obesity could make it impossible for GPs to hit national targets for managing diabetes, research suggests. Although monitoring and prescribing of oral anti-diabetic drugs has increased, glycaemic control has worsened since...

Diet-only treatment needs more vigour.(research report)(Brief Article)
August 2, 2004... Many patients whose type 2 diabetes is managed by diet alone need more vigorous control of their disease, a new study concludes. Almost a third of people with diabetes are managed only by diet, yet these patients are more likely to have...

Drug firms urge link-ups with PCOs.(primary care organizations)(Brief Article)
August 2, 2004... The primary care tsar has urged pharmaceutical companies and PCOs to win over GPs' `sceptical hearts and minds' with small-scale grassroots collaboration. Dr David Colin-Thome's advice came in new guidance aimed at persuading PCOs of the...

New pneumococcal vaccination backing.(government plans for child vaccination)
August 2, 2004... Introducing pneumococcal vaccination for all children would substantially cut mortality and morbidity from the disease, according to a 20-year UK surveillance study. The new data came as Government advisers indicated they were on the verge...

MMR febrile seizure risk small.(Measles, Mumps, Rubella vaccine)(Brief Article)
August 2, 2004... The risk of febrile seizures following MMR vaccination is very small and short-term, even in children at increased seizure risk, according to a Danish study of more than 530,000 patients. Researchers found the risk of seizures was 2.75...

Smear test changes supported.(testing to have medical benefits to the patients-research report)(Brief Article)
August 2, 2004... The recent increase in the frequency of cervical smears for women aged 25-48 will have `major benefits' and further reduce the incidence of cervical cancer, a new study shows. Use of HPV testing would also bring down the lifetime risk of...

Payment by Results threatens GP funds.(general practitioners)(Brief Article)
August 2, 2004... The new funding system for hospitals threatens to cut spending on primary care, a report by the public spending watchdog has concluded. The Audit Commission said community and mental health budgets were in danger because primary care trusts...

Lunch-hour BP checks net patients.(blood pressure)(physician signs up patients for services)(Brief Article)
August 2, 2004... Dr Brigid Hughes signed up four patients to her practice after she offered lunch-hour blood pressure checks at a local restaurant. The patients, who were not registered with a GP, will join a practice in Liverpool which is being run as a...

#500m for care in quangos cull.(government decides to close down many health facility units)(Brief Article)
August 2, 2004... The Government has promised to channel #500 million savings resulting from its decision to axe almost half of `arms length' NHS bodies back into patient care. Health Secretary John Reid made the pledge after announcing the number of bodies...

New complaints body takes over.(Healthcare Commission and it's new role)(Brief Article)
August 2, 2004... The Healthcare Commission has formally taken over the investigation of complaints against doctors that have not been resolved at local level. It insisted the new process would be `fairer, faster, more independent and more consistent'. The...

`Look for root cause in somatic disease'.(duties of general practitioners )(Brief Article)
August 2, 2004... It is GPs, not patients, who search for physical causes to psychological problems, Professor Christopher Dowrick believes. Professor Dowrick, a GP as well as professor of primary care at the University of Liverpool, rejects the general...

GP makes levy protest over joint PCO and LMC roles.(general practitioners)(primary care organizations)(local medical committees)(Brief Article)
August 2, 2004... A GP is refusing to pay his LMC levy in protest at the number of doctors who have dual roles on the committee and local primary care organisations. Dr Bill Spiegler said GPs had a `conflict of interest' if they combined work on a PCO...

Fears on `GP cash for pharmacists'.(general practitioners)(pharmacists on contract for chronic disease management and repeat prescribing)(Brief Article)
August 2, 2004... There will be a `national outcry' if the new contract for pharmacists is funded with money earmarked for enhanced services, GPs are warning. Pharmacists are in the final stages of negotiations with the Government on a contract that breaks...

Warning on use of warfarin in elderly.
August 2, 2004... Many elderly patients on warfarin should not be and are being put at unnecessary risk of a major haemorrhage, a new study suggests. Patients with atrial fibrillation are often receiving the drug from their GP despite having `relative...

ximelagatran studies.(Brief Article)
August 2, 2004... * NICE is to appraise the as-yet unlicensed drug ximelagatran for use in the treatment of stroke and venous thrombo-embolism. Early studies suggest ximelagatran is as effective and safe as warfarin, but does not need INR monitoring during...

Government criticises GPs over hip referrals.(Brief Article)
August 2, 2004... The Department of Health has criticised GPs for referring too many patients for hip replacements. In its response to an earlier report from the parliamentary committee of public accounts, the department called for `robust exchange of...

BMA backs ID cards.(British Medical Association )(Brief Article)
August 2, 2004... Doctors should be allowed to treat patients who are not eligible for free care and who do not fulfil the criteria for `immediately necessary' treatment, according to the BMA. In a response to Government plans to introduce an ID card system,...

Letter: Our negotiators should try again.(Letter to the Editor)
August 2, 2004... I wonder how many of my GP colleagues, while being strongly urged by our representatives to vote for the new contract, were made aware that this would result in all of our pay for non-core work effectively being reduced by 14 per cent. This is...

EDITORIAL COMMENT: Principals will always be vital.(Brief Article)(Editorial)
August 2, 2004... Why be a GP principal? This is the big question those entering the profession, and many doctors already in it, are asking. And their answer is increasingly that it's not the most attractive option around. Latest recruitment figures show an...

Letter: We've been duped by monstrous new contract.(Letter to the Editor)
August 2, 2004... It should have been blindingly obvious to anyone a long time ago that GPs have been completely duped by this monstrous new contract. I do the finances for our practice. I have spent hours fiddling around trying to forecast superannuation...

Letter: NHS isn't be all and end all.(Letter to the Editor)
August 2, 2004... Welcome Dr Pullinger (Letters, July 26) and Dr Reggler (Features, July 26) to the happy band of those deciding we'd had enough of the illusion of being `independent contractors' to an increasingly bureaucratic NHS. I suspect they already regret...

Letter: Square root of numeracy problem.(Letter to the Editor)
August 2, 2004... While I understand Neil Robinson's point about square root transformations of relative prevalence (Letters, July 26), the essence of the problem is that the practice population multiplier is not subject to the same transformation - or...

Letter: Will every little thing soon need consent?(Letter to the Editor)
August 2, 2004... Regarding recent correspondence (July 12 and 26), I have been fitting IUDs since 1975 and on no occasion have I had to have written consent. If we are not careful every patient will have to sign before we check their ears, throat, chest or any...

Letter: Why antibiotics propaganda may cause extra deaths.(Letter to the Editor)
August 2, 2004... Lower respiratory tract infection is not the commonest thing managed in general practice (News, July 19) and 807 patients is a scandalous lack of evidence on which to base research, especially as the result is not what we see in hospital and...

Letter: Cure your patients with luxury!(Letter to the Editor)
August 2, 2004... I was recently asked to fill in for a GP who was unable to see his patients that morning. When I was escorted to his spacious room I thought a mistake had been made - it did not look like an ordinary consulting room. The luxurious...

Letter: Follow NICE on use of Cox-2s.(Letter to the Editor)
August 2, 2004... I believe your story `Cox-2s no better on GI safety than standard NSAIDs, says EU' (News, June 28) was rather sensationalised. The key points are that the CPMP review found an acceptable risk-benefit profile in their assessment of the cox-2s,...

How to minimise cost of expensive locums.(work management)
August 2, 2004... If you can't get around using a locum at least keep the costs down - Dr John Couch shows how The cost of locums is now a major expense for many practices. With some locum agencies charging #70 an hour and more, we often pay locums at rates...

Practice Q&As: Seniority payment for a salaried GP?(Brief Article)
August 2, 2004... Q: I am a salaried GP - under GMS2 will I be eligible for seniority payments? A: Section 13 of the SFE sets out the details of seniority payments under GMS2 and identifies those posts that may be eligible: a) in the case of posts held...

August contract calendar.(Calendar)
August 2, 2004... Dr Bob Button advises practices on what they need to be doing this month August 2 The review and revision to the complaints procedure has been published as statutory instrument (SI) 1768/2004. This comes into effect after July 30. If...

The GP's role in reducing falls.
August 2, 2004... Dr Opinder Sahota and Dr Ramin Yazdani explain the strategies GPs can use to prevent falls in older people The need to reduce falls and fractures has risen steadily up the agenda of health care politics over recent years. The White Paper...

Preventing falls with calcium and vitamin D.
August 2, 2004... Dr Lester Russell makes the case for wider use from a GP's perspective There are 120,000 falls annually among the UK's nursing home population of 180,000. These result in some 12,000 fractures, of which 4,500 are hip fractures. The...

LEARNING FROM ILLNESS: I know how frightening asthma can be.
August 2, 2004... Dr Vincent McGovern's vivid memories of poorly controlled asthma have convinced him that GPs and patients need to raise their expectations of treatment I developed asthma around the age of two. It wasn't a difficult diagnosis: recurrent...

TRAUMA CLINIC: Shoulder pain.
August 2, 2004... Mr Carlos Cobiella and Mr Fares Haddad offer advice on management Case history A 57-year-old right-handed housewife presents with a three-year history of pain in the left shoulder, particularly when doing overhead activity. A month ago...

ANSWER BACK: Which test for schistosomiasis?(Brief Article)
August 2, 2004... Q: A patient swam in Lake Malawi two weeks ago and came in asking for treatment `just in case' of schistosomiasis How soon after infection will tests be positive and which is best? A: Exposure in Lake Malawi is an increasingly common source...

ANSWER BACK: Which investigations in childhood UTI?(Brief Article)
August 2, 2004... Q: How likely are further investigations to be positive in a child with UTI? A: Ultrasound as a first-line allows structural abnormality to be seen. The gold standard for reflux is a micturating cysto-urethrogram and for renal problems is...

Pay at risk in access crackdown.(General Practitioners pay, Department of Health's crackdown, compliance with access targets)
August 9, 2004... GPs risk losing #3,000 each following a Department of Health crackdown on how they comply with access targets. Ministers have ordered PCTs to stop practices restricting pre-booked appointments to achieve 48-hour access. A Department of...

GP stubs out misleading PCT advert.(General Practitioner, Primary Care Trust, advertising of smoking cessation service, Advertising Standards Authority's finding)(Brief Article)
August 9, 2004... A GP has had a complaint upheld against his PCT for advertising its smoking cessation service in a misleading way, after it based claims of success on the Government's four-week quitting targets. Dr Stephen Nickless, a GP in Kilburn,...

MPs condemn PCT failure to involve GPs in out-of-hours.(members of parliament)(primary care trusts)(general practitioners)(Brief Article)
August 9, 2004... MPs have blasted PCTs for sidelining GPs from new out-of-hours arrangements and failing to take their responsibility for 24-hour care seriously. Bigger financial incentives would need to be offered to GPs to prevent an `exodus' from the...

Pulse stretches its lead.(general practitioners subscribe more to Pulse than to any other periodical, survey report)(Brief Article)
August 9, 2004... Pulse is read by more GPs than any other publication and is now seven points clear of its nearest rival. According to the latest industry survey, which covers the period January to June, 75 per cent of GPs read Pulse every week. This compares...

PCT signs up private firm to provide GMS.(primary care trusts)(General Medical Services)
August 9, 2004... A private contractor has struck a #1.25 million-a-year deal to run five practices dogged by recruitment problems. News of the deal emerged as the NHS Confederation revealed 15 PCTs had attended a forum designed to link them with private,...

GP anguish over `difficult' patient.(general practitioner reprimanded for treatment refusal to a patient)(Brief Article)
August 9, 2004... A GP who had a complaint against her partly upheld by the Health Service Ombudsman has spoken out about the complainer's alleged `campaign of harassment'. Dr Ali Prust, a GP in Exmouth, Devon, was reprimanded by the Ombudsman for...

Small practices angry over `unfair' quality pay formula.(general practitioners)(Brief Article)
August 9, 2004... GPs in small practices are furious that a little-noticed element in calculating quality pay means they will get less money than larger surgeries for treating the same number of chronic disease patients. Calculations by Northampton...

Safer pertussis and polio vaccine to be available next month.
August 9, 2004... Exclusive By Emma Wilkinson The UK's childhood immunisation schedule will become significantly safer next month, with the long-awaited introduction of a combined acellular pertussis and inactivated polio vaccine. Pulse has learned...

Teen MMR boycott breaches care duty.(Measles, Mumps, Rubella vaccination drive of the government demands general practitioners involvement )(Brief Article)
August 9, 2004... Defence bodies have warned that GPs may breach their duty of care if they follow GPC advice to boycott the Government's teenage MMR drive. The Medical Protection Society said GPs would have to request retrospective payment, since refusing...

`Grave concern' over new OTC drive.(over the counter)
August 9, 2004... Antibiotics, antihypertensives and B2 agonists will all join statins over the counter, under Government plans to accelerate the OTC revolution. The Medicines and Healthcare Products Regulatory Agency has released proposals for a data...

Primecare profits warning.(Brief Article)
August 9, 2004... The number of patients covered by commercial deputising service Primecare could drop by more than half by the end of the year, its parent company has warned, because PCTs are opting for in-house providers. Nestor Healthcare Group estimated that...

GP logs on to central patient notes.(Brief Article)
August 9, 2004... Dr Richard Brook's practice is one of five involved in a project where clinical data will be extracted from GPs' IT systems by a central repository. The data can then be accessed by other services such as out-of-hours providers. Dr...

BMA suggests 10% rise in private fees.(British Medical Association )(Brief Article)
August 9, 2004... The BMA has suggested a 10 per cent rise in GP fees for private work, with time in the practice now valued at #176.50 an hour. It has recommended GPs charge: * #11.50 for a straightforward certificate of fact, without examination ...

Warning on methotrexate safety.(Brief Article)
August 9, 2004... The National Patient Safety Agency has warned GPs to take extra precautions prescribing methotrexate after the drug was linked to 25 deaths in England in the last 10 years. Nearly one in five adverse events were caused by poor or absent...

Muslim GPs refute bias claim.(Brief Article)
August 9, 2004... The British International Doctors' Association has refuted media claims that Muslim GPs are refusing sexual health services to patients on moral grounds. BIDA accused national newspapers of `stirring' anti-Muslim feeling in the country by...

Contract threatens pastoral GP care.(general practitioners)
August 9, 2004... The core values of general practice are `under real threat' from the new contract, according to an architect of the quality and outcomes framework. The emphasis on hitting quality targets, the out-of-hours opt-opt and the fragmentation of...

Younger GPs giving more antidepressants.
August 9, 2004... GPs are prescribing antidepressants for milder symptoms as studies highlight other approaches. By Cato Pedder Young and female GPs are more likely than their peers to prescribe antidepressants and may be contributing to a cultural shift in...

Drugs best with cognitive therapy.(Brief Article)
August 9, 2004... Antidepressants are more effective when used alongside psychological treatments than on their own, new research shows. Patients receiving combined treatment were 86 per cent more likely to improve than those on antidepressants only, the...

Mental health workload cut.(Brief Article)
August 9, 2004... Training nurses in NHS walk-in centres to deal with mental health problems can ease GP workload by preventing patients being sent back to practices, a Government pilot shows. During the pilot, patients attending eight centres across the...