Pulse articles from August 2006

Pulse archives from August 2006

#2,500 extra each year to make your pension stand still.
August 3, 2006... BMA fights off rise in retirement age, but dynamising factor capped and all must pay more By Ian Cameron GPs in England and Wales will have to pay around #2,500 a year more to earn the same pension under proposed reforms to the NHS...

How GPs are affected.(General Practitioners benefits and retirement age)(Brief article)
August 3, 2006... * Personal contributions 7.5 per cent for GPs on #60,880 to #100,000, 8.5 per cent for those on over #100,000 * Dynamising factor to be retail prices index (RPI) plus 1.5% * Retirement age 60 for existing members, 65 for new * No...

Safety probe into asthma drugs.(investigations on adverse effects of beta agonists in asthma)(Brief article)
August 3, 2006... Exclusive The UK drug regulator is to investigate use of long-acting Beta- agonists in asthma amid growing concerns over their safety, Pulse can reveal. The decision follows two recent studies suggesting the drugs could increase...

RCGP spruces up knowledge test for recertification.(Royal College of General Practitioners)
August 3, 2006... Major revamp of online test will bring in pass/fail threshold By Anna Hodgekiss The RCGP is to revamp its existing online knowledge test to enable it to be used for recertification of GPs. It confirmed this week it has begun major...

What is the PEP e-kit?(online learning product for General Practitioners)(Brief article)
August 3, 2006... * Online multiple choice package * First emerged in CD ROM format in Scotland, now available nationally online at www.pep-ekit.org.uk * Used to identify learning needs for CPD * Costs #150 or #120 for RCGP members * No...

Warning of `miscarriages of justice'.(General Practitioners negative reaction on medical regulation overhaul)(Brief article)
August 3, 2006... The CMO's proposals to overhaul medical regulation will lead to miscarriages of justice and damaging levels of bureaucracy, GPs are warning. Opposition to Sir Liam Donaldson's plan to change the burden of proof in fitness to practise...

How to respond to CMO's report.
August 3, 2006... The RCGP is asking members to respond by 1 September, using its website www.rcgp.org.uk. To air your views to the GMC, log comments under a podcast by Sir Graeme Catto, at www.doctors.net.uk, post on the forum or e-mail the GMC at...

Study urges antibiotics for chest infections in over-65s.
August 3, 2006... GPs should prescribe antibiotics to patients over 65 with lower respiratory tract infections to prevent them developing pneumonia, a new study concludes. The recommendation, at odds with current guidance, came after the researchers...

Some flu vaccine supplies delayed until December...(Brief article)
August 3, 2006... Some practices will have to wait until the start of December before receiving supplies of flu vaccine for this year's campaign. GPs were warned in June that there had been problems in the vaccine manufacturing process, but the UK Vaccine...

Pregnant women in next year's risk groups.(Brief article)
August 3, 2006... Pregnant women and patients with neurological conditions are to receive the flu vaccine from 2007/8, Pulse can reveal. The influenza subgroup of the Government's Joint Committee on Vaccination and Immunisation has formally recommended the...

GP contract talks get off to `delicate and difficult' start.(General Practitioners)(Brief article)
August 3, 2006... The GPC and NHS Employers have admitted they are a long way apart in early talks on changes to the GP contract for 2007/8. Both sides have described negotiations on issues such as the future of the minimum practice income guarantee (MPIG)...

InBrief: Fixed retirement unlawful.(Brief article)
August 3, 2006... GPs will no longer have to retire from a partnership solely because of age, under new age discrimination laws. Partnership agreements that state a partner must retire at 65 or 70 will be unlawful from 1 October unless the stipulation can be...

InBrief: Care plan for new mothers.(postnatal care )(Brief article)
August 3, 2006... NICE has warned a `tick-box approach' is widespread in postnatal care and wants a new `personalised' approach including individual care plans. Women should be asked about their emotional well-being at every postnatal contact, new guidance...

InBrief: GPs shun IT programme.(General Practitioners)(Information Technology)(Survey)(Brief article)
August 3, 2006... Only one GP in four supports the National Programme for NHS IT, latest figures show. A MORI poll found GPs had a far more negative view of the multi-billion pound programme than hospital doctors. Only 24 per cent of GPs had a favourable opinion...

InBrief: Death certificates plea.(strategy for reforming death certification )(Brief article)
August 3, 2006... The Government is at risk of wasting a `golden opportunity' to reform the `unsafe' Victorian death certification and investigation system in England and Wales, a committee of MPs has warned. A Constitutional Affairs Committee report urged...

InBrief: MS services are criticised.(multiple sclerosis )(Brief article)
August 3, 2006... Current provision of multiple sclerosis services is poor, a joint report from the Royal College of Physicians and the Multiple Sclerosis Trust has concluded. The report calls for the Healthcare Commission to audit quality of services after...

InBrief: Practice workload survey.(general practitioners workload survey)(Brief article)
August 3, 2006... Four-thousand practices are being encouraged to participate in a major survey designed to assess the workload of GPs and their staff. Everyone participating in the survey, backed by the Government, BMA and NHS Employers, will fill in a...

InBrief: Bird flu vaccine on way.(GlaxoSmithKline develops H5N1 bird flu vaccines)(Brief article)
August 3, 2006... GlaxoSmithKline has developed a vaccine against H5N1 bird flu which it says has produced a strong immune response in 80 per cent of volunteers. The Government could order the vaccine for delivery and stockpiling in early 2007, the company said....

InBrief: Warning on pandemic flu.(practices of general practitioners)(Brief article)
August 3, 2006... GPs are less equipped to deal with pandemic flu than in the 1969/70 outbreak because of the out-of-hours opt-out and other changes in working practices, the RCGP's Birmingham research unit has warned. A separate survey found GPs were...

Treasury set to agree cash for new therapists.(general practitioners access to psychological therapies)
August 3, 2006... GP access to therapy likely to get boost as Pulse campaign nears success By Daniel Cressey Pulse Action on depression GPs look set to gain a significant boost in access to talking therapies after the Government gave the strongest...

Opt-out hits palliative care.(palliative care services survey report)(Survey)(Brief article)
August 3, 2006... GPs' out-of-hours opt-out has had a damaging effect on provision of palliative care, new figures included in a Government report reveal. A survey of GPs reveals that only 37 per cent are satisfied with their local palliative care services...

Productivity in the NHS on decline.(National Health Service)(Brief article)
August 3, 2006... NHS productivity has failed to keep pace with the vast increase in investment by the Government, research has concluded. A study by the Centre for Health Economics at the University of York found that between 1999 and 2005 emergency...

Consultants stand in to cover GP.(General Practitioners)(Brief article)
August 3, 2006... There can't be many GPs who can say it takes two consultant surgeons and a GP colleague to provide sabbatical cover for them. But that's the case for Dr Mike Seymour, a GP at Clare House surgery in Tiverton, Devon. In addition to the...

GPs suspicious over Boots' plans.(General Practitioners)
August 3, 2006... GPs fear pharmacy chain's move to rent out rooms to the NHS is a precursor to offering services directly By Ian Cameron Boots is to rent out rooms in its stores to the NHS in a move GPs suspect will lead to the pharmacy chain competing...

Boots' plans for Poole.(Brief article)
August 3, 2006... * Up to nine consulting rooms available for Poole PCT to rent for orthopaedic care, sexual health screening, podiatry, health promotion, blood pressure monitoring and cardiac clinics. * Walk-in services, extended opening hours for GP...

Easier for GPs to fill vacancies.(General Practitioners)(Brief article)
August 3, 2006... Practices in England and Wales are finding it easier to recruit GPs, Department of Health figures suggest. The number of GP vacancies in England left unfilled in excess of three months more than halved in the past year, falling from 2.4 per...

`PCTs abuse power on performers'.(Primary Care Trusts employee suspension rate increased )(Brief article)
August 3, 2006... Medicolegal experts have accused PCTs of abusing their powers after the number of GPs removed from performers lists almost trebled in the past year. The Family Health Services Appeals Authority received 175 notifications of removal in...

MediaWatch: `NSAIDS cause impotence'.(Nonsteroidal anti-inflammatory agents)(Brief article)(Clinical report)
August 3, 2006... The Story Regular use of painkillers can make men impotent, warn the Daily Mail and Daily Telegraph. The Source Incidence of erectile dysfunction was nearly three times higher in men who used NSAIDs regularly than those who did...

MediaWatch: `Hope for endometriosis'.(iron to reduce proliferation of lesions)(Brief article)(Clinical report)
August 3, 2006... The Story New research offers fresh hope for women with endometriosis, BBC News Online and the Times report. The Source Results of a series of experiments in mice suggested treatment to mop up excess iron could prevent lesions...

MediaWatch: `Daily pill for Alzheimer's'.(PBT2 helps in preventing development of Alzheimer's disease)(Brief article)
August 3, 2006... The Story A simple daily pill could help prevent the development of Alzheimer's disease, the Daily Mail claims. The Source A team from the Mental Health Research Institute in Australia found daily use of the pill, called PBT2,...

X-rays failing to find lung cancer.
August 3, 2006... GPs warned to consider referral whatever X-ray result By Danusia Osiowy GPs are deciding whether to refer for suspected lung cancer on the basis of misleading chest X-ray results, a study warns. The researchers urged GPs not to...

Referral without X-ray.(clinical guidelines)(Brief article)
August 3, 2006... * Offer urgent referral while waiting for chest X-ray for: - persistent haemoptysis in smokers/ex-smokers over 40 - signs of superior vena caval obstruction - stridor * If there is a high suspicion of cancer, offer urgent...

CVD screening boost.(cardiovascular disease)(Brief article)
August 3, 2006... Screening for cardiovascular disease by searching practice computer records can identify the vast majority of at-risk patients, a new study reports. The strategy estimates Framingham scores for every patient on a practice list. Full...

Stroke care pay anomaly.(quality care and associated benefits)(Brief article)
August 3, 2006... GPs may be missing out on payments for high-quality stroke care because the Read code system for the disease is a confusing mess, researchers say. A new study found the achievement of QOF points was not related to gold standard quality of...

Systematic failures in osteoporosis care.
August 3, 2006... Government fails to deliver promised investment in GP diagnostic services By Emma Wilkinson A failure to invest in GP osteoporosis care has brought systematic failures in implementing best practice, a major new audit of half a million...

Priorities for general practice.(general practitioners objectives)(Brief article)
August 3, 2006... * Development of a fracture register * Treatment of patients over 75 in line with NICE technology appraisal * Prescribing of vitamin D3/ calcium for patients in a nursing home or residential care * Management of patients over 65...

Signs aid early TB diagnosis.(tuberculosis)(Clinical report)
August 3, 2006... A series of `red flag' symptoms can help GPs make an early diagnosis of tuberculosis, a new study concludes. Researchers found sweating, involvement of lymph nodes and weight loss were all much more strongly indicative of TB than coughing....

Antibiotics caution.(prescription writing for general practitioners)(Brief article)(Clinical report)
August 3, 2006... GPs should not prescribe anti-biotics for patients with acute purulent rhinitis because the risk of adverse effects outweighs potential benefits, a new study concludes. The study, published online by the BMJ, found there was evidence of...

GPSI clinics snubbed.(General practitioners with special interests )(Brief article)
August 3, 2006... Patients would rather wait to see specialists than gain quick access to GPSIs, a new study concludes. The finding challenges a key plank of the argument behind wider GPSI use - that they improve patient satisfaction by reducing waiting...

GPs criticise Government plans for allergy services.(fund allocation for allergy care)(Brief article)
August 3, 2006... GPs have criticised the Government for failing to invest in allergy services after a Department of Health report admitted severe failings in current services - but failed to commit to new funding. The department's Review of Allergy Services...

CMO's report: Proposals are overkill, say GPs.(Chief Medical Officer medical regulation )
August 3, 2006... Overwhelming majority of GPs condemn Sir Liam Donaldson's plans to overhaul medical regulation * Dr Helen Alpin, Leeds `I have concerns about miscarriages of justice from shifting the burden of proof, and reducing the role of the GMC...

JournalWatch: Migraine link with CVD.(cardiovascular disease)(Brief article)(Clinical report)
August 3, 2006... Migraine with aura is associated with a significantly increased risk of cardiovascular disease, US research reveals. The prospective study followed 27,840 women aged 45 or older who participated in the Women's Health Study and were free of CVD...

JournalWatch: Men's raised clots risk.(venous thromboembolism recurrence risk higher in men)(Brief article)(Clinical report)
August 3, 2006... Men have a substantially higher risk of recurrent venous thromboembolism than women after stopping anticoagulation, a Canadian study reports. The meta-analysis included data from nine randomised trials and six prospective observational...

JournalWatch: Statin kidney benefits.(Brief article)(Clinical report)
August 3, 2006... Statins appear to have a beneficial effect on pathological albuminuria, a US study concludes. The meta-analysis collated data from 15 studies involving 1,384 patients, with an average study duration of 24 weeks. Statins reduced albuminuria...

JournalWatch: Opioid counselling doubts.(Brief article)(Clinical report)
August 3, 2006... Primary care counselling and frequent dispensing does not improve adherence to treatments for opioid dependence, a US study reports. The randomised controlled trial of 166 patients taking buprenorphine- naloxone for opioid dependence...

JournalWatch: Weight a knee arthritis risk.(Brief article)(Clinical report)
August 3, 2006... A high body mass index is related to the development of osteoarthritis of the knee but not the hip, a Dutch study shows. The researchers analysed data on 3,585 patients selected through the Rotterdam study, followed up for an average of 6.6...

Q&As: Parental responsibility.(medical records access for parents)(parental responsibility acquisition tips)
August 3, 2006... One of my patients is divorcing his wife and has now requested access to his children's medical records. He claims that although he was unmarried at the time of his children's birth, he acquired parental responsibility for them by...

Q&A: Must I go SOLO?(Letter to the editor)
August 3, 2006... I am a salaried doctor working in a practice and separately do a few out-of-hours sessions. I understand I must use a SOLO form to record these for superannuation purposes. Where can I obtain one? You should be able to get the SOLO...

PulseFinance: Check your spending and earn more in these austere times.
August 3, 2006... Dr John Couch shows how to keep profits up by curbing expenditure As NHS income has at best levelled off this year, there is only one realistic way to keep non-private profits up - and that is to reduce expenses. It was very easy to...

Letter: CMO's proposals must be resisted.(Letter to the editor)
August 3, 2006... From Dr Nev Bradley Chair, Wirral LMC The CMO's proposals for continuing professional development and revalidation (`Crackdown', News, 20 July) clearly show him to be a creature of government, clearly clueless about the workings of general...

SecondOpinion - Andy Jones: Perfect score in commissioning.(Brief article)
August 3, 2006... I have devised a points scoring system enabling you to evaluate for yourself whether it is worth espousing practice-based commissioning. First off - is your PCT being merged, with no obvious direction or chief executive in mind? If so, give...

FOR THE RECORD.
August 3, 2006... The RCGP has asked us to point out that the Government's patient choice reference group, which will be co-chaired by Professor Mayur Lakhani (News, 20 July), will not be considering accreditation of practices. The college has also not resumed...

PulseClinical: Need to know lifestyle.(Mediterranean diet for good health)(physical activity health benefits)(traffic light for system for customer nutritional information)
August 3, 2006... Public health expert Dr Matt Kearney answers questions on lifestyle issues from GP Dr Des Spence Take-home points * A modified Mediterranean diet (substituting polyunsaturated for monounsaturated fats) has been shown to...

PulseClinical: Calcium cuts fractures only in most compliant patients.(Clinical report)
August 3, 2006... Osteoporotic fractures, such as this Colles' fracture in an elderly woman, may not be preventable with calcium Q In elderly women with or without a previous fracture, can calcium supplementation without vitamin D decrease fracture rates?...

Will last person in Britain not on a statin turn out the lights.
August 3, 2006... Our clinical columnist Dr Malcolm Kendrick is back with a second provocative series challenging sacred cows - and he argues that NICE has been sucked in by the statin propaganda machine So another three to four million adults in the UK are...

PulseClinical: How not to miss septic bacterial arthritis.(Disease/Disorder overview)
August 3, 2006... Dr Rod Hughes advises on the key signs to look out for Worst outcomes if missed The following outcomes are all related to duration of untreated infection, bacterial virulence, host defences and age. * Mortality (especially in the...

PulseRegistrar: Is woman's lower abdominal pain really ibs?(Irritable bowel syndrome case study)(Disease/Disorder overview)
August 3, 2006... Dr Melanie Wynne-Jones discusses KEY POINTS * Irritable bowel is a common and distressing functional disorder * Serious pathology should be excluded, especially in older patients * Stress can trigger IBS and vice versa *...

You stumble across a report that reveals your partner has hepatitis C.(patient care guidelines)
August 3, 2006... CASE HISTORY While looking for the practice accounts in your partner's room, you find under a bundle of papers a medical report about your partner. It is dated last month and discusses his recent medical problems which seem to centre...

PulseComment: Knowledge test a folly.(knowledge tests for general practitioners at Royal College of General Practitioners)(Brief article)
August 3, 2006... In leaving it to the RCGP to decide whether or not knowledge tests should be part of a new system of revalidation, the Chief Medical Officer has pulled a political masterstroke. Whether or not such tests are imposed is now a matter for the...

Choice of hospital exposed as a sham.
August 10, 2006... GPs blocked from making Choose and Book appointments to ensure wait targets are met Exclusive By Ian Cameron Patients are being denied treatment at their chosen hospital to ensure Government waiting targets are not breached. ...

`Intellectual corruption'.(medical referral services are example of corruption in National Health Service)(Brief article)
August 10, 2006... Dr Michael Caruana says bookings in at least two or three specialties at his local community hospital are blocked each week to ensure 13 week waits are met. Dr Caruana, GP and medical director of Swanage Community Hospital in Dorset, says...

Steroids more than double suicides.(Brief article)(Clinical report)
August 10, 2006... Oral steroids greatly increase the risk of suicide - by more than four- fold at high doses - a new study of UK general practice concludes. Previous research has suggested the drugs adversely affect mental health, but the new study of half a...

Revealed: trusts block GPs' choice over BP drugs.(General Practitioners)(Blood Pressure)
August 10, 2006... PCOs override NICE and insist on diuretics first-line - sidelining CCBs By Emma Wilkinson and Sarah Neville GPs are being barred a choice of first-line treatments for hypertension by cash-strapped primary care organisations in a direct...

How PCOs are distorting guidance.(Primary Care Organisations)(Brief article)
August 10, 2006... What nice says `In hypertensive patients aged 55 and over, or black patients of any age, first choice of initial therapy should be either a calcium channel blocker or a thiazide-type diuretic.' How PCOs describe the advice Leeds...

GPs angered by drug restrictions.(General Practitioners against guidelines for restricting hypertension drug)(Brief article)
August 10, 2006... GPs have strongly criticised moves by PCOs to attempt to restrict hypertension drugs choice. Dr Pravin Shah, CHD lead for South Stoke PCT, said some local guidelines were clearly misleading. `PCTs are narrowing the field in so many areas....

High dose antibiotics curb resistance surge.(General Practitioners)
August 10, 2006... GP prescribing of short, high-dose courses of antibiotics can curb surging rates of drug-resistant infections, researchers report. A series of new studies of UK primary care reveal GP prescribing of antibiotics is driving up resistant...

NSAID use raises risk of birth defects.(Non Steroidal Anti-Inflammatory Drugs )(Brief article)(Clinical report)
August 10, 2006... Taking NSAIDs while pregnant multiplies the risk of certain birth defects by up to five-fold, a new study suggests. The Canadian researchers warned the risk could be highest in the first trimester - raising concerns over NSAID use in women...

London PCTs jump gun on `star rating'.(Primary Care Trusts)(Brief article)
August 10, 2006... PCTs are already trying to introduce local `star rating' style systems to grade GP practices. Three trusts in east London have proposed performance-monitoring frameworks which include a system to rate practices against a series of...

GPs told: cut referrals by 20 per cent.(General Practitioners)(Brief article)
August 10, 2006... GPs in south London are being ordered to reduce referrals across the board by up to 20 per cent as part of desperate cost cutting measures. Southwark and Lambeth PCTs are seeking to reduce referrals by 10 per cent on average in order to...

RCGP faces struggle for GPs' backing.(Royal College of General Practitioner)(General Practitioners)(Brief article)
August 10, 2006... The RCGP faces a battle to win the confidence of all GPs over its role in a new system of recertification, a former chair of the college has admitted. Professor Mike Pringle, who was chair from 1998 to 2001, said engaging around 20,000 GPs...

Sessional GPs warn against two-tier regulation system.(General Practitioners)(Brief article)
August 10, 2006... Sessional GPs are warning against the creation of a two-tier system of regulation which would mean they have to go through a more stringent recertification process. In his report Good Doctors, Safer Patients, Sir Liam Donaldson said locum...

InBrief: New pathology IT urged.(Information Technology)(Brief article)
August 10, 2006... An independent review of pathology labs has stressed the need for a new computer system allowing GPs to order pathology tests as key to improving the service. In response, the Department of Health has allocated #1m to fund 12 pilot schemes to...

InBrief: Inhaler strength warning.(asthma drug therapy)(Brief article)
August 10, 2006... The Medicines and Healthcare Products Regulatory Agency is warning of potentially dangerous variations in strength between different beclometasone dipropionate CFC-free inhalers for asthma. Differences in design mean Qvar is `approximately...

InBrief: Optometrists to prescribe.(prescription writing powers for Optometrists )(Brief article)
August 10, 2006... Optometrists may be the latest group to gain prescribing rights under new Department of Health plans. A consultation document outlines options for optometrists prescribing, including access to the whole formulary. It follows the controversial...

InBrief: Practice manager jailed.(Helena Chirodian jailed for falsifying practice records )(Brief article)
August 10, 2006... A practice manager has been jailed for two and a half years for defrauding a practice of #266,000. Helena Chirodian, who worked at a surgery in Stratford, east London, paid herself two salaries over four years. She covered her tracks by...

InBrief: Minocycline not justified.(Brief article)
August 10, 2006... There is no compelling evidence that minocycline is better than other tetracyclines for treating of acne, according to the Drug and Therapeutics Bulletin. It says it is `difficult to justify' using minocycline when other tetracyclines are as...

InBrief: IT scheme no help for NHS.(Information Technology)(National Health Service)(Brief article)
August 10, 2006... Computer systems in the NHS would have been better and developed more quickly without the multi-billion pound National Programme for IT, according to a former senior executive at the programme. A 12-page analysis of the project was sent to MP...

InBrief: Flu vaccine onus on PCTs.(Primary Care Trusts)(Brief article)
August 10, 2006... The Department of Health has insisted it is up to local GPs and PCTs to handle this year's flu vaccination delays. A Pulse survey of flu vaccine producers indicates an average delay in deliveries of three to four weeks, with about 5 per cent...

InBrief: GMS costs increase in NI.(General Medical Services)(Northern Ireland )(Brief article)
August 10, 2006... The GMS contract led to a 20 per cent increase in the cost of GP services in Northern Ireland in 2004/05, a report from the Department for Health, Social Services and Public Safety has concluded. Copyright: CMP Information Ltd.

PCTs deserve `rocket' for lack of GP support.(Primary Care Trusts)(General Practitioners)
August 10, 2006... Commissioning doomed to failure unless `laggardly' PCTs support GPs By Helen Crump PCTs are condemning practice-based commissioning to failure by not backing GPs and denying them crucial information, the body charged with helping...

GPs now wary with opiates.(General Practitioners)(Survey)(Brief article)
August 10, 2006... A post-Shipman climate of suspicion is leading many GPs to stop administering opiates, research by the Small Practices Association reveals. A survey of 238 small practices found only 36 per cent of GPs stocked opiates in their surgery and...

`We turned our practice around'.(primary care nursing improvement)(Brief article)
August 10, 2006... This time last year, the Rossington Practice in Doncaster was floundering. Patient complaints were high, the QOF outlook was miserable, there was no in-house training or summarisation of patient notes. A year on, the situation has been...

BMI not the best guide.(Body Mass Index)(Brief article)
August 10, 2006... BMI measurements are inappropriate in older people and should be replaced by waist-hip ratios, say the researchers on a new study. The London-based team found BMI overestimated risk of mortality from excess weight in those over 75 and might...

Help for GPs to compete on APMS.(General Practitioners)(Alternative Provider Medical Services)
August 10, 2006... PCT puts four practices out to tender but pledges to advise GPs on how to compete with private firms By Ian Cameron A PCT that is putting four practices it directly manages out to tender has pledged to help the incumbent GPs compete...