Pulse articles from August 2007

Pulse archives from August 2007

QOF overhaul set to ramp up workload.
August 2, 2007... Next version of framework set to merge CVD targets to make room for new clinical areas EXCLUSIVE By Lilian Anekwe Ministers are planning a dramatic overhaul of the quality and outcomes framework that would ramp up GP workload by...

How ministers plan to combat double counting.(Brief article)
August 2, 2007... * Conditions such as diabetes, hypertension, left ventricular heart failure, stroke and coronary heart disease would be merged into one indicator, for `metabolic disease' * Streamlining inefficient areas of the QOF could release points to...

Exception reporting rules to be tighter.(Brief article)
August 2, 2007... Ministers plan to tighten the rules on exception reporting amid continuing concerns over GPs `gaming' the contract. The Department of Health wants to reduce the number of valid reasons for exception reporting by scrapping `softer'...

GPs facing cash squeeze from PCTs as profits crash.
August 2, 2007... Some practices see income slump 40% as financial climate worsens By Tony Lithgow GPs are facing a financial backlash from PCTs that is exacerbating the effect of the two-year pay freeze and sending profits crashing, Pulse can reveal....

`How can trusts claim our money?'.(Brief article)
August 2, 2007... `A nationwide problem' is how Dr Ethie Kong, vice chair of Brent LMC, describes the move by PCTs to claw back thousands from GP practices. `In Brent, they are reviewing PMS. We've been told budgets will be cut and how much they will be cut...

US to keep rosiglitazone on market.(Brief article)
August 2, 2007... The US Food and Drug Administration has decided to keep rosiglitazone on the market, despite new research adding to concerns over its effect on the heart. An advisory panel convened by the FDA voted 22 to one to allow continued marketing...

Practices lose #2,000 as new targets hit QOF scores.
August 2, 2007... EXCLUSIVE By Clare Ryan GPs will see a fall in income through the quality framework this year, despite dealing impressively with controversial new indicators on depression and chronic kidney disease. Figures for more than 700 practices...

Psychologists wary of CBT rollout.(Brief article)
August 2, 2007... The Government has injected fresh impetus into its rollout of psychological therapies with the announcement of 11 new pathfinder sites - but is facing accusations of providing therapy on the cheap. New mental health minister Ivan Lewis gave...

GPs risk ruin by litigious US patients.(Brief article)
August 2, 2007... GPs who treat American and Canadian patients in the UK risk financial ruin and could be breaking GMC guidance. A warning sent by the Medical Protection Society has sparked fears that GPs could end up the target of legal action in the US....

InBrief: Waiting times dispute.(Brief article)
August 2, 2007... Waiting times in advanced access practices are longer than claimed in PCT data, according to a new report. The Patient Care Access Survey had claimed 97%of patients got an appointment on the same day. But the new study, led by...

InBrief: Yellow card QOF points?(Brief article)
August 2, 2007... The UK drug regulator is pushing for incentives in the GP contract for yellow card reporting after a sharp fall in the number of submissions in recent years. Yellow card reports by GPs fell by 50% from 2001to 2005, prompting the MHRA to...

InBrief: Mental health teams rated.(Brief article)
August 2, 2007... Mental health services are gradually improving, but stark variation remains and there is substantial room for improvement, a new report concludes. Almost half the local implementation teams evaluated by the Healthcare Commission and the...

InBrief: PCT suspends Dr Siddiq.(Brief article)
August 2, 2007... A Muslim GP who described gay patients as `twisted' has been suspended by Walsall PCT. Dr Muhammad Siddiq, president of the Islamic Medical Association, cannot treat patients on the NHS in the area covered by the trust until its...

InBrief: CHD progress stalls.(Brief article)
August 2, 2007... The reduction in deaths from coronary heart disease in England and Wales appears to be slowing down,a study reported online by Heart concludes. For men aged 33 to 44, CHD mortality in 2002 rose for the first time in two decades, indicating the...

InBrief: Brakes on new centres.(Brief article)
August 2, 2007... Health secretary Alan Johnson has put the brakes on the rollout of controversial new independent sector treatment centres. He said last week he was cancelling a third wave of the centres and terminating a contract for diagnostic tests with...

InBrief: Antidepressant scripts up.(Brief article)
August 2, 2007... GPs have rejected criticism they are overusing antidepressants in children after the release of figures showing a sharp rise in prescriptions in the past decade. In the last financial year, GPs wrote 631,000 prescriptions to children with...

InBrief: New GPC positions.(Brief article)
August 2, 2007... Dr Laurence Buckman, a GP in Barnet, north London, has been elected new GPC chair. Dr Richard Vautrey, a GP in Leeds, is his deputy. * Dr Buckman interviewed, page 15 Copyright: CMP Information Ltd.

Ministers to use QOF to force longer hours.(quality and outcomes framework)
August 2, 2007... Plans for quality points, local schemes and practice ratings to tackle access by Steve Nowottny The Government has announced plans to redraft the quality and outcomes framework and redesign local incentives in a bid to cajole GPs into...

Government access plans.(Brief article)
August 2, 2007... * Incentive payments for access to be revised, QOF to address `local issues and concerns' * National improvement team to give targeted support to poorly performing PCTs and practices to improve access * PCTs to produce `robust' local...

GP fury over workload statistics spin.
August 2, 2007... GPs reacted angrily this week after an apparent leak of misleading workload statistics by the Department of Health prompted fears that the Government is still hell-bent on attacking the profession. The GP workload survey was released by the...

Half of GPs have lost enthusiasm for PBC.(general practitioners and practice-based commissioning)
August 2, 2007... Pulse survey finds financial problems top list of obstacles to commissioning By Steve Nowottny GP confidence in practice-based commissioning has plummeted over the past year, a Pulse survey reveals this week. Nearly half of GPs...

Polyclinics set for national rollout.
August 2, 2007... Controversial plans to replace most of London's GP surgeries with a network of polyclinics may be extended to other big cities, the new health secretary has confirmed. In his first appearance before the health select committee, Alan...

Review casts doubt on lithium use.(Brief article)
August 2, 2007... Prescribing lithium for schizophrenia exposes patients to side-effects without effectively treating their illness, according to a new Cochrane Collaboration report. The report, reviewing trials of the mood-stabilising drug on 611 patients,...

Choose and Book upgrade a confidentiality risk.(Brief article)
August 2, 2007... Common sense on IT An upgrade to computer software used in the Choose and Book electronic referral system has put the confidentiality of patients at risk, Pulse can reveal. The change has removed an automatic failsafe measure that...

GP takes Choose and Book hot seat.(Dr. Stephen Miller appointed by the UK National Health Service)(Brief article)
August 2, 2007... Dr Stephen Miller, a GP in south-east London, has been appointed Connecting for Health's new medical director for the national Choose and Book programme. Previously a choice and booking lead for South East London SHA, and last year chair...

MediaWatch: `Pill for all men over 50'.(Brief article)
August 2, 2007... The story All men over 50 should be taking a polypill to cut heart attacks and strokes, according to a report in the Daily Mail. THe source Professor Roger Boyle, the Department of Health's national director for heart disease and stroke,...

MediaWatch: `Dieting harms next baby'.
August 2, 2007... The story Dieting between pregnancies can affect the health of your next baby, warn the Daily Express and Independent. The source A report published in the BMJ assessed two cohort studies, one Swedish and the other American, on the impact...

MediaWatch: `Dope's schizophrenia risk'.(Brief article)
August 2, 2007... The story Cannabis use is linked to a 40% rise in the risk of schizophrenia, report the Independent, Guardian, Daily Express and BBC News Online . THe source Scientists analysed 35 studies concerning whether `transient' use of cannabis...

CKD in elderly has no effect on mortality.
August 2, 2007... Study finds over-75s with mild or moderate CKD do not need treatment By Joanna Clarke-Jones Calculating eGFR is a `waste of time' in the elderly because it suggests chronic kidney disease in patients who actually have no excess...

Go-ahead for child Hib vaccine drive.(Brief article)
August 2, 2007... The Department of Health has confirmed plans for an urgent Hib vaccine catch-up programme in young children, as reported exclusively in the last issue of Pulse. The programme - to cost #800,000 and be delivered by GPs via a locally...

Cluster of symptoms offers clue to coeliac disease risk.(Brief article)
August 2, 2007... A cluster of gastrointestinal and psychological symptoms has been identified that can allow GPs to spot patients at high risk of coeliac disease. A new study found that patients presenting with depression, anxiety, symptoms of diarrhoea...

Suffolk PMS chaos is `testbed' for rest of UK.
August 2, 2007... GP leaders warn `bullying' negotiations in Suffolk are part of wider trend By Steve Nowottny Gridlocked PMS contract negotiations in Suffolk will act as a `testbed' for the rest of the country, GP leaders are warning. GPC...

GPs battle flood chaos.(Brief article)
August 2, 2007... This was the scene in the patients' car park behind a flood-hit GP surgery in the Gloucester town of Tewkesbury last week. Family doctors had to evacuate the Church Street practice after water gushed into the cellar, knocking out the...

Decision time for Suffolk PMS GPs.(Brief article)
August 2, 2007... * Current PMS contracts will expire on 1 January 2008 * Practices can sign up to a revised PMS offer, which the GPC says would mean `more work for less money' * Practices can choose to revert to GMS contracts, with a LES encompassing a...

Advisers push for GP antibiotic clampdown.
August 2, 2007... Government advisers have urged a clampdown on GP antibiotic prescribing as new research shows the speed with which resistance in the community emerges, writes Lilian Anekwe. The Department of Health's expert advisory committee on...

Antibiotics `do not change the natural history of pertussis'.(Brief article)
August 2, 2007... There is no evidence antibiotics can change the natural history of whooping cough, GPs have been advised in a newly published review from the Cochrane Collaboration. But the RCGP warned it could be regarded as `unethical' to withhold...

JournalWatch: Regular steroid benefits.(Brief article)
August 2, 2007... Regular use of the inhaled steroid budesonide controls asthma better than budesonide given as needed in mild, persistent childhood asthma, according to a Finnish trial. The study randomised 176 newly diagnosed children aged five to 10 years to...

JournalWatch: Long-term HIV boost.(Brief article)
August 2, 2007... Patients infected with HIV and treated with combined antiretroviral therapy over the long term have levels of CD4 cells in their immune system which are similar to those seen in uninfected individuals. The study of 1,835 patients from a...

JournalWatch: Workplace asthma risks.(Brief article)
August 2, 2007... Workplace conditions could be responsible for a quarter of new asthma cases in developed countries, a Europe-wide study of respiratory health has found. The study followed up a population who had not reported any history or symptoms of...

JournalWatch: New combination aids BP.(Brief article)
August 2, 2007... The combination of the ARB valsartan with the experimental treatment aliskiren, which directly inhibits plasma renin, reduces blood pressure more than either drug used alone, a US study reports. The trial studied 1,797 hypertensive...

JournalWatch: Chlamydia screen doubts.(Brief article)
August 2, 2007... GP register-based population screening programmes for chlamydia infection are poor value for money, according to a new economic model. It would cost about #22,300 to prevent one `major outcome' - most commonly pelvic inflammatory disease...

GPs get varenicline nod.(Brief article)
August 2, 2007... NICE has given GPs the green light to prescribe varenicline for smoking cessation as drug regulators moved to allay fears that it might prompt suicidal thoughts in some patients, writes Emma Wilkinson. A committee of the UK's Commission on...

PulseInterview: Will Buckman bite match the bark?(Laurence Buckman)
August 2, 2007... New GPC chair faces a series of major challenges and calls for a more robust approach to negotiation By Tony Lithgow It is a week after Dr Laurence Buckman's election as GPC chair and the Confederation of British Industry has just...

LETTER: Choose and Book is no nirvana.(Brief article)
August 2, 2007... Dr Nick Luscombe, Barnsley, Yorkshire Common sense on IT Open letter to Dr Mark Davies, clinical lead for Choose and Book at Connecting for Health I read with interest your description of the Choose and Book and NHS IT nirvana...

LETTER: I've shredded my so-called smartcard.
August 2, 2007... Dr Michael Linton, Rochdale, Lancashire Further to my letter about Choose and Book (Letters, 10 May), I am writing again to say that the whole process has not improved locally at all. Unfortunately, although my PCT is well aware of my...

LETTER: C&B is slow, but a powerful aid.(Brief article)
August 2, 2007... Dr Steve Cox, Handcross, West Sussex I support Choose and Book! It's slow, maybe. It's also new and therefore threatening to GPs - definitely. Nevertheless, this system is a powerful aid to helping our patients. The choice...

LETTER: Chiropractic is certainly not deadly.(Letter to the editor)
August 2, 2007... Barry Lewis, president, British Chiropractic Association I refer to your article `Chiropractic "can be deadly"' (News, 12 July), and in particular to your opening statement `GPs should not refer patients for chiropractic treatment as there...

LETTER: Polyclinics: conveyor belts or vital reform?
August 2, 2007... Dr Max Levy, Warrington Lead GP, Mid-Mersey LMC Your article on polyclinics (News, 12 July) was particularly relevant here in Warrington. The PCT's crude attempt to centralise services into five APMS-run clinics - without any prior...

FOR THE RECORD: 19 July 2007.(Correction notice)
August 2, 2007... In Letters, 19 July, we published a letter from the director general of the Association of the British Pharmaceutical Industry and misspelled his name as Dr Richard Baker. The letter was in fact from Dr Barker. Copyright: CMP Information...

LETTER: No benefits from QOF? No way.(Letter to the editor)
August 2, 2007... Dr Laurence Buckman, chair, General Practitioners Committee Your headline `QOF has failed to bring benefits for patient care' (News, 12 July) is misleading as both surveys you mention show improvement in standards, which has been sustained...

LETTER: Spot on about the jobs crisis.(Letter to the editor)
August 2, 2007... Dr Masood Majoka, Worcestershire I fully agree with the article about the GP job market crisis (News, 19 July). I haven't had a job in the past 12 months since qualifying as a GP. I live in Worcestershire but I am looking for a job...

LETTER: Dr Ford has got my backing.(Letter to the editor)
August 2, 2007... Florence Durrant, practice nurse, east London Would you vote for Dr Steve Ford, who is standing as an independent in the next election (Opinion, 12 July)? My answer is a big YES! I would even come over and help with the campaign. On...

Dinah'sDiary: 02.08.07.(Diary entry)
August 2, 2007... Dinah has an explosive week with a slimy enemy Monday Up early to mow lawn before work, garden rampant from heavy rain. Beetroot doing particularly well but rocket attacked by slug epidemic. Ugh, I hate their slimy squirming, and their...

OPINION: Complaints revamp will fail GPs.(Viewpoint essay)
August 2, 2007... New plans for dealing with accusations against GPs won't fix the faults in the current system, says Steve Ainsworth Confident and conciliatory, angry and unrepentant, bothered and bewildered. For more than 30 years I've observed the...

PulseFinance: Ask the Experts.
August 2, 2007... As Pulse launches its website pulsetoday.co.uk, we showcase a new online feature giving you the chance to get financial and professional advice from our panel of specialists ACCOUNTS Bob Senior has a solution to overly high partner...

PulseFinance: Make use of the summer quite period.
August 2, 2007... Many practices find it tempting to put their feet up in the summer - but now is the time to check your business is healthy, says Dr John Couch For most practices, our seaside colleagues excluded, summer is a relatively quiet period of the...

HOW TO...Give a talk.
August 2, 2007... Even GPs who do not see themselves as teachers or lecturers may be asked to give a talk. It might be to a voluntary group, to a patients' group or to students. Before refusing, or turning up reluctantly and reading from notes, learn a few...

PulseClinical: Keeping on top of CKD management.(chronic kidney disease )
August 2, 2007... GPs are increasingly managing chronic kidney disease in its early stages. Dr Kathryn Griffith advises on the clinical implications For many years we have had poor indicators of renal function in primary care. Renal function has to...

PulseClinical: Need to know headache.(Disease/Disorder overview)
August 2, 2007... Specialist Dr Leone Ridsdale answers questions from Dr Sonia Barros D'Sa about the most common neurological reason for a patient to consult their GP 1. How common is headache? Headache is the most common symptom people experience. Each...

PulseClinical: Faecal occult blood test and bowel cancer screening.
August 2, 2007... As the colorectal cancer screening programme is rolled out, pioneer Dr Richard Tighe explains the clinical evidence on which it is based and the implications for general practice Why screen for bowel cancer? Bowel cancer develops from...

PulseRegistrar: Patient who says 'Something`s got to be done!'.
August 2, 2007... This well-worn phrase usually comes from somebody who feels at the end of their tether. Dr Melanie Wynne Jones explains how to handle such a consultation A patient, relative or colleague who says this to you is either very worried, very...

LITTLE GEMS: How hot are you on... sickle cell anaemia?(Disease/Disorder overview)
August 2, 2007... Test your knowledge for the nMRCGP with this little GEM from GPnotebook Helen is a 28-year-old white woman who lives in rural Devon. During the second trimester of her pregnancy, the midwife completed a family origins questionnaire and...

PulseCareers: Life as an academic GP.
August 2, 2007... Dr Robbie Foy describes the highs and lows of this diverse and challenging career I once attended an inaugural public lecture given by a new professor of general practice. Introducing him, the dean commented how impressive it was that the...

PulseComment: Double dealing.(Brief article)
August 2, 2007... First we had gaming, now we have double counting. Ministers continue to gripe about alleged abuses of exception reporting, but they now mutter equally darkly about a new flaw in the quality and outcomes framework, supposedly allowing GPs to be...

LAST WORD: Dr Shan Whitear.
August 2, 2007... Dr Shan Whitear... on The Apprentice, PCTs and not being pregnant The best thing about my practice is my colleagues, staff and patients. The worst thing is my patients always thinking that I am pregnant. I keep telling them I am just...

Huge explosion in nurse prescribing.(Report)
August 23, 2007... Patient safety fears resurface as figures show growing use of potentially risky drugs EXCLUSIVE By Richard Hoey The full extent of the UK's nurse prescribing revolution is exposed by new data showing an explosion in nurse prescriptions...

Fresh row over standard of proof.(Brief article)
August 23, 2007... CAMPAIGN: Justice for GPs The GMC has claimed proposed changes to medical regulation would not lower the standard of proof used to judge the most serious fitness-to- practise cases. But the council has admitted in new guidance that the...

NHS managers ask practice staff to rate GPs as bosses.(United Kingdom National Health Service)(general practitioners)
August 23, 2007... GP fears over independent status on discovering secret NHS survey of staff By Christian Duffin The Government is furtively quizzing thousands of practice staff on whether GPs are good employers and whether they provide good patient...

Department `bullying' PCTs on access.(United Kingdom Department of Health)(primary care trusts)(Brief article)
August 23, 2007... The GPC has hit out at a `bullying' letter from the Department of Health which demands PCTs take immediate action to improve access to GPs. PCTs will be called to meet their SHA next month to discuss local action plans, and are expected to...

GP job-hunting crisis as vacancies crash.(general practitioner)(Report)(Brief article)
August 23, 2007... Job opportunities for GPs have fallen by more than a quarter in England and halved in Wales, official figures show. NHS Information Centre statistics show the proportion of all GP posts vacant fell from 1.1% to 0.8% between March 2006 and...

Push for asthma telephone review.(Brief article)
August 23, 2007... GPs have increased the pressure to allow telephone review of asthma patients for the quality and outcomes framework after submitting the strongest evidence yet on its effectiveness. The General Practice Airways Group has pressed for...

BMA warns of records breach.(British Medical Association)(Brief article)
August 23, 2007... Common sense on IT Large amounts of patient-identifiable data from the Secondary Uses Service have been made available to academics funded by private company Dr Foster Intelligence, the BMA has warned. In a letter to new health...

InBrief: Growth charts for review.(Brief article)
August 23, 2007... Expert advisers to the Department of Health have called for a change in the standards used to assess child growth. The Scientific Advisory Committee on Nutrition says the UK should adopt the WHO standards, based on women who breastfeed, rather...

InBrief: Care records rolled out.(Brief article)
August 23, 2007... South Birmingham PCT has become the fourth early adopter area to roll out Summary Care Records. Four practices have so far joined the scheme, with a further seven due to take part in September. But Birmingham LMC has refused to endorse the...

@InBrief: Flu pandemic contract.(Brief article)
August 23, 2007... The Government has awarded a #155m contract to GSK and Baxter Healthcare, to supply vaccine for a possible flu pandemic. The companies will supply a vaccine once the pandemic strain is identified by WHO, when, the Department of Health says,...

InBrief: Call for care record opt-in.(Brief article)
August 23, 2007... Patients should not be assumed to have given consent for their data to be used for secondary purposes, a Connecting for Health report said this week. The Care Record Development Board Working Group called for greater communication with...

@InBrief: Ambulance death risk.(Brief article)(Clinical report)
August 23, 2007... The further seriously ill patients have to travel by ambulance, the more likely they are to die, research published in the Emergency Medicine Journal reveals. The study found the absolute risk of death rose by 1% for each 10km travelled,...

NICE under pressure to revise lipid guidance.(National Institute for Clinical Excellence)
August 23, 2007... Institute criticised for vague advice and `tabloid medicine' By Rashmi Wadehra NICE is under pressure to revise its controversial lipid modification guidance after being accused of having muddied the waters with its `ambiguous' initial...

GP spirometry is `unsatisfactory'.(general practitioner)(Report)(Brief article)
August 23, 2007... GPs frequently conduct `unsatisfactory' spirometry and are insufficiently trained to interpret results, an analysis claims. Only with substantial specialist input would GPs be able to conduct spirometry adequately in primary care, the...

NICE suggests CBT for irritable bowel after year of drugs.(National Institute for Clinical Excellence)(cognitive behavioral therapy)(Brief article)
August 23, 2007... Patients with irritable bowel syndrome are to be the latest to join the queue for psychological therapies, following draft guidance from NICE. The institute advised that patients who did not respond to 12 months of first-line therapies and...

GPs told to up steroids in asthmatic smokers.
August 23, 2007... New SIGN/BTS guidelines warn smokers are resistant to treatment By Cato Pedder Many patients with asthma who smoke need higher-than-usual doses of inhaled steroids, GPs have been warned in new guidance. But experts said smokers...

Antibiotics scripts on increase again.(Report)(Brief article)
August 23, 2007... GPs are prescribing more antibiotics to children, reversing the dramatic fall following Government campaigns in the late 1990s, new research shows. Antimicrobial resistance experts are waiting for 2006 data to see if the slight increase in...

MediaWatch: `New mums codeine alert'.(Brief article)(Clinical report)
August 23, 2007... The story Nursing mothers are to be warned of the risks of taking medicines containing codeine in the US after a baby was found to die of a morphine overdose, reports the Times. The source The US Food and Drug Administration issued a...

MediaWatch: `Fresh HRT-breast Ca link'.(hormone replacement therapy)(Brief article)(Clinical report)
August 23, 2007... The story New research has reignited the row over the safety of hormone replacement therapy, says the Daily Telegraph. The source A study published in the Journal of the National Cancer Institute found that between 2000 and 2003, HRT use...