Pulse articles from August 2008

Pulse archives from August 2008

GPC frozen out over MMR catch-up plan.
August 13, 2008... * Negotiators taken `completely by surprise' * GPs warned to expect increase in workload By Lilian Anekwe GP leaders have angrily condemned the Government's failure to consult them in advance of a major #5.5m rescue package to...

How catch-up campaign may work.
August 13, 2008... * #5.5m campaign aims to increase uptake from 84.1% currently to 95% * Average PCT to get #30,000 extra funding - excluding vaccine costs and support and information materials * London PCTs to get #60,000 to reflect low MMR coverage...

QOF tackles inequality and deprivation.
August 13, 2008... The QOF has reduced health inequalities and improved care in deprived areas, according to a study published in The Lancet this week. In the three years since the introduction of the framework, the gap in median QOF achievement between the...

GP cancer care curbed by cash disincentives.
August 13, 2008... GPs are prevented from taking on more cancer care in the community because of `adverse incentives' in the way hospital trusts are paid, a Department of Health report has found. The report looks at the effect of Payment by Results on the...

Pay for practice managers is latest to be hit.
August 13, 2008... Practice manager pay is the latest casualty of the GP pay freeze as practices fight to keep a lid on costs, new figures show. The average practice manager's salary rose by 2.2% in 2008, compared with a 5.3% increase in 2007, according to a...

Surgeries under threat from second wave of polyclinics.
August 13, 2008... Polyclinic drive picks up pace, dramatically increasing the number of GP surgeries earmarked for closure PULSE: SOS - Save Our Surgeries Exclusive By Nigel Praities PCTs across the country are planning a second wave of polyclinics,...

SAVE OUR SURGERIES: Second wave gathers pace.
August 13, 2008... Heart of Birmingham: Expects all 75 surgeries to move into 24 new polyclinics Cumbria: Two polyclinics to open,nine surgeries to close North-East Lincolnshire: Thirteen polyclinics to open, 31 surgeriesto close Heywood, Middleton...

SAVE OUR SURGERIES: Fiercest challenge yet to polyclinic rollout.
August 13, 2008... Two sets of plans for polyclinics are being referred all the way up to health secretary Alan Johnson in the strongest challenge yet to the planned national rollout. Local councils have taken the ultimate step of appealing to the secretary...

SAVE OUR SURGERIES: Patients value continuity of care over convenience.
August 13, 2008... Patients value continuity of care and their relationship with their GP far more than flexibility of appointments and extended opening, reveals a survey carried out by Pulse readers. The survey - a key strand of Pulse's Save Our Surgeries...

Furore as doctor is suspended for slating senior colleague.
August 13, 2008... A huge row has erupted over doctors' freedom of speech after a trainee was suspended for making offensive comments about a senior medical figure on the website Doctors.net.uk. The comments - reportedly made about the re-election of Dame...

Doubts over private firm scheme.
August 13, 2008... Faltering start for flagship Government programme to use the private sector to help spend NHS cash Exclusive By Tony Lithgow The Government's controversial drive to use the private sector to help spend NHS cash is faltering, with...

Care record climbdown on implied consent.
August 13, 2008... COMMON SENSE: ON IT Patients will be required to give explicit consent before their Summary Care Record is accessed, after Connecting for Health agreed to a fundamental overhaul of the way records were accessed. After a meeting of the...

Double pay boosts extended opening.
August 13, 2008... PCT bosses are to pay GPs twice over for running evening and weekend surgeries in a desperate bid to meet the Government's extended opening target, Pulse has learned. Under the terms of a new LES agreement offered by South West Essex PCT,...

Ministers slow down pace of CVD screening rollout.(cardiovascular diseases)(Brief article)
August 13, 2008... The Government has decided to slow down the rollout of its controversial programme for cardiovascular screening. The Department of Health told Pulse only a few `spearhead' PCTs would implement vascular checks from next April. The DH...

GPs to face further clinical scrutiny.
August 13, 2008... The Government's new health and social care regulator plans to use its powers to ensure GPs implement NICE guidance. The boss of the Care Quality Commission said it would look to enforce NICE guidance and national service frameworks, and...

LMC call to fight GP ratings site.
August 13, 2008... GPs urged to immediately demand the removal of their details By Steve Nowottny GPs are being advised by LMC leaders to write to controversial new doctor ratings website www.iwantgreatcare.org to demand their details are removed. ...

IN BRIEF: Care for asylum seekers.
August 13, 2008... Government plans to prevent foreign nationals, including failed asylum seekers, accessing primary care treatment have been strongly criticised in consultation responses. The responses, obtained under the Freedom of Information Act by a...

IN BRIEF: #550m for Darzi changes.
August 13, 2008... The changes to the health service outlined in Lord Darzi's NHS Next Stage Review are set to cost taxpayers more than half a billion pounds, ministers have revealed. The Department of Health has confirmed that a range of initiatives,...

The practice with two patients.
August 13, 2008... Practice that Ben Bradshaw identified to justify scrapping the MPIG is actually highly atypical Christian hospital By Steve Nowottny A GP practice with just two registered patients - cited by ministers as a justification for abolishing...

Warfarin rival gets the go-ahead from NICE.
August 13, 2008... NICE has given a green light to the first oral anticoagulant potentially to rival warfarin for more than half a century. The final appraisal determination on dabigatran says the treatment is as cost-effective as other anticoagulants used...

LIFT scheme raises private sector fears.(Local Improvement Finance Trust)(Brief article)
August 13, 2008... The GPC has raised fresh concerns over the increasing role of the private sector in primary care after the Government announced a major expansion to LIFT, in a bid to fast-track funding and development of new surgeries. GPC negotiator Dr...

Legal fears curb GP co-proxamol prescribing.
August 13, 2008... GPs are increasingly unwilling to take the legal risk of prescribing co- proxamol, with the number of scripts halving in six months, Pulse can reveal. The Government had promised unlicensed co-proxamol would be available on a named-patient...

MEDIA WATCH: THIS WEEK'S TOP... Miracle cure.
August 13, 2008... Marriage may offer a cure for the insanity of love - so the saying goes - but it could also prevent even more serious brain disorders later in life, according to Swedish researchers. As reported in the Daily Mail and BBC News Online, their...

MEDIA WATCH: THIS WEEK'S TOP... Scare story.
August 13, 2008... The pressures to snap back into shape after pregnancy like celebrity `yummy mummies' is spurring a surge in the number of `pregorexics', the Daily Mail warns. More and more pregnant women are dieting and exercising to excess during...

MEDIA WATCH: THIS WEEK'S TOP... most pointless research.
August 13, 2008... Blondes may have more fun, but they are less successful at work and in love, according to research sponsored by hair dye company Schwarzkopf & Henkel. The study of 3,000 women found brunettes rated themselves as 10% more successful with the...

FOCUS ON... GPs' battle against spin.(General practitioners)(Survey)
August 13, 2008... After the latest spate of negative press, GP leaders prepare to fight back by stepping up their PR operations By Lilian Anekwe It's not what you do that counts - it's how you look while you're doing it. A lesson more familiar to...

FOCUS ON... Do claims against GPs stack up?
August 13, 2008... THE CLAIM Waiting time to see a GP `still too long'. THE FACTS A recent survey by the Picker Institute for the Healthcare Commission found 25% of respondents had been put off going to their GP because of inconvenient opening times - up from...

EDITORIAL: GPC cannot afford another MMR snub.(Editorial)
August 13, 2008... The Department of Health seems to share a magician's delight at plucking new policies from its hat. Perhaps it is the drama of the moment, or the sense of power that comes from holding important secrets, but ministers apparently like nothing...

VOX POP: Will the MMR catch-up campaign be a success?
August 13, 2008... Dr Nigel Watson a GP in New Milton, Hampshire `Getting people vaccinated is a good idea. I've seen two children die of measles when I was in paediatrics. But the Government needs to negotiate on a national basis before announcing it like...

LETTER: Claims about QRISK do not serve debate.(Letter to the editor)
August 13, 2008... From Dr Peter Brindle QRISK2 co-author and a GP in Bristol I am writing to express my concern at important factual errors in Professor Paul Durrington's article for your recent debate (`Is it time to turn our back on Framingham?',...

LETTER: Little gaming in exception reporting.(Letter to the editor)
August 13, 2008... From Dr Craig Wakeham Dorchester, Dorset With regard to your story `Practices with outlying exception reporting rates face fraud investigations' (pulsetoday.co.uk/news), perhaps the civil servants at the Department of Health would care to...

LETTER: My PCT had not even heard of BNP testing.(Letter to the editor)
August 13, 2008... From Dr David John Winscombe, Somerset I was interested to read the story about BNP testing (`Poor BNP provision "a scandal"', pulsetoday.co.uk/news). I put a practice-based commissioning proposal to North Somerset PCT for near patient...

LETTER: Further training and funds vital in sexual health.(Letter to the editor)
August 13, 2008... From Dr Chris Ford Clinical lead for the RCGP's Introductory Certificate in Sexual Health Sexual health services in general practice have indeed been the victim of underfunding and a failure to engage GPs (`Sexual health warning',...

LETTER: Choose and Book `failures' down to GPs.(Letter to the editor)
August 13, 2008... From Dr Graham Croker, Primary care clinical lead for Choose and Book Again we have a headline that misrepresents the truth - `Choose and Book "failing to offer patients choice"', pulsetoday.co.uk/news). It is not Choose and Book that...

LETTER - Osteoporosis guidance: work in progress.
August 13, 2008... From Carol Bewick Director of communications, NICE Your article 10 Top Tips on osteoporosis (pulsetoday.co.uk/ clinical) refers to the `latest NICE guidance, published earlier this month'. To clarify, NICE did not publish any final...

LETTER: We owe it to the planet to talk to patients about family size.(Letter to the editor)
August 13, 2008... From Dr Pip Hayes GP in Exeter, a mother of two and trustee of The Optimum Population Trust We as doctors are increasingly encouraged and expected to become involved in health issues that are global or could affect population well-being....

DEBATE: Should GPs compete for patients?
August 13, 2008... YES Competition between GPs for patients is an essential driver of innovation and quality and good practices should have nothing to fear from it, says Dr James Kingsland Our society flourishes on competition. Nature thrives on it....

PULSECLINICAL: RHEUMATOID ARTHRITIS.
August 13, 2008... Rheumatologist Dr John Halsey answers GP Dr Mandy Fry's queries on RA's impact on heart disease, oral versus intramuscular steroids and treatment of the condition during pregnancy Take-home points * Although RA increases the risk of...

PULSECLINICAL: CHLAMYDIA.
August 13, 2008... Genitourinary physician Dr Olwen Williams offers her advice on this common STI 1 Young people are more predisposed to acquiring chlamydia but age is no bar to contracting a sexually transmitted infection. Over the past 10 years STI rates...

PULSECLINICAL: BACK PAIN.
August 13, 2008... Dr Nick Summerton shows how likelihood ratios can help in establishing whether back pain might have a serious cause Many of us have received criticism for excessive use of imaging in patients with back pain. But knowing when to investigate...

SNAPSHOT DIAGNOSIS: THICKENING FINGERS.(Case study)
August 13, 2008... Dr Mike Wyndham describes how a patient's casual comment about his hands rang alarm bells The patient This 46-year-old man had been sitting talking to me about his fingernails for five minutes, when he threw in `by the way, I think my...

HOW NOT TO MISS... BILIARY ATRESIA.
August 13, 2008... Although biliary atresia is a rare condition,a missed case canhave catastrophic consequences. Paediatric surgeonMr Mark Davenport explains how to spot it Worst outcomes if missed * Death - untreated biliary atresia is invariably fatal....

ASKTHEEXPERT: PENSIONS.
August 13, 2008... Specialist medical accountant Bob Senior advises on whether the BMA's court victory on the pensions cap will increase GPs' entitlement I retired from full-time NHS work in April 2006 and got my lump sum and pension. Now that the BMA has...

BUSINESSBRIEFING: DON'T MISS OUT ON FEES YOU'VE EARNED.
August 13, 2008... If your systems are poor you could be failing to collect money owed to you, warns accountant Rosemary Smith As income streams slow it has become more important than ever to ensure you are receiving all the income you are entitled to. ...

PULSESERVICES: An exciting option for your savings.
August 13, 2008... Investments no longer offering attractive rates? There is very interesting alternative, says Stuart Smith According to the latest inflation figures released by the Government, in the 12 months to June 2008 the rate of inflation excluding...

Losing the blame game.
August 13, 2008... If GPs are so at fault, ponders Phil, how come the public likes us so much better than MPs? We are evil people, we GPs. Not only evil, but stupid, venal and incompetent. It must be true. The evidence is overwhelming. The proof is all out...

Advisers ignored as antibiotic goes OTC.
August 27, 2008... Regulator condemned for `disastrous' decision to make trimethoprim available over counter Exclusive By Lilian Anekwe The Government drug regulator plans to make a mainstream antibiotic available over the counter for the first time -...

Patients less satisfied with same-day slots.
August 27, 2008... Offering same-day appointments reduces patient satisfaction, according to a new analysis in the September issue of British Journal of General Practice. Researchers surveyed 12,825 patients in 47 practices. They found that increasing the...

Conservatives to review NHS policy on IT.
August 27, 2008... The Conservative party has commissioned an independent review of NHS IT to advise on `policy options' for an `incoming Conservative government'. The review, to be led by Dr Glyn Hayes, former chair of the British Computer Society's Health...

Varenicline best therapy to stop smoking.
August 27, 2008... Varenicline was the most successful pharmacotherapy in helping people quit smoking last year, figures from the NHS Information Centre reveal. Despite concerns over the risk of serious psychiatric side-effects with the drug, 63% of people...

All pharmacists could get right to prescribe statins.
August 27, 2008... Pharmacy trade body asks Government to set up patient group direction as part of vascular screening Exclusive By Nigel Praities The Government is to consider plans to give all pharmacists the right to prescribe statins as part of the...

`Not enough cash' for clinical DESs.
August 27, 2008... The money offered for the new clinical enhanced services will barely even cover costs and is unlikely to prove attractive to practices, the GPC says. The warning came as it released new details of the DES arrangements, which are to be...

Ministers name their figure on cash for MPIG phase-out.(Minimum Practice Income Guarantee)(Brief article)
August 27, 2008... Government ministers have already told GPC negotiators how much they are willing to spend to scrap the MPIG as plans for a phase-out gather pace, Pulse can reveal. Just two months after ministers confirmed they would scrap the income...

Fifth of PCTs failing to offer pulmonary rehabilitation.(Brief article)
August 27, 2008... A fifth of PCTs are failing to follow NICE guidelines by providing pulmonary rehabilitation services for patients with COPD, a Pulse investigation reveals. The findings come more than four years after NICE guidelines recommended pulmonary...

POLYCLINIC ROLLOUT: LMCs launch bids for Darzi centres.
August 27, 2008... GP leaders set their opposition to APMS to one side in attempt to keep polyclinics out of private sector hands Exclusive By Gareth Iacobucci GP leaders are setting aside their opposition to APMS and taking the private sector head on in...

POLYCLINIC ROLLOUT: PCTs set to miss polyclinic deadline.
August 27, 2008... Exclusive PCT bosses are set to bust the Government's deadline for the rollout of polyclinics, after demanding more time to consult GPs and patients, Pulse has learned. The move will mean that in some areas PCTs will be months behind...

POLYCLINIC ROLLOUT: Secret talks with private providers.(Brief article)
August 27, 2008... PCT bosses have been holding secret talks with private providers to discuss plans for the UK's first fully fledged polyclinic, without keeping any official records of what was discussed. Pulse revealed last month that Camden PCT had held...

POLYCLINIC ROLLOUT: Conflict of interest as PCTs seek APMS contracts.
August 27, 2008... PCT provider arms are bidding for APMS contracts in tenders presided over by their own managers, in a move described as a `glaring conflict of interest' by the GPC. GP leaders claim the moves, revealed by a Pulse investigation, contravene...

Firms rule on cull of surgeries.
August 27, 2008... GPs angry as private consultants get say on need for practice mergers By Gareth Iacobucci Private companies are being given key roles in deciding which GP surgeries face the axe, under controversial plans to merge small practices on...

Private firms move in.
August 27, 2008... * FESC: The Government's drive to use the private sector to help spend NHS cash. UnitedHealth and Bupa have already signed local deals to advise PCTs on various aspects of commissioning services. * The Assura deal, which is not part of...

Call for routine aspirin.
August 27, 2008... GPs should consider routine aspirin for primary prevention of heart disease in all men over 48 and all women over 57, according to UK researchers. The first study of its kind in UK patients looked at the risk-benefit ratio of aspirin in...

GPs told to get patients off sick pay.
August 27, 2008... NICE wants GPs to assess patients' suitability for employment and develop return-to-work programmes By Nigel Praities GPs are to be formally handed a role in the Government's controversial drive to get patients off long-term incapacity...

What does NICE want GPs to do?
August 27, 2008... * Assess need for sick leave and prognosis of returning to work within 12 weeks of a person starting sick leave (and ideally between two and six weeks) * Ensure the co-ordination and delivery of interventions is agreed by employee and...

IN BRIEF: Extended hours surge.
August 27, 2008... More than half of Scottish GP surgeries are now offering extended hours, according to official statistics. Government figures show 51% of surgeries now have some form of extended hours, with practices offering an extra two-and-a-half hours a...

IN BRIEF: Surgery closure row.
August 27, 2008... A PCT has been forced to apologise to patients after it issued a letter informing them their GP surgery was to close without consultation. Patients at the Solent Surgery in Hythe received a letter from Hampshire PCT informing them of plans to...

IN BRIEF: More to do on diabetes.
August 27, 2008... Diabetes care in the UK is improving, but there is more work to be done in providing access to support services and treatment for vulnerable patient groups, according to a new Government report. A progress report on the National Service...

IN BRIEF: Legal costs up 15-fold.
August 27, 2008... A sharp increase in the number of doctors being investigated by the GMC and lengthier hearings have resulted in spiralling legal costs, the Medical Defence Union has reported. In the MDU's annual report, the defence body said it had seen a...

IN BRIEF: Call to challenge PCTs.
August 27, 2008... Patients should challenge PCT decisions not to fund new treatments before they have been appraised by NICE, says the institute's chief executive. Andrew Dillon said because there was no consistent basis on which exceptional funding for...

Pilot backs bowel screening.
August 27, 2008... The UK Bowel Cancer Screening Programme can successfully detect early- stage cancers, research from one of the programme's two key pilot sites has shown. Faecal occult blood testing was able to detect treatable early bowel cancers without...

Trial prompts early clopidogrel review.
August 27, 2008... NICE has responded to new trial data by bringing forward a review of its antiplatelet guidance, in a move that could push clopidogrel to the front line of stroke prevention. The institute was due to review its technology appraisal on use of...

Combination therapy slows progression of COPD.
August 27, 2008... Long-acting Beta-agonists in combination with an inhaled steroid slow the progression of lung disease in patients with COPD, research shows. COPD patients treated with combined salmeterol and fluticasone had a significantly lower rate of...

HRT trial calls advice into doubt.
August 27, 2008... Researchers call for rethink as study reveals wide-ranging benefits in quality of life for older women By Lilian Anekwe The controversy over hormone replacement therapy has been reignited by data from a major new trial suggesting it...

GPs meeting HPV vaccine demand.
August 27, 2008... GPs are increasingly prescribing the HPV vaccine to women who request it, amid confusing signals from the Department of Health. The monthly prescribing rate for vaccination has jumped more than fourfold in the past year, despite doubts over...

GPs given role detecting cholesterol families.
August 27, 2008... GPs will be handed a major role in screening children at risk of familial hypercholesterolaemia in NICE guidelines due to be released this week. Around one in 500 people have FH, but only around 10% of these have been identified with the...

MEDIA WATCH: THIS WEEK'S TOP... Miracle cure.
August 27, 2008... Noisy sleepers face a tough challenge as their long-suffering partners send them off to a military-style camp in Birmingham to cure their snoring, reports The Times. The paper claims the boot camp, run by a snoring relief aid manufacturer,...

MEDIA WATCH: THIS WEEK'S TOP... Scare story.(moisturisers may increase the risk of skin cancer)(Brief article)
August 27, 2008... For years fresh-faced beauties and high-maintenance men have extolled the virtues of daily cleansing, toning and moisturising. But The Independent warns that moisturisers may increase the risk of skin cancer. Scientists found that a common...

MEDIA WATCH: THIS WEEK'S TOP... most pointless research.
August 27, 2008... New research blames Wayne Rooney's chubby cheeks and broad, squat face - with a distance between the cheeks that is much greater than that from the upper lip to the top of the nose - for him being aggressive and confrontational on the pitch....

BACK PAIN: NICE to consider Alexander technique for back pain.
August 27, 2008... NICE is set to consider `unusually good' results from a landmark trial suggesting the Alexander technique has dramatic benefits for chronic back pain. The move raises hopes the institute will open the door to NHS access to the technique,...

JOURNAL WATCH: Steroid use curbed.(Brief article)
August 27, 2008... Children with early, persistent mild asthma who are well controlled with daily inhaled steroids can have doses lowered and in some cases administered on an as-needed basis, Finnish researchers report. Their study looked at 176 children aged...

JOURNAL WATCH: PPI fracture risk.(proton pump inhibitors )(Brief article)
August 27, 2008... Long-term use of proton pump inhibitors significantly increases the risk of osteoporosis-related fractures, a large Canadian study reports. Researchers studied data from three medical claims databases on 15,792 patients with...

JOURNAL WATCH: Antibiotics ease COPD.
August 27, 2008... Antibiotics lower the risk of subsequent exacerbations when prescribed with oral steroids to COPD patients. Dutch researchers analysed the drug dispensing records of more than two million patients in the Netherlands - comparing 49,599...

BACK PAIN: GP-led clinic cuts back pain referrals.
August 27, 2008... A GP-led clinic can manage as many as 84% of patients with low back pain without the need for hospital referral, an audit has revealed. The community service - which includes physiotherapists and osteopaths - is now being considered by the...

BACK PAIN: GP poll reveals revalidation scepticism.
August 27, 2008... Half of GPs believe revalidation will belittle their professionalism, with almost two-thirds fearing it will reduce morale, according to a new survey. The poll of 203 GPs by market research consultancy TNS Healthcare found widespread...

PULSEINTERVIEW: Dr Laurence Buckman - A year of living with the flak.(Interview)
August 27, 2008... On his anniversary as GPC chair, Dr Laurence Buckman brushes aside critics, insisting it's his patients who matter By Steve Nowottny As we're about to start the interview, the mobile phone of Dr Laurence Buckman, chair of the GPC and...