Pulse articles from December 2008

Pulse archives from December 2008

Private companies' ambitions exposed.
December 3, 2008... DH figures reveal firms are swamping bidding process, with 15 chasing every Darzi centre Exclusive By Steve Nowottny Private companies' ambitions to muscle in on general practice are dramatically exposed by new figures revealing they...

JOHNSON'S WARNING: Singlehanders `behind times'.(Brief article)
December 3, 2008... Health secretary Alan Johnson launched the first GP-led health centre last week by predicting they would spell the end of traditional singlehanded practice. Mr Johnson courted controversy at the launch by claiming singlehanded practices...

Number of measles cases hits record high.
December 3, 2008... Experts have warned of the potential for a measles epidemic after official statistics showed the number of cases has soared to a record high. Figures published by the Health Protection Agency showed there were 1,049 cases of confirmed...

Every GP listing on NHS Choices to be checked.
December 3, 2008... The Information Centre is to write to every GP practice in England to check whether its listing on NHS Choices - including whether it offers extended opening hours - is correct. The massive data-checking exercise, which is expected to...

Practices in London PCT to sign up to QOF+.
December 3, 2008... All practices in Hammersmith and Fulham PCT are expected to sign up to a new QOF-plus scheme, which will include higher payment thresholds and new indicators to tackle local health problems. The three-year, #2.2m drive comes as the...

Trusts warning of deficits as GP referrals soar again.
December 3, 2008... PCT financial forecasts reveal GP referrals crisis is taking its toll, as official figures show second successive rise By Nigel Praities Dozens of PCTs are forecasting their surpluses will be wiped out if the GP referrals crisis...

RECOMMENDATIONS: NHS advised to cut QOF earnings to 10%.
December 3, 2008... Exclusive By Lilian Anekwe The proportion of earnings GPs are paid via the QOF would be cut by two- thirds under recommendations prepared for the NHS by a former senior adviser to the Department of Health. A document seen by Pulse...

GP SUPPORT: LMCs look to enhanced services to prop up QOF losers.
December 3, 2008... LMC secretaries are writing to practices urging them to come forward if they believe they will be hit by the scrapping of the square root formula, as GP leaders prepare to negotiate local enhanced services to try to compensate the major losers....

Revealed: blueprint for the future of general practice.
December 3, 2008... Health secretary hails opening of first GP-led health centre as fulfilment of Nye Bevan's vision By Gareth Iacobucci It's only one building - admittedly a smart and modern one - but according to the health secretary, it is a blueprint...

Is this how the future will look?
December 3, 2008... The Hillside Bridge health centre in Bradford last week became the first of Lord Darzi's GP-led health centres to open its doors - here is the lowdown: Hours 8am - 8pm, seven days a week, 365 days a year Appointments *...

Dispensing GPs are branded `unsafe'.
December 3, 2008... Dispensing GPs are fighting for their future after the pharmacist professional body accused them of being `unsafe' and putting profits over quality of prescribing. The inflammatory claims were submitted to the Department of Health as part...

Statins do cut deaths in low-risk.
December 3, 2008... Comprehensive meta-analysis concludes primary prevention lowers mortality across wide range of conditions By Nigel Praities Statins have been shown for the first time to lower all-cause mortality when used for primary prevention across...

Generics `as good as branded drugs'.
December 3, 2008... Branded cardiovascular drugs are not superior to their generic equivalents, a study has found. The meta-analysis concluded branded and non-proprietary equivalents were usually similar in their clinical effect. The findings may be used to...

Clampdown urged on GP minor surgery.
December 3, 2008... Dermatologists demand action on PCT failures to implement accreditation By Nigel Praities Specialists are urging the Department of Health to clamp down hard on GPs who carry out minor surgery after it emerged many PCTs were failing in...

Accreditation of GPSIs.
December 3, 2008... * All new and existing GPSIs have to be accredited from March 2009 to enable them to `safely take on their new roles' * Existing GPSIs should reapply for their positions with their PCT and justify their expertise and training, provide a...

Call for pertussis boosters.
December 3, 2008... Immunisation experts are calling for a campaign to give the parents of young babies booster vaccinations against whooping cough to protect children from infection. Whooping cough is part of the childhood vaccination schedule and is usually...

#100m investment in training practices.
December 3, 2008... The Government is to invest #100m next year in upgrading up to 600 GP surgeries to enable them to become training practices. The programme, unveiled as part of the Chancellor's pre-budget report last week, is intended to create...

MEDIA WATCH: THIS WEEK'S TOP... Miracle cure.
December 3, 2008... The humble glass of water could be something more than it appears. Scientists have developed a new kind of super water, loaded with a rare form of hydrogen called deuterium, that could add up to 10 years to our lives, according to a report in...

MEDIA WATCH: THIS WEEK'S TOP... Scare story.
December 3, 2008... The economic downturn could be detrimental to your health as well as your finances, according to a report in the Daily Telegraph. Dr Aric Sigman, an associate fellow of the British Psychological Society, says the increased access to news of the...

MEDIA WATCH: THIS WEEK'S TOP...most pointless research.
December 3, 2008... Manufacturers of sugary snacks deliberately target children in marketing strategies, according to a study in Preventive Medicine. A survey of 313 US primary schools found one in eight had been approached by a corporation that `sells foods high...

Doubt over steroids in COPD.
December 3, 2008... Researchers warn steroids could do more harm than good in patients with mild symptoms By Nigel Praities A new analysis has thrown serious doubt on the routine use of inhaled steroids in patients with COPD, after finding little benefit...

Warning on underuse of Beta-blockers.
December 3, 2008... GPs are struggling to deliver appropriate Beta-blocker treatment to everyone who needs it, partly because of a lack of access to good- quality specialist services, researchers warn. An audit of 152 general practices showed that in 2005,...

Steroids debate.
December 3, 2008... FOR A post-hoc analysis of TORCH found inhaled steroids plus LABA significantly slowed progression of lung disease in COPD patients NEJM 2007;356:775-89 A Cochrane review reported a 33% fall in mortality with steroids plus LABA,...

IN BRIEF: Rise in HIV infection.
December 3, 2008... More than a quarter of people living with HIV in the UK are unaware of their infection, a report from the Health Protection Agency warns. It is thought there are about 77,400 people living with HIV in the UK, yet 28% of those do not know...

IN BRIEF: Fit notes to start in 2009.
December 3, 2008... Fit notes will be introduced as soon as next year as part of an overhaul of medical certification, the Government has confirmed. GPC chair Dr Laurence Buckman said the committee had been calling for a review of the sick note system for over...

IN BRIEF: GP charm offensive urged.
December 3, 2008... GP practices must learn to provide service with a smile if they are to avoid losing patients to private sector competitors, a senior LMC leader is warning. Londonwide LMCs is to include advice on improving customer service in a series of...

Care of the dying hit by gaps in GP training.
December 3, 2008... NAO finds widespread variation in funding and poor community support By Emma Wilkinson GPs are having to manage dying patients in the community without proper training or sufficient resources, a report by the National Audit Office...

Key findings.
December 3, 2008... * Between 56% and 74% of patients express a preference to die at home * Only 29% of doctors received any pre-registration training in end-of- life care, and 39% received pre-registration training in communicating with patients approaching...

Call for osteoarthritis care to be added to the QOF.
December 3, 2008... A study showing wide variation in osteoarthritis care in general practice has prompted calls for the condition to be one of those NICE adds to the QOF. An audit of 18 practices in England found substantial differences in the recorded...

NHS staff push to access GP records remotely.
December 3, 2008... GPs act to prevent NHS bodies accessing records without explicit consent By Steve Nowottny NHS organisations are attempting to use data extraction systems to access patient records from practice systems without the permission of GPs....

How data can be extracted.
December 3, 2008... * Clinical initiatives: data sent to IT system operated by Improving Access to Psychological Therapies * PCT staff: Manchester LMC raised concerns over PCT plans for `secure data extraction', warning of `mission creep' * Other...

Entire GP practice IT system is stolen.
December 3, 2008... Thieves have managed to steal an entire GP practice system, it emerged last week, in the latest of a series of NHS data security breaches to be revealed. A list of breaches reported to SHAs and obtained by the Liberal Democrats under the...

PCT warns hospital on C&B.
December 3, 2008... A PCT has become the first in the country to take formal action over the abuse of Choose and Book by hospitals desperately attempting to hit the 18-week referral-to-treatment target, writes Steve Nowottny. The move follows a letter in...

GPs draw up alternative accreditation proposal.
December 3, 2008... GP leaders have drawn up proposals for a `two-tier' practice accreditation scheme that could be set up in place of national plans for performance management. The scheme would require GPs to demonstrate quality against a series of...

JOURNAL WATCH: Prenatal antidepressants.
December 3, 2008... Antidepressants taken during pregnancy may increase the risk of heart problems in newborns, a team of international researchers reports. In 2,191 women from Israel, Italy and Germany, the risk of heart problems in newborns was raised by 4.5...

JOURNAL WATCH: Scan-free PAD diagnosis.(peripheral arterial disease)(Brief article)
December 3, 2008... GPs can use a stethoscope to measure ankle-brachial index when diagnosing peripheral arterial disease in the absence of a Doppler scanner, say Italian researchers. In a study of 88 patients assessed with both methods there was a good...

JOURNAL WATCH: White-coat BP risks.
December 3, 2008... Patients with diabetes who have white-coat hypertension are at increased risk for diabetic retinopathy and diabetic nephropathy, Brazilian researchers report. In 319 patients with diabetes, 46 were found to have white-coat hypertension,...

FOCUS ON... The OTC drugs drive.(over the counter drugs)
December 3, 2008... Switching medicines from POM to P may be more convenient for patients but is it always medically sound? By Lilian Anekwe Brightly lit and crammed with enticingly colourful pills, vials and bottles, a modern pharmacy lies somewhere on...

FOCUS ON... Pharmacy provision of POM drugs.
December 3, 2008... Paul Hughes, pharmaceutical adviser at Cornwall and Isles of Scilly PCT, oversees a minor ailments scheme that makes five POMs available as part of a patient group direction. He says: We have PGDs for five medicines - impetigo, vaginal...

EDITORIAL: Time to rally round dispensing practices.(Editorial)
December 3, 2008... Dispensing GPs may have assumed things couldn't get any worse. They are already the Government's least favourite health professionals, if the pharmacy white paper is anything to go by. Up to 700 practices face losing their lucrative dispensing...

VOX POP: Should dispensing practices be consigned to history?
December 3, 2008... Dr Gary Calver GP in Folkestone, Kent `Patients value them, and they are important to rural communities. There are questions about how they're organised, but the system seems to work well.' Dr Sarah Bedford GP in Doncaster, South...

Should medical researchers get access to patients' care records?
December 3, 2008... References 1 www.wellcome.ac.uk/GPrecords 2 Health Select Committee Sixth Report 2007,chapter five - the Secondary Uses Service YES With proper safeguards, access to patient records can open up a new era of medical research...

PULSECLINICAL: NEED TO KNOW - ECZEMA.
December 3, 2008... Take-home points * The current treatment trend is to start with a moderate-to-potent steroid and taper down * An alternative is to use the steroid one or two days a week - the `weekender' regimen * Ask patients to bring the tube...

PULSECLINICAL: AMBULATORY ECG RECORDING.
December 3, 2008... Cardiologists Dr Clive Handler and Dr Gerry Coghlan continue their series on tests commonly used in primary care First described by the physician Norman Jeff Holter in 1949, this test records a patient's heart rhythm and rate, usually over...

PULSECLINICAL: MICROSCOPIC HAEMATURIA.(Case study)
December 3, 2008... The case A 45-year-old man has attended for a medical. He has no relevant past medical history other than mild asthma treated with an occasional bronchodilator and is on no other prescribed medication - though he admits to taking low-dose...

SNAPSHOT DIAGNOSIS: PUSTULAR REACTION ON THE LIMBS.
December 3, 2008... These pustules appeared after a course of prednisolone. Is it an infection? Dr Mike Wyndham describes the case The patient This 63-year-old man had been a longstanding sufferer of asthma. His latest attack had been precipitated by a...

PULSECLINICAL: NOROVIRUS.
December 3, 2008... As the norovirus season gets into full swing, Dr John Harris, epidemiologist and expert on norovirus at the Health Protection Agency's Centre for Infections, gives GPs advice on managing the problem 1 The main symptoms of norovirus are a...

HOW NOT TO MISS... ACUTE ONSET DIABETES IN A CHILD.
December 3, 2008... Paediatric endocrinologist Professor Timothy Barrett advises on the key signs and pitfalls in diagnosing type 1 diabetes in children Worst outcomes if missed * Death - mortality in type 1 diabetes is usually due to complications of...

ASKTHEEXPERT: DATA PROTECTION.
December 3, 2008... Andrew Lockhart-Mirams sets a data controller's mind at rest As data controller under the Data Protection Act for my patients' records, am I responsible for changes written to that database via the Spine without my knowledge? Do I still...

BUSINESSBRIEFING: MANAGING SUPERANNUATION.
December 3, 2008... Practices often give little attention to the amounts being deducted from GMS and PMS monies and this can bring nasty surprises, says accountant Ian Tongue Managing the practice's exposure to superannuation liabilities is not an exact...

COPPERFIELD: Why nothing's ever idiot-proof.(medical protocols)
December 3, 2008... Copperfield suspects few medical procedures can be made truly idiot- proof. Someone's always working to perfect a better idiot It's said the Ottawa rules to assess which ankle injuries need an X-ray are so simple that even nurses can...

GPs must obey NICE or face sanctions.
December 10, 2008... Care Quality Commission reveals NICE guidance to be legally enforceable from 2009/10 By Nigel Praities GPs will have to prove they follow NICE guidelines or face the possibility of suspension, prosecution or the closure of their...

Regulatory crackdown on GPs.
December 10, 2008... * The Care Quality Commission will be the first regulator in the world to have such a wide remit over both health and social care * The Department of Health says it expects all GP practices will eventually have to register with the CQC, but...

PCTs to get 5.5% increase in funding.(Brief article)
December 10, 2008... PCTs will receive #164bn of funding for 2009/10 and 2010/11, an average increase of 5.5% over both years. The Government announced the increase as part of a shakeup of PCT funding which includes the use of a `new, more technically robust...

BMA hits out at freeze on Welsh GP premises.
December 10, 2008... The BMA has hit out at plans to put a freeze on the development of GP premises in Wales until further notice. The National Assembly Government has instructed local health boards to immediately cease planning for primary care projects in...

Half of those with dementia undiagnosed.
December 10, 2008... More than half of people with dementia are going undiagnosed because of a dire lack of investment at PCT level, according to new figures released by the Liberal Democrats. A survey conducted with the Alzheimer's Society found that of an...

QOF OVERHAUL: NICE review of QOF to crack down on `double counting'.
December 10, 2008... Cardiovascular indicators to be radically cut back and exception reporting may be scrapped, says institute Exclusive By Lilian Anekwe NICE plans to radically reduce the number of cardiovascular indicators in the QOF to avoid...

QOF OVERHAUL: HOW QOF INDICATORS CAN COUNT TWICE.
December 10, 2008... Coronary heart disease CHD 5: The percentage of patients with coronary heart disease whose notes have a record of blood pressure CHD 6: The percentage of patients with coronary heart disease in whom the last blood pressure reading is...

QOF OVERHAUL: Cutting QOF indicators may harm quality, NICE admits.
December 10, 2008... NICE may be forced to reinstate indicators it removes from the QOF if quality is found to slip as a result, a leading official at the institute has conceded. The admission came as a leading primary care academic warned quality could...

DH launches national marketing drive for extended hours.
December 10, 2008... PCTs are ramping up their efforts to promote competition in general practice with a major new marketing drive aimed at attracting patients to practices that offer extended hours. The Department of Health has ordered all PCTs to highlight to...

WORKFORCE FEARS: Job blackspots warning as practices begin to shed GPs.
December 10, 2008... Oversupply of trainees and funding cuts create jobs desert as one singlehander in 10 closes Exclusive By Gareth Iacobucci GPs are facing a jobs desert in many areas of the country, with salaried posts virtually impossible to find...

WORKFORCE FEARS: Fall in singlehanded practices picks up speed.
December 10, 2008... Singlehanded GP practices are rapidly disappearing from the map, with one in 10 closing in the past year, Pulse can reveal. Figures obtained from 50 PCTs show 56 singlehanded practices went in that time, as PCTs merged them or redistributed...

Scots practices to shut for eight days at Christmas.
December 10, 2008... NHS bosses in Scotland have ordered every GP practice in the country to close its doors for eight days over the Christmas period - despite warnings from GP leaders that the move risks causing chaos. A country-wide order to close practices...

Pharmacy to give contraceptive pill.
December 10, 2008... DH approves two schemes allowing pharmacists to supply pill to women over 16 without prescription By Lilian Anekwe Controversial pilots offering the contraceptive pill in pharmacies without prescription will be launched next year,...

MEDIA WATCH: THIS WEEK'S TOP... Miracle cure.
December 10, 2008... Get ready to say goodbye to sleepless nights and blurry days after returning home from a glamorous location many time zones away. The Independent, Daily Mail, Daily Telegraph and Guardian report that researchers have developed a...

MEDIA WATCH: THIS WEEK'S TOP... Scare story.
December 10, 2008... Living in a hermetically sealed bubble seems a more attractive idea than ever after research reported in the Daily Mail, Telegraph and Sun showed an uncovered sneeze could infect 150 people with a cold in five minutes. The study, conveniently...

MEDIA WATCH: THIS WEEK'S TOP... most pointless research.
December 10, 2008... In a remarkable study, US researchers have found pre-school children trained in swimming and water safety are less likely to drown than untrained ones. The researchers took two groups of children to a pool to put the sink-or-swim theory to the...

IN BRIEF: Choice drive flagging.(Survey)
December 10, 2008... The Government's drive to increase patient choice is still foundering, with new figures showing no increase in the number of patients being offered choice in England between July and September. Provisional results for the September patient...

IN BRIEF: PBC providers announced.(practice-based commissioning )(Brief article)
December 10, 2008... The Department of Health has announced a list of providers to take forward its latest attempt to reinvigorate practice-based commissioning by fast-tracking support to failing areas. They are: NHS Alliance/Humana PBC Partnership, supported...

IN BRIEF: Stroke awareness effort.
December 10, 2008... The Government has announced plans for a three-year, #12m campaign to promote public awareness of stroke. The campaign, to be launched in February 2009, will use advertising, PR and direct marketing to teach the public and NHS staff to better...

Cash crisis forces PCTs to cut patient bed-days.
December 10, 2008... Patients shifted out of hospital faster to cope with rise in GP referrals By Nigel Praities Financially stricken trusts are planning to pile further pressure on GPs by ramping up efforts to clear patients out of hospital more quickly,...

How PCTs plan to make savings.
December 10, 2008... Buckinghamshire: Cutting follow-up appointments (#1.9m); letting patients go home earlier (#1.4m) and reducing GP referrals (#1.3m) Hampshire: Excess bed reduction (#750,000); reducing capacity in specialties hitting their 18-week targets...

MMR catch-up campaign yet to increase uptake.
December 10, 2008... The MMR catch-up campaign has had little impact so far on vaccine uptake in the urban areas most at risk of a measles epidemic, preliminary figures obtained by Pulse reveal. Uptake of the MMR vaccine at age five in six PCTs in London,...

BMA puts fight against anti-GP spin on hold.
December 10, 2008... GP leaders defer campaign pending results of health centre tendering By Gareth Iacobucci The BMA has put its campaign against Government reforms to general practice on ice, pending the results of the GP-led health centre tendering...

LMC campaign goes it alone.(London Medical Council)
December 10, 2008... Bedfordshire and Hertfordshire LMC launched its own `Save my GP' campaign in September and has since received more than 100,000 signatures. Chief executive Peter Graves said the local response to the campaign was `well over double' that of...

Score assesses depression risk.
December 10, 2008... UK researchers have developed a `Framingham-style' risk score for predicting future bouts of major depression. It is hoped the risk algorithm, which was developed and tested on 5,200 people across Europe, will eventually be used in GP...

Private provider makes cuts.
December 10, 2008... One of the UK's biggest private primary care providers is implementing a programme of cuts to its business in an attempt to fight off the credit crunch. Assura, which has invested more than #500m in 150 sites across the country, including...

JOURNAL WATCH: Dementia drug benefit.
December 10, 2008... Galantamine is safe and may improve cognitive function in elderly patients with severe Alzheimer's disease, an early trial shows. In the European study, led by UK researchers, 407 patients aged over 84 living in nursing homes received...

JOURNAL WATCH: Fractures cut in over-50s.
December 10, 2008... Strontium ranelate can reduce the risk of vertebral fracture in young postmenopausal women, a European study suggests. The Spinal Osteoporosis Therapeutic Intervention study, in 353 postmenopausal women aged 50-65 with severe osteoporosis,...

JOURNAL WATCH: Folic acid linked to RTIs.
December 10, 2008... Folic acid supplements in the first three months of pregnancy are associated with a small increase in the risk of early respiratory infections and wheeze, Norwegian research suggests. Data from questionnaires answered by the mothers of...

FOCUS ON... The fall in singlehanders.
December 10, 2008... Alan Johnson's remark that some singlehanders are not at 1948 standards reflects a wider drive to phase them out By Steve Nowottny For a health secretary with a reputation as a diplomatic type, it was not a particularly diplomatic...

EDITORIAL: Crude attempt to force NICE on GPs.(Editorial)
December 10, 2008... There was a time when regulation of GPs' clinical performance was supposed to be light-touch. GPs would be interviewed about their QOF achievement, sure. They would be expected to demonstrate they had met the standards agreed in the contract....

VOX POP: Do you still see the private sector as a threat?
December 10, 2008... Dr Krishna Chaturvedi GP in Southend, Essex `Absolutely - they are interested, despite the fact that with the present economy we thought they would not be. I know Branson and others have pulled out of a few things, but if they get the...

LETTER: Profit squeeze leaves me with the BMA blues.(Letter to the editor)
December 10, 2008... From Dr David Church Machynlleth, Powys The Department of Health's submission to the pay review body sounds fair enough in headline form (`No pay rise without work, DH tells review body', pulsetoday.co.uk/ news). So our Government...