Pulse articles from February 2004

Pulse archives from February 2004

PCT attacked for hounding GP to death.
February 2, 2004... The partners of a GP found hanged after he was investigated for high referral rates have denounced their PCT for `hounding' him and `looking only at numbers'. Dr Stephen Farley, described by colleagues as `the most caring GP you can...

DIY tests may help GPs meet pay target.
February 2, 2004... GPs involved in a ground-breaking trial of a do-it-yourself screening test for human papilloma virus hope it will help them meet their cervical cytology pay targets. Practices with low smear uptake rates in Hounslow, west London, have...

GPs who over-refer face penalties on quality pay.
February 2, 2004... NHS managers will have the right to dock practices' quality pay if they suspect GPs have been over-referring patients in a bid to hit quality targets. PCTs have been given powers to `rescore' practices if there is any evidence of GPs...

Chance leads GP to save dying man.
February 2, 2004... Dr Andrew Field carried out a roadside resuscitation on a dying man he spotted by chance on an out-of-hours call. The 57-year-old patient had been beaten unconscious by a gang of youths after challenging them over a theft. Dr Field, a GP...

Flu vaccine scrutiny stepped up as focus turns to young.
February 2, 2004... Official monitoring of influenza vaccine uptake in younger patients is set to be launched next winter after the most recent data suggested GPs are immunising as few as one in 20 at-risk children. Scientists at the Health Protection Agency...

This winter's flu vaccine `was ineffective'.
February 2, 2004... This winter's influenza vaccine may have conferred little or no protection against flu, according to a study from the US Centers for Disease Control and Prevention (CDC). Dr Susan Dolan and colleagues asked more than 1,800 health workers...

GPs given #30m for IT upgrades.
February 2, 2004... The Department of Health is giving an extra #30 million to PCTs for maintaining GP computer systems and ensuring they can cope with the new contract. The cash covers replacements of old systems that cannot cope with the quality framework...

Co-ops to transform as minister admits service `concerns'.
February 2, 2004... Health minister John Hutton has admitted there are `genuine concerns' that out-of-hours services will deteriorate when GPs give up their 24- hour responsibility. His concession came at the launch of a Government-backed plan to change the...

OTC statins will `widen inequalities'.
February 2, 2004... Dr Michael Varnam, a Government adviser on disease prevention, has voiced strong reservations over the plan to sell statins in pharmacies. Nottingham GP Dr Varnam, vice-chair of the Health Development Agency, claims the ground-breaking plan...

Target pay `key to MMR uptake'.
February 2, 2004... The importance of GP vaccine target payments in bolstering MMR uptake has been highlighted by new research. Coverage among two-year-olds was 74.8 per cent in practices not eligible for target pay - compared with 81.7 per cent in practices...

Smoking drug rules `illogical'.
February 2, 2004... Specialist nurses should be given powers to prescribe bupropion (Zyban) to smokers because the current policy `makes no sense', claims Dr Scott Wilkes. Dr Wilkes, clinical research fellow in primary care at the University of Sunderland,...

1 in 10 young adults has early COPD.
February 2, 2004... One in 10 young adults in the UK has early symptoms of chronic obstructive pulmonary disease, reveals a major international study. GP experts and respiratory specialists expressed shock at the finding and called for improved GP facilities...

GPs braced for surge in hep C.
February 2, 2004... GPs have been warned to brace themselves for a surge of patients who believe they may have undiagnosed hepatitis C following new Government guidance on the condition. The National Institute for Clinical Excellence guidance said only 2,000...

NICE urges GPs to spot eating disorders earlier.
February 2, 2004... New Government guidance on eating disorders puts GPs at the forefront of a drive to diagnose and treat the conditions. The guidance on anorexia and bulimia nervosa and related disorders from the National Institute for Clinical Excellence...

PCT's bill for asylum seeker.
February 2, 2004... A PCT facing a #440,000 bill for the treatment of a failed asylum seeker has criticised the Home Office for failing to tell the trust he was no longer eligible for free NHS care. North East Lincolnshire PCT has warned plans to improve GP...

Complaints system reform `is not about catching another Shipman'.
February 2, 2004... GPs have condemned the Consumers Association after it claimed that planned reforms to the NHS complaints procedure `would not stop another Shipman'. The association said in its evidence to the Shipman Inquiry that Government plans for...

Quantum leap needed to be top quality.
February 2, 2004... GPs involved in a prototype of the quality and outcomes framework believe most practices will have to make `a quantum leap' to score high marks in the first year of the contract. The warning by members of the Primary Care Clinical...

Non-EU GPs in row over seniority.
February 2, 2004... GPs who qualified outside of Europe are claiming new seniority pay arrangements are `discriminatory' because they cannot claim for any service before they joined the NHS. Doctors who qualified in the European Economic Area (EEA) are able...

NICE rulings `just one part of big picture'.
February 2, 2004... NICE guidance can reinforce information from other sources but has little impact in isolation on GPs' prescribing choices, research shows. The study, published in the British Journal of General Practice (February), used prescribing data...

Angry GPs demand to see `did not attends' punished.
February 2, 2004... GPs and practice staff view patients who miss appointments as `criminal' and are in favour of ways they can `punish' them, research concludes. The study of 336 GPs in separate practices in Yorkshire found nearly half favoured charging...

Cutting down doesn't cut carcinogens.
February 2, 2004... Reducing the number of cigarettes smoked has little effect on the levels of carcinogenic metabolites in the body, a new study suggests. In a US trial of 153 smokers, cigarettes were reduced by up to 90 per cent over six months, but the...

Coffee linked to type 2 diabetes risk.
February 2, 2004... People who drink more than six cups of coffee every day have a significantly lower risk of developing type 2 diabetes. US researchers tracked 125,000 people without diabetes, cancer or heart disease for more than 10 years, checking coffee...

Hope for Alzheimer's combination therapy.
February 2, 2004... Patients with moderate to severe Alzheimer's disease could benefit from combination therapy with the cholinesterase inhibitor donepezil, plus the NMDA inhibitor memantine, a new study has found. It found improvements in measures of cognition,...

Antioxidants in Alzheimer's prevention.
February 2, 2004... Antioxidant vitamin E and C supplements protect the ageing brain against oxidative damage associated with Alzheimer's disease, a large US study concludes. It found significantly reduced prevalence of Alzheimer's in an elderly population who...

Exercise effective for heart failure.
February 2, 2004... Supervised exercise training programmes for patients with left ventricular failure can reduce deaths and hospital admissions. A meta-analysis of nine randomised controlled trials totalling 801 patients over a mean of 705 days showed a...

Melatonin hope for hypertension.
February 2, 2004... Melatonin taken an hour before sleep reduces 24-hour ambulatory blood pressure, Dutch research suggests. A small randomised, controlled trial on men with uncontrolled hypertension showed three weeks' of daily melatonin reduced systolic and...

PCOs to audit GP notes to curb allergy errors.
February 2, 2004... Primary care organisations will audit GPs' notes in a bid to cut the number of `potentially devastating' prescribing errors in patients with allergies. A major new Department of Health report has recommended that all notes should be...

GPs told to report `near misses'.
February 2, 2004... GPs are being urged by the Government to report `near misses' or potential prescribing errors as well as mistakes that resulted in patient harm. Reinforcing the message from the National Patient Safety Agency's anonymous `no blame' system,...

RCGP wants new debate on cannabis.
February 2, 2004... The RCGP has called for a national debate on the health risks of cannabis. The call came as the drug was reclassified from a class B to a class C drug last week. Dr Clare Gerada, the college's drugs spokesperson, said health issues...

Preventing prescribing errors - the `Swiss Cheese' model.
February 2, 2004... GPs have many defences at their disposal to prevent medication errors, the report said. It recommended GPs visualise these as layers of Swiss cheese, warning that although any one of the checks could save a life, in reality each contained...

Q&O points `may lead to spirometry errors'.
February 2, 2004... Quality and outcomes incentives for GPs to carry out spirometry could lead to clinical errors, a leading specialist has warned. Professor Martyn Partridge, professor of respiratory medicine at Imperial College London, said he feared quality...

Talking POINTS.
February 2, 2004... Dr Bill Cunningham has been a GP in Corbridge, Northumberland, since 1979 - Jo Carlowe spoke to him about the hot topics in his practice Out-of-hours Will you opt out of this responsibility? Yes - no other option makes sense. ...

GPs face soaring locum cover bills for maternity leave.
February 2, 2004... GPs are warning they face mounting bills to cover maternity leave despite increases in locum allowances under the new contract. Locum reimbursement for partners on maternity or paternity leave will rise 6.5 per cent to #948 a week from...

GPs get action card in terrorism battle.
February 2, 2004... GPs are to be sent `action cards' to help them identify patients who may have been exposed to chemical or biological weapons. The move comes as part of a Health Protection Agency programme designed to raise awareness of the effects of...

Vacancy rates rise by 220% in London.
February 2, 2004... Vacant GP posts in London rocketed by 221 per cent between 2000 and 2003, the Government has admitted. In response to a parliamentary question from Liberal Democrat mayoral candidate Simon Hughes, health minister John Hutton said there...

It took a year to sort out my IT.
February 2, 2004... Dr Charles Morrison spent almost a year trying to ensure data would not be lost when he upgraded his IT system. Whenever the supplier did a dummy run of the switch, information from consultations was lost. Only after taking the server to...

GPs warned over data migration when switching their computers.
February 2, 2004... GPs are putting themselves at risk of legal action when they change or upgrade their practice computer systems because vital patient information is usually lost, the BMA has warned. It wants GPs to complete a questionnaire with their...

EDITORIAL COMMENT: Pressure must ease to stop these tragedies.
February 2, 2004... The tragic death of Leicestershire GP Dr Stephen Farley has highlighted the often intolerable pressure on GPs. Here we examine the cause of the problem and ask how well GPs are bearing up to increased scrutiny and contractual change. GPs...

Implications of making changes to Read codes.
February 2, 2004... Quality points earnings will depend on the right Read codes - Dr Sally Barnard of the Medical Defence Union discusses legal implications of amending notes Imagine the following scenario. A patient comes to see you with chest pain. You make...

February contract calendar.
February 2, 2004... This month could be the busiest month leading up to the new contract, says Dr Bob Button, who looks at key dates for GPs and their practice managers FEBRUARY 7 Check with the PCO to ensure there is a visit schedule in place that...

Diabetes mellitus.
February 2, 2004... Dr John Couch on the money available and what is required to earn points from diabetes Points achieved with complete ease DM 1 Practice can produce register of all patients with diabetes mellitus Value six points Keep...

New rules for GP study leave and locum payments.
February 2, 2004... Dr Bob Button looks at how the new contract guidance affects payments for prolonged study leave and locum cover The old Red Book and the new statement of financial entitlement (SFE) are very similar. However, one change is that prolonged...

NHS or private law contract? How to decide.
February 2, 2004... GPs need to decide whether they want their practices to become a health service body with access to the NHS's internal disputes resolution service, or instead have a private law contract - solicitor Daphne Robertson gives advice Practices...

Old notes arrive and reveal worrying past.
February 2, 2004... Three GPs give their opinion on a complex practice issue Case history Brian, 39, is a new patient who disclosed depression when he registered, but his records have not yet been summarised. You met him only once when he said that St...

Unexpected aspects of head injury.
February 2, 2004... Head injuries may cause subtle, long-term behavioural problems that often go unrecognised in primary care - Dr Jonathan Bird explains Head injury has been called the silent epidemic. It accounts for one in 10 of all visits to A&E and severe...

10 TOP TIPS: Eyelid swellings.
February 2, 2004... Bite-sized practical advice for busy GPs 1. Styes are the most common eyelid swelling, especially in children. They are due to a staphylococcal infection of the lash follicle, where there are modified sebaceous glands known as glands of...

INFERTILITY: Risks and benefits of assisted conception.
February 2, 2004... New ways of helping childless couples have exciting potential but limited effectiveness - Dr Chandra Kailasam and Dr Julian Jenkins explain Since the birth of Louise Brown in 1978, assisted conception has seen amazing developments both in...

Tattoos and body piercing.
February 2, 2004... In this series a GP interviews an expert to get first-hand information that goes beyond the textbook on a topic of current clinical interest GP Dr Stefan Cembrowicz in conversation with plastic surgeon Mr Nigel Mercer about the medical...

YOUR FIRST: Dubious request for a sicknote.
February 2, 2004... Not all requests for sicknotes are medically justified but some can be a cry for help - Dr Melanie Wynne-Jones suggests ways to spot them Sooner or later you will be asked for a sicknote by someone who seems perfectly well enough to work....

ANSWER BACK: How safe is ranitidine for infant acid reflux?
February 2, 2004... Q: One of my patients, a four-month-old baby, was admitted with vomiting and failure to thrive and discharged on ranitidine for reflux. How safe is this? A: Gastro-oesophageal reflux is a normal phenomenon which if frequent and prolonged...

ANSWER BACK: Should HRT be stopped before major surgery?
February 2, 2004... Q: Should HRT be stopped before major surgery such as hip replacement? If so when, and when can it be restarted? A: In trials of thromboprophylaxis in orthopaedic surgery, rates of total and proximal VTE after hip replacement are 16.1 per...

Turmoil as NICE tears up BP rules.
February 9, 2004... GP management of hypertension has been plunged into confusion by a controversial draft ruling from the National Institute for Clinical Excellence. NICE has concluded there is no evidence to support first-line use of ACE inhibitors or...

GP's Valentine message to 800 smokers.
February 9, 2004... Dr Charles Broomhead, a GP in Birmingham, is sending Valentines to 800 patients who smoke with the message that smoking damages the heart. He said: `What better time of year to encourage people to look after their heart?' Copyright: CMP...

Pulse is the best-read medical publication - bar none.
February 9, 2004... According to the latest industry survey, 77 per cent of GPs read Pulse each week during 2003 compared with 72 per cent who read GP. Pulse has also overtaken MIMS to head the table of all publications read by GPs. We would like to thank you...

Another delay to income details.
February 9, 2004... Yet another Government delay means practices will not be told their likely income for next year until the end of this week at the earliest. The Department of Health said `technical difficulties' were to blame for the hold-up. GPs in...

Consultant backs tragic GP.(General practitioners)(Brief Article)
February 9, 2004... A consultant has contacted Dr Stephen Farley's practice to recall how he had never known him to make an incorrect diagnosis. The tribute comes in advance of an inquiry by Leicestershire, Northamptonshire and Rutland strategic health...

Contract clauses scrapped after outcry over indemnity.
February 9, 2004... Clauses in the new GMS contract that would have made GPs liable for the cost of any primary care organisation investigation into their practice have been scrapped. The decision marks an embarrassing climbdown by GPC negotiators. They had...

GP's `offer to buy baby' was just a joke.(Brief Article)
February 9, 2004... Dr Anand Singh says he is `devastated' after being accused by parents of trying to buy their baby. Dr Singh, a GP in Stoke-on-Trent, said he made a `lighthearted comment' during an out-of-hours consultation, but denied ever offering to buy...

Contract row as GPs attack NHS managers for gloating.
February 9, 2004... GP negotiators are demanding that ministers publicly reject NHS managers' boasts that they have `fooled and outmanoeuvred' practices in drawing up the GMS contract. The furious row broke out after GPs reported that speakers at an NHS...

GPs accused over children at risk.
February 9, 2004... A Government minister has accused GPs of `hiding behind legislation' and `refusing to co-operate' with its efforts to improve sharing of information about vulnerable children. Children's minister Margaret Hodge also claimed GPs were the...

Demand for overhaul of rules on controlled drugs.
February 9, 2004... The GP academic who unmasked the scale of Harold Shipman's crimes has warned that controlled drugs regulations need to be `entirely overhauled' or GPs will stop holding supplies. Professor Richard Baker's comments came after his research...

GPs are `not sure what RCGP is for'.
February 9, 2004... The RCGP has embarked on a wholesale review of its activities after admitting many GPs are not sure `what the college is for'. In a strategic plan for 2004/7, the college conceded it had suffered from a `lack of focus and direction' leading...

GPC issues advice on explaining enhanced services to patients.
February 9, 2004... The GPC has issued guidance for GPs on how to tell patients their practice has stopped providing services because they are not being paid for them. The guidance comes after LMCs reported many trusts are not commissioning national enhanced...

Pay increase for GP educators.
February 9, 2004... GP educators have been given their first pay increase for a decade. Established course organisers and tutors will see their pay rise by 32 per cent from #56,470 to #75,000, backdated to October last year. Associate advisers and associate...

Review calls for influenza vaccine for all children.
February 9, 2004... Government immunisation advisers are set to consider a controversial recommendation that all children should have an annual influenza vaccination to reduce excess hospitalisation and antibiotic use. The recommendation - from a review of...

Aluminium safe for vaccine use.
February 9, 2004... A safety review by the influential Cochrane Collaboration has concluded there is no link between aluminium in vaccines and side-effects including muscle wasting. The review, carried out by Dr Tom Jefferson, co-ordinator of the Cochrane...

GPs get advice on repeat prescribing.
February 9, 2004... The National Prescribing Centre has launched a guide to help GP practices improve their repeat prescribing, saving themselves money and ensuring effective treatment. The guide, Saving Time, Helping Patients, has been commended by the RCGP...

Reid seeks GP views on public health challenge.
February 9, 2004... GPs will get the chance to bring the primary care agenda before the public this month in a national consultation exercise on public health. Health Secretary John Reid will seek the profession's views on smoking, alcohol, sexual health,...

Patient choice is a hard job to sell, warns GP.
February 9, 2004... Dr Chris Neal has warned NHS managers they have a hard job to convince GPs of the merits of the Government's patient choice agenda. GPs may see new obligations such as discussing choice of hospital with patients as extra burdens that...

GPs attacked over care home scripts.
February 9, 2004... GPs have been sharply criticised by MPs and the Commission for Health Improvement for over-prescribing multiple medicines for elderly people in care homes. CHI chair Dame Deirdre Hine told a Commons health select committee inquiry into...

`Difficult' GP access target set for review.
February 9, 2004... The Government has launched a `priority review' of the primary care access target after conceding it may be difficult to achieve it. The review which will report to the Prime Minister in March will consider the incentives and support...

GP's anguish over legal threat after tragic baby death.
February 9, 2004... A GP criticised by parents when their baby died days after he gave them out-of-hours advice has insisted he could not have done anything differently. Dr Mike Scott could face a GMC investigation and legal action after the 13-week-old girl...

Glasgow GPs strike deal to aim for maximum quality points.
February 9, 2004... All 200 practices in Glasgow will get the maximum quality aspiration pay after GPs struck a deal with their PCT to aspire to all 1,050 points. Greater Glasgow PCT reached an agreement with the GPs after being convinced that no practice...

Fears over safety of pharmacist advice.
February 9, 2004... Evidence that pharmacists are failing to give proper medical advice has been revealed by an undercover investigation, prompting new fears over plans to shift GP prescribing workload to pharmacists. Researchers from Which? magazine who asked...

Benzodiazepine prescriptions to be dispensed in instalments.
February 9, 2004... The Government has announced plans to introduce instalment dispensing of benzodiazepines, reminding GPs that the drugs should only be prescribed for short-term treatment. Although benzodiazepine prescriptions have fallen from 15.8 million...

PCTs could bar GPs from opting out.
February 9, 2004... An LMC has warned rural PCTs could veto GPs' right to give up out-of- hours responsibility if there are not enough doctors willing to cover shifts. Dr Harry Yoxall, medical secretary of Somerset LMC, said primary care organisations could...

Scotland complaints rise.
February 9, 2004... Written complaints from patients about primary care services in Scotland increased by 13 per cent last year to 3,172 cases. But the number of complaints that involved requests for an independent review fell to 69 in 2002/3 compared with 92...

Flu vaccine cuts cardiovascular deaths.
February 9, 2004... Vaccination during the influenza season reduces the risk of cardiovascular mortality, according to a study of more than 200 patients who had an infarction, and 101 who had undergone angioplasty. Researchers found vaccination had a...

Grapefruit's role in weight loss.
February 9, 2004... A US pilot study has suggested grapefruit reduces glucose levels and can help weight loss in obese patients. Researchers checked weight and blood glucose after 12 weeks in 100 patients randomised to 200g of grapefruit or grapefruit juice...

Folic acid may reduce stroke in men.
February 9, 2004... A major new study has concluded that folic acid may significantly reduce ischaemic stroke in older men. In 14 years follow-up, US researchers checked dietary information in 43,732 men aged 49 to 75 and recorded a total of 725 incident...

Childhood eczema linked to smoking.
February 9, 2004... Researchers studying the links between environmental tobacco smoke and atopy have found that exposed children have a higher risk of developing eczema. Assessments of 1,669 school beginners in Germany also found a positive, but...

Poor prognosis for adult eczema.
February 9, 2004... A UK follow-up study of 922 adults attending a clinic for atopic dermatitis in the 1960s and 1970s has found two-thirds reported an episode of the condition within the last year. Respondents aged 45 to 86 at follow-up reported incidence of...

Exercise-induced asthma in children.
February 9, 2004... Parents and children perceive a child's exercise-induced asthma differently, according to UK researchers, and although neither can accurately judge symptoms, children are better than their parents at estimating severity. Using validated...

Go-ahead for US-style GP assistants.
February 9, 2004... The Government has given the go-ahead for American-style `physician assistants' to be trained in the UK as a way of easing the GP recruitment crisis. A new two-year honours level course will teach the same skills as the existing four-year...