Pulse articles from February 2005

Pulse archives from February 2005

Matrons plan `will not cut admissions'.
February 5, 2005... The Government's much-touted community matrons scheme is in tatters after researchers concluded it would have barely any effect on hospital admissions. US-style active case management - hailed by the Government as the answer to spiralling...

Tsar signals tougher heart failure scrutiny.(Brief Article)
February 5, 2005... GPs will face much tougher scrutiny of their heart failure care from April as part of a Government drive to force up standards. Heart tsar Dr Roger Boyle told Pulse Government inspectors would be monitoring heart failure interventions in...

A home-grown alternative to Evercare.(Brief Article)
February 5, 2005... Dr Donal Hynes has set up a rapid assessment system for high-risk patients within primary care which he says is far more cost-effective than using community matrons. In the scheme, unplanned admissions are flagged up automatically by an...

Choose and Book scheme mandatory if you want to commission.
February 5, 2005... GPs who take up practice-based commissioning in April will be forced to take on Choose and Book as well. Final guidance from the Department of Health - due out last Friday but delayed by internal wrangling - is expected to confirm the...

GP's #327k queries over discharge data.(Brief Article)
February 5, 2005... Dr Phil Taylor queried #327,000 of work done by his foundation trust over three months last year because of incomplete, wrong or absent discharge information. The queries amounted to 20 per cent of the total admissions to the trust for his...

Double blow to GPs' plans.(Brief Article)
February 5, 2005... The failure of hospitals to supply discharge information for patients will make practice-based commissioning impossible for GPs. Problems with the Payment by Results tariff system also mean practices can have no confidence in taking over...

GPs forced into limbo by complaint system chaos.
February 5, 2005... Government reforms have plunged the NHS complaints system into chaos, forcing GPs into agonising waits to have even trivial cases against them resolved. The Healthcare Commission revealed this week that complaints being escalated to...

Ministers to act on 0870 phone numbers.(Brief Article)
February 5, 2005... Ministers are planning to order practices that use an 0870 number to offer a local rate alternative as well. The move is seen as a compromise to an outright ban on GPs using the controversial numbers, which are charged at a more expensive...

#100k-jibe MP had #150k expenses bill.(Brief Article)
February 5, 2005... An MP who claimed GPs `earned more than #100,000 a year for a nine-to- five job' claimed #152,861 in expenses last year. Parliamentary figures show Eric Joyce, Labour MP for Falkirk West, was the fifth highest claimer out of all 658 MPs in...

Saturday surgery axed.(Brief Article)
February 5, 2005... A PCT has been forced to close a Saturday morning out-of-hours service due to lack of interest from patients. Just seven patients had used the service in Bury St Edmunds since it was set up last October. A spokesman for West Suffolk PCT...

Co-proxamol ban throws GP surgeries into chaos.
February 5, 2005... GP care of millions of people has been thrown into turmoil after the Government's drug regulator ruled the painkiller co-proxamol would be withdrawn. Surgeries reported being swamped with worried patients after the Medicines and Healthcare...

`Ignore NICE on dyspepsia'.(Brief Article)
February 5, 2005... GPs should ignore NICE guidance and continue to refer patients with dyspepsia for endoscopy, one of Britain's most senior gastrointestinal specialist insists. In a letter to the BMJ, Professor Michael Griffen, head of the Association of...

Atomoxetine liver risk.(Brief Article)
February 5, 2005... The Medicines and Healthcare Products Regulatory Agency has issued new advice to GPs on atomoxetine (Strattera) after finding it might very rarely be associated with liver reactions. The agency said GPs should use an alternative treatment...

Death not linked to statin.(Brief Article)
February 5, 2005... The recent death of a patient taking rosuvastatin (Crestor) was not associated with the drug, manufacturer AstraZeneca insists. The company said the patient's doctor had concluded an infection was the `most likely' cause of death and not...

NSF sets out GP kidney care role.(Brief Article)
February 5, 2005... GPs will be expected to routinely screen hypertensive patients for early signs of chronic kidney disease under a national service framework for renal disease released this week. The NSF outlines new `quality requirements' covering...

BMA anger over public health.(Brief Article)
February 5, 2005... The BMA has condemned the Government's `fuzzy thinking and faulty logic' over its public health reforms. Dr Vivienne Nathanson, head of science and ethics, said ministers had not listened to medical experts who had called for a total ban on...

Patients consider cox-2 suit.(Brief Article)
February 5, 2005... Patients are considering taking legal action against Pfizer for heart problems suffered while on celecoxib (Celebrex). Solicitor firm Alexander Harris has had 20 inquiries from people who believe they have been harmed by celecoxib as well...

Job advisers in GP practices.(Brief Article)
February 5, 2005... Ministers have announced plans to put employment advisers in GP surgeries, as part of an overhaul of incapacity benefit. Alan Johnson, Work and Pensions Secretary, said GP surgeries should be `the first step back to work, not the route to a...

First kidney dialysis unit to be based in a GP practice.(Brief Article)
February 5, 2005... Dr Peter Ingham this week opened the doors on what he believes is the country's first kidney dialysis unit to be based in a GP practice. Dr Ingham and his partner Dr Harj Dau are training in nephrology and will oversee the unit, which will...

`Cervical Ca to be wiped out'.(Brief Article)
February 5, 2005... THE STORY A vaccine to wipe out cervical cancer could be available as soon as next year, the Daily Mail, Times and Guardian report. THE SOURCE The latest stories were sparked by a Science Media Centre briefing where the question...

Government reveals its hand on Q&O overhaul.
February 5, 2005... The Government wants obesity targets and many more points for cancer and mental health in the next version of the quality and outcomes framework, Pulse has learned. Primary care tsar Dr David Colin-Thome told Pulse he expected there to be...

`Spinal injury regrowth hope'.(Brief Article)
February 5, 2005... THE STORY An electrical device to stimulate regrowth of nerve fibres offers hope to people with spinal cord injuries, the Daily Express claims. THE SOURCE Researchers conducted a phase 1 trial examining the use of an oscillating...

`Shoelaces to stop snoring'.(Brief Article)
February 5, 2005... THE STORY A new implant that looks like the end of a shoelace can put an end to snoring, the Daily Mail reports. THE SOURCE Researchers presented results on the effectiveness of palatal implants to reduce snoring at the American...

`Mad cow fear over implants'.(Brief Article)
February 5, 2005... THE STORY The Government is investigating fears that cosmetic implants used in lips and cheeks could trigger mad cow disease, according to The Times. THE SOURCE An expert panel on regulation of the cosmetic industry raised...

Foundation trusts plan to take over GP surgeries.
February 5, 2005... Foundation hospitals are considering radical plans to take over GP surgeries, Pulse can reveal. The NHS Confederation's policy group, the Foundation Trusts Network, admitted trusts across the country were considering the move in order to...

GPs urged to check disease registers.(Brief Article)
February 5, 2005... GPs are being urged to clean up the data on their computer systems ahead of National Prevalence Day to ensure they earn the highest possible quality pay. The National Association of Primary Care has advised practices to check disease...

High Court orders GMC to retry case.(Brief Article)
February 5, 2005... The High Court has referred a misconduct case against a doctor back to the GMC for the first time after ruling that its original verdict was `unduly lenient'. In a landmark decision, Mr Justice Richards ruled there was a `strong case' that...

NPfIT to improve its image.(Brief Article)
February 5, 2005... The NHS National Programme for IT has struck a six-figure deal with a top public relations company to help improve its image. Porter Novelli will run a campaign for the public and NHS staff about the national electronic patient record. ...

Call centres help GPs hit diabetes targets.
February 5, 2005... Call centres for patients with diabetes could help GPs hit their quality targets while coping with the surging incidence of the disease, a new study concludes. Trained non-medical telephonists supported by a diabetes nurse were able to...

Inequalities may worsen.(Brief Article)
February 5, 2005... Pushy middle-class patients may be getting themselves referred to hospital at the expense of their poorer counterparts, Government-funded research suggests. The study, to be published in March's Social Science and Medicine, found people on...

Practices fail young men over chlamydia.(Brief Article)
February 5, 2005... Practices are failing to screen and diagnose chlamydia in young men, a UK study suggests. Researchers said improved training was required to iron out inequalities in testing. They called for better funding of sexual health in general...

`Cock-up' sees every practice paid wrongly.(Brief Article)
February 5, 2005... Every GP practice in England and Wales is likely to have been paid the wrong amount for the second and the third quarters of this year. A fault in the Exeter payments system meant practices that had taken on more patients were paid less....

Pension bills to take edge off bumper GP profits.
February 5, 2005... GPs should keep a sizeable chunk of this year's bumper profit in reserve to deal with `huge liabilities' from pension contributions. Medical accountants are warning GPs not to be seduced by 30 per cent- plus profit increases because of...

Fears calmed on GP appointments bonus.(Brief Article)
February 5, 2005... Fears that practices will miss out on quality pay if they refuse to offer advance appointments have been allayed. Concerns had been raised after the Department of Health inserted a new question into its monthly access survey in November to...

JOURNAL WATCH: Ca linked to child passive smoking.(Brief Article)
February 5, 2005... Passive smoking in childhood may increase the risk of developing lung cancer in later life, according to European researchers. The prospective cohort study asked 123,479 non-smokers aged 35-74 about their exposure to smoke during childhood....

JOURNAL WATCH: Sibling contact cuts MS risk.(Brief Article)
February 5, 2005... Children who have contact with infant siblings up to the age of six have less risk of developing multiple sclerosis than those without contact, an Australian study finds. Researchers conducted a case-control study in Tasmania based on 136...

JOURNAL WATCH: Fibre can reduce blood pressure.(Brief Article)
February 5, 2005... Intake of dietary fibre could reduce the incidence of hypertension, a study suggests. Dutch researchers conducted a meta-analysis of 24 randomised, placebo-controlled trials on the effect of fibre supplements on blood pressure. Fibre...

JOURNAL WATCH: PPIs don't affect ulcer mortality.(Brief Article)
February 5, 2005... Treating ulcer bleeding with proton pump inhibitors reduces rebleeding and the need for surgery but has no effect on overall mortality, a study finds. Researchers from the UK and US undertook a meta-analysis of 21 randomised controlled...

JOURNAL WATCH: Limit testing to 10 HPV types.(Brief Article)
February 5, 2005... Screening for more than around 10 types of human papillomavirus appears to decrease specificity without increasing sensitivity. A US team analysed data from two prospective trials involving 6,223 and 3,363 women in order to explore the...

Private firm moves in as jobs crisis blights city.
February 5, 2005... A single GP handling 6,000 patients and a practice run entirely by locums... just two of the flashpoints that has seen Nottingham reeling - by Rob Finch Two practices in Nottingham are being taken over by a private company because of a...

GP statistics reveal gaps in recruitment.(Brief Article)
February 5, 2005... New figures reveal a five-fold discrepancy in the number of GPs per head of population across the country. An analysis by market research firm GMAP Consulting found that while Western Isles health board boasted one GP for every 680...

BP workload to soar in black patients.
February 5, 2005... New guidelines will have a dramatic impact on the treatment of hypertension - Emma Wilkinson reports The number of black patients treated for hypertension will leap by a fifth under Joint British Societies guidelines due out later this...

GP's CVD bills soar.(Brief Article)
February 5, 2005... Dr Robert Morley sees several patients with hypertension in every surgery. As a GP in an inner-city Birmingham practice with a high proportion of Afro-Caribbean patients, he has seen prescribing bills for cardiovascular disease soar in recent...

Calcium blockers best in black patients.(Brief Article)
February 5, 2005... Calcium channel blockers should be used as gold-standard first-line treatment in black patients, an upcoming Cochrane review concludes. The analysis of 30 randomised controlled trials found calcium channel blockers were the only drug type...

GP halves numbers on antidepressants.(Brief Article)
February 5, 2005... Dr Mark Storey has halved the number of patients with depression who are on medication after introducing a new fast-track referral system. The electronic system, which has been running since October, is used with a depression questionnaire...

Chaperones more for GPs than for patients.
February 5, 2005... GPs are increasingly offering chaperones for intimate examinations, but for their own protection rather than because patients have asked for them. Patients are also more likely to turn down a GP's offer because most chaperones are not...

Reid argues the case for part-private NHS.(Brief Article)
February 5, 2005... Health Secretary John Reid has set out his case for extending patient choice and private provision in the NHS. In a new book, Dr Reid argues the NHS is too centralised and inflexible. But he adds that a private health market would have...

Complaints against GPs rise.(Brief Article)
February 5, 2005... More than 43,000 complaints were made against GPs and other family health service workers last year, latest Government figures reveal. The figure of 43,347 complaints during the financial year 2003/4 was marginally up on the previous year's...

Even low-dose steroids can cause fractures.
February 5, 2005... Government guidelines for giving patients on oral steroids medication to protect their bones should be extended to cover even those on low doses, a study suggests. The analysis of 280,000 patients found that taking oral steroids at any...

STROKE CONFERENCE UPDATE: Aspirin compliance vital.(Brief Article)
February 5, 2005... Stroke patients who stop taking their daily aspirin triple their chances of having another stroke within a month, researchers warn. Three-quarters of strokes related to aspirin discontinuation occurred in the first eight days of stopping...

STROKE CONFERENCE UPDATE: Beta-blocker cuts severity.(Brief Article)
February 5, 2005... Patients taking Beta-blockers may suffer from less severe strokes than those not on the drugs. Their use appeared to be an independent predictor of higher than normal neurological scores after stroke, according to the prospective study of 111...

STROKE CONFERENCE UPDATE: Higher HDL, less stroke.(Brief Article)
February 5, 2005... Raising HDL cholesterol could significantly reduce the risk of acute stroke. US researchers from Indiana University School of Medicine studied 7,500 patients and found that for every 1mg/dl increase in HDL cholesterol, there was a significant...

Letter: Withdraw this slur on GPs.(Letter to the Editor)
February 5, 2005... I read with astonishment the article on cancer diagnosis in primary care (News, January 29). Gerry Steinberg MP is talking absolute nonsense. He should provide evidence to support what he claims or withdraw his accusation against GPs. What...

EDITORIAL COMMENT: Why is tsar ignoring data on matrons?(Editorial)
February 5, 2005... This week saw a damning evaluation of the Government's US-style active case management pilots. Intensive, nurse-led management was barely any better than standard GP care at keeping patients out of hospital. Given that `evidence-based medicine'...

Letter: So much for pension `experts'.(Letter to the Editor)
February 5, 2005... I was fascinated by the illustrated examples in your pensions coverage (Special Report, January 29). I hope Dr Simon Fradd will read it as well. It was not long ago that GPs were being exhorted to delay retirement by three years to enjoy...

Letter: Blair leads epidemic of GP bashing.(Letter to the Editor)
February 5, 2005... The Prime Minister suggests GPs will be disciplined, sent for retraining and potentially fail revalidation if they issue sicknotes excessively. He forgets that countries with no social security benefits don't have this problem. A few years...

Letter: Is this pharmacist plan safe?(Letter to the Editor)
February 5, 2005... A study by the University of East Anglia found hospital admissions by the elderly rose by 30 per cent after a home-based medication review by a pharmacist. Attempting to both wriggle out of it and to pass the blame, pharmacists have...

Letter: Protect us from Reid!(Letter to the Editor)
February 5, 2005... Like most GPs I was more than a little disturbed to hear our esteemed Health Secretary come out with such arrant rubbish as his claim that we now all enjoy 14-minute consultations (News, January 22). It should be pointed out that with...

Letter: We've got the surgery site but where's the money?(Letter to the Editor)
February 5, 2005... I was interested to read Lesley Mayo's letter (January 22) regarding their difficulties in relocating to adequate surgery premises. Their situation very closely echoes our own. In our suburban area, appropriate sites are very hard to come...

Letter: I reported a colleague for barbarism.(Letter to the Editor)
February 5, 2005... This week I reported a doctor to the GMC for misconduct. I have never done this before. I have earned my living as a doctor over the space of three continents and time of three decades. I have come across a tiny number of doubtful characters...

Do violent patients lose right to confidentiality?
February 5, 2005... If a patient behaves violently does he lose the right to confidentiality, and if so how much information can the GP disclose? Dr Paul Colbrook of the MDU provides answers Almost a quarter of GPs questioned recently by the MDU had been...

Avoid financial suicide while costing your consultations.
February 5, 2005... At a time when the profession is less financially secure, GPs should know how much their consultation time is worth before accepting new work, says Dr Peter Stott An unnamed health authority manager is quoted in a 1995 paper1 as saying:...

Reduce the risk of error in GP freelance work.
February 5, 2005... Freelance GP work has its own risks and difficulties, whether clinical or administrative, says Dr Paula Wright All clinical work has risks. These include: delays, deaths, missed diagnoses, misunderstandings, complaints and so on. Keeping...

Why GPs are central to premises development.
February 5, 2005... PCTs are mistaken if they believe GPs have no role to play in strategic service development plans says Deb Farnworth-Wood, managing partner of a large practice in Somerset PCTs are required to produce strategic service development plans...

Practice Q&As: What if patient refuses to have chaperone present?(Brief Article)
February 5, 2005... Q: I am a young male GP and one of our female patients says various previous doctors have performed inappropriate intimate examinations on her. She frequently comes to me with minor gynaecological problems that require a pelvic examination. I...

Practice Q&As: Can we just change a name in the records?(Brief Article)
February 5, 2005... Q: A mother recently came to the surgery and asked us to change her child's name on its medical records. Is this permissible? If a woman marries we change the name if we have seen a copy of the marriage certificate. What happens if an adult...

Urinary incontinence: what the GP can do.
February 5, 2005... One in four women suffers urinary leakage - Dr James Balmforth and Professor Linda Cardozo advise on initial management strategies and look at the place of surgery Urinary incontinence is a distressing symptom that has a major impact on a...

FACE TO FACE: Childhood asthma.
February 5, 2005... GP Dr Alex Williams asks consultant paediatrician Dr Patrick Oades about latest evidence on childhood asthma Practical points * Evidence of improvement with allergen avoidance is tenuous and disappointing * Appropriate device...

10 TOP TIPS: Chlamydia.
February 5, 2005... Dr Richard Burack passes on his tips gained as a GP - he practises in Romford, Essex, and is a member of the RCGP adolescent task group ONE Chlamydia is the UK's most prevalent STI and is caused by the bacterium Chlamydia trachomatis....

Which problems can be helped by a hand surgeon?
February 5, 2005... Ms Rupi Grewal advises on the place of conservative management and the role of surgery The three main reasons for patients presenting with hand problems are: pain, abnormal appearance and loss of normal function. Each of these can arise...

10 COMMON QUESTIONS ABOUT: RESTLESS LEGS SYNDROME.
February 5, 2005... Many patients have now heard of restless legs syndrome - Dr John Shneerson advises how to answer their questions A recent survey suggests 3.4 per cent of the adult population have restless legs syndrome (RLS) severely enough to warrant...

CLINICAL CASEBOOK: Taking action in a suspected case of elder abuse.
February 5, 2005... Talking to the old person alone when you have suspicions can be hard to achieve Case history Mrs Smith is 85, has angina and lives in a purpose-built granny flat attached to her son's house, where she is cared for mainly by her...

CAREERS: Why motorsport medicine sets my pulse racing.
February 5, 2005... Dr Simon Morris spends 16 weeks a year away in exotic locations with the Ford World Rally team Not so long ago you had to join the army to see the world but today I travel the globe as a practising doctor. I combine my day-to-day GP work...

CV: Dr David Pickersgill answers the Pulse careers questionnaire.(Brief Article)(Interview)
February 5, 2005... What/who made you decide to go into general practice? Being brought up in my grandparents' house, which was a GP's branch surgery in a mining community, and hero worship of my uncle who was reading medicine at the time. What would have...

CAREERS: WHY I LOVE BEING AN ISLAND GP.(Brief Article)
February 5, 2005... * Smaller list size means I know each patient and their extended family * It's an excellent environment in which to raise a family * The community spirit is especially vibrant and gladly welcomes 'incomers' * Crime is extremely...

CAREERS: LET'S PRACTISE IN LIVERPOOL.(Brief Article)
February 5, 2005... Where? `A premier European destination with a rich and diverse heritage - and an exciting future; the city has a passion for music, sport, live entertainment and nightlife with a multitude of fascinating places to visit....' Visit Liverpool.com...

Call for 100 obesity points.
February 12, 2005... The Department of Health is considering proposals to devote up to 100 quality points to obesity after a major trial showed GP interventions were effective. Ministers are already determined to include `organisational markers' for obesity...

It's not for everyone, says GP.(Brief Article)
February 12, 2005... A GP involved in the Counterweight Project is pleased with the results - but not convinced quality targets for obesity are appropriate. Dr Paul Singer, a GP in Luton, said the project was `useful' but `fairly intensive in nursing time'. ...

Blair wages war on closed lists.(Brief Article)
February 12, 2005... Tony Blair wants a crackdown on closed and `full' lists as a centrepiece of third-term NHS reforms which will give even more power to patients. Senior officials told Pulse the Prime Minister and election supremo Alan Milburn were...

PCTs `undermining quality framework'.
February 12, 2005... PCTs have been accused of `undermining the national quality framework' after offering GPs quality money without requiring them to hit cholesterol targets. GPs in three PCTs are being allowed to exception report patients who are not brought...

Ministers braced for sicknotes backlash.(Brief Article)
February 12, 2005... The Government has admitted it is braced for a backlash from GPs over its plans for intense scrutiny of their sickness certification. Under proposals to overhaul incapacity benefit, the Department for Work and Pensions wants to audit how...

GP first to link to national care record.
February 12, 2005... Dr Jim Lee's practice this week became the first to link up with the spine of the new national care record system. Dr Lee said the practice in Batley, West Yorkshire, wanted to get involved with the National Programme for IT because it...

GP training set for major overhaul.(Brief Article)
February 12, 2005... GP training is set for a radical overhaul which will see registrars spend at least 50 per cent longer in general practice. Under the new model drawn up by the RCGP and due to come into force in 2007, registrars will spend a minimum of 18...

GP premises neglect revealed.
February 12, 2005... A `planning and building blight' caused by chronic Government underinvestment is leaving thousands of GPs trapped in crumbling premises. Official figures released this week reveal a 44 per cent drop in Department of Health-controlled...