Pulse articles from February 2006

Pulse archives from February 2006

Adapt or die: White Paper's warning to GPs.
February 2, 2006... GPs challenged to compete with private companies to provide more and better services By Rob Finch GPs will have to open longer, take on more patients and offer more services in order to survive under Government plans to shake up...

Competition for patients will be no holds barred.
February 2, 2006... GPs to get incentives to expand their boundaries and open for longer By Rob Finch Practices will be thrust into `no holds barred' competition with each other for patients as part of a Government drive for improved access. The...

PMS earning power is under threat.(premenstrual syndrome)(Brief Article)
February 2, 2006... PMS practices are being warned that their earning power could be under threat as part of a `fundamental review' of funding arrangements. The review, signalled by the White Paper, is expected to address the pay disparity that has developed...

Practice praised for innovation.(Brief Article)
February 2, 2006... A general practice dialysis service was cited in the White Paper as the kind of innovative community care the Government wants. The service, at the Ashfurlong Health Centre in Sutton Coldfield, West6 Midlands, can treat 25 patients a week...

End for income guarantee.(Brief Article)
February 2, 2006... The Government has demanded an end to the Minimum Practice Income Guarantee, claiming it is a barrier to patient choice. The Community Health White Paper instructs NHS Employers to examine the `impact on equity' of the MPIG during the...

DoH will help PCTs on private services.(primary care trusts)(Brief Article)
February 2, 2006... Every PCT will get Department of Health support to bring in private firms to set up services in under-doctored areas. The White Paper states it is an `urgent priority' for PCTs to `actively commission' extra services to increase capacity....

`Open but full' GP lists not allowed.(Brief Article)
February 2, 2006... GPs are to be barred from running `open but full' lists to ensure there are no barriers to patients registering with a practice. Practices will either have to be open to all patients or closed entirely. Procedures for practices to close or...

Right to register near workplace.(Brief Article)
February 2, 2006... Patients have been given the right to register at a practice near their work rather than their home. But as revealed by Pulse, `dual registration' allowing patients to register at more than one practice has been ruled out. Dr David...

In Brief: Choose and Book delays.
February 2, 2006... The Government's target for referrals arranged by GPs using Choose and Book has slipped further. It now expects 90 per cent of referrals to go through the booking system by March 2007, and 25 per cent by March 2006. The original target of...

In Brief: SSRI/suicide link refuted.(Brief Article)
February 2, 2006... A UK/Swedish study of 20,851 suicides, published in International Clinical Psychopharmacology, found suicide rates were significantly lower in a period of high SSRI prescribing than a low prescribing period. Copyright: CMP Information Ltd....

In Brief: GP incapacity incentives.(Brief Article)
February 2, 2006... GPs will get incentives for helping people on incapacity benefit back into work. A Department of Work and Pensions Green Paper has also proposed piloting employment advisers in GP practices and giving GPs and practice staff extra training. ...

In Brief: Bipolar guidelines for GPs.(Brief Article)
February 2, 2006... GPs should consider offering telephone support for patients with bipolar disorder, particularly for monitoring medication regimes, NICE recommends. The institute's draft guidance on the disorder also urges practices to hold registers of...

In Brief: Pay for deprived areas.(Brief Article)
February 2, 2006... GPs should be paid more to work in deprived areas, a new report concludes. The report by the Institute of Public Policy Research said the new contract had failed to correct historic problems and should be changed to `pay GPs according to...

In Brief: Anticholinergics concern.(Brief Article)
February 2, 2006... Researchers are urging GPs to assess their use of anticholinergics in elderly patients after finding `significant deficits' in cognitive functioning. The French study, published online by the BMJ, found 80 per cent of continuous users had...

In Brief: GPs to train more juniors.(Brief Article)
February 2, 2006... The Government is to fast-track plans that will see four in every five junior doctors train in general practice. Health Minister Lord Warner said he had approved the Modernising Medical Careers reforms last week in order to `reduce...

In Brief: Ketek liver warning.(Brief Article)
February 2, 2006... The European Medicines Agency has asked the manufacturers of telithromycin (Ketek) to include stronger warnings about liver disorders. The EMEA has cautioned doctors to use the antibiotic with caution in patients with liver impairment and...

NHS life checks for all.
February 2, 2006... GPs warn self assessments will not benefit those most in need By Emma Wilkinson The Government has announced that patients will have a series of `life checks' from childhood through to middle age to promote health and pick up early...

Life checks are `poorly thought out'.(Brief Article)
February 2, 2006... Dr John Ashcroft, who has helped to develop a `health MOT' scheme for teenagers in his PCT, believes the Government's plans are poorly thought out. Dr Ashcroft said: `Who will do this? It will be the middle classes, of course. This is...

Limited CBT access pledge.(Brief Article)
February 2, 2006... The Government has pledged to expand access to psychological therapies in primary care - but has stopped short of making concrete commitments. The White Paper outlines plans to develop new roles for GPs with special interest and graduate...

Government White Paper round-up.(quality and outcomes framework )(Brief Article)
February 2, 2006... QOF measures By 2008/09 the QOF will include new measures to focus on `wider health and well-being outcomes'. Self care will become increasingly important and `one of the highest priorities for future changes to contractual...

Guidance on PBC will kill scheme.(practice-based commissioning )
February 2, 2006... GPC condemns ministers for messing with enhanced service, but Warner defends policy. Rob Finch reports New Government guidance on practice-based commissioning could `kill' the scheme stone dead, GP leaders are claiming. GPs said the...

Warner: patients will notice if you opt out.(Brief Article)
February 2, 2006... Exclusive GPs who opt-out of practice-based commissioning will be at a severe disadvantage, health minister Lord Warner told Pulse. In an exclusive interview after the release of Department of Health guidance on commissioning, Lord...

MediaWatch: `Test kit predicts fertility'.(Brief Article)
February 2, 2006... The story A new testing kit can predict a woman's fertility for the next two years, The Times, Daily Telegraph, Independent, Daily Express and BBC News Online report. The source The company Lifestyle Choices this week launched the...

MediaWatch: `Echinacea cures colds'.(Brief Article)
February 2, 2006... The story Echinacea is an effective treatment for the common cold, the Daily Mail claims. The source A Cochrane review of 16 trials found the herbal remedy echinacea may help in the treatment of colds but not the prevention. Nine...

MediaWatch: `Drug boosts brainpower'.(Brief Article)
February 2, 2006... The story A drug used for Alzheimer's can also boost brainpower in healthy people, the Daily Mail and Guardian report. The source Dr Andrea Malizia, a consultant senior lecturer in psycho-pharmacology at the University of Bristol,...

Inhaled insulin arrives.
February 2, 2006... Go-ahead for Exubera set to bring dramatic changes in diabetes care By Daniel Cressey GPs can expect dramatic changes ahead in their care of diabetes after the European Commission granted approval for an inhaled insulin. Pfizer's...

JournalWatch: Warfarin link to fractures.(Brief Article)
February 2, 2006... Long-term warfarin treatment appears to increase the risk of fractures, US researchers report. They analysed Medicare data on 4,461 long-term users of warfarin, 1,833 short-term users and 7,587 non-users among patients with atrial...

JournalWatch: H. pylori screening helps.(Brief Article)
February 2, 2006... A screening and eradication programme for H. pylori is feasible and greatly reduces consultations for dyspepsia, a UK study reports. Researchers analysed data from 10,537 unselected patients, aged 20 to 59, who were screened for H. pylori...

JournalWatch: Asthma and salmeterol.(Brief Article)
February 2, 2006... Treatment with salmeterol may increase the risk of respiratory-related death, according to a US study. Researchers conducted a 28-week randomised controlled trial with 26,355 patients, who received salmeterol plus usual drug therapy or...

JournalWatch: Five-a-day cuts stroke risk.(Brief Article)
February 2, 2006... Fruit and vegetable consumption significantly reduces the risk of stroke, a UK study concludes. The meta-analysis combined eight studies covering 257,551 people with an average follow-up of 13 years. People who ate five or more...

JournalWatch: Blood cells predict cancer.(Brief Article)
February 2, 2006... A high white blood cell count is significantly predictive of subsequent cancer mortality, an Australian study concludes. Researchers measured circulating white blood cell counts in 3,189 patients aged 49 to 84, who were free of cancer at...

GPs best for STI testing.
February 2, 2006... Study backs calls for funding for chlamydia screening in general practice Emma Wilkinson Sexual health experts have urged the Government to fund GP chlamydia screening after new research showed general practice was the best place to...

Analysis: APMS providers undermine GPs.(Alternative Provider Medical Services)(General Practitioners)
February 2, 2006... No level playing field for GPs to compete against firms Ian Cameron Ever since the Government opened up the prospect of competition in primary care, it has repeatedly assured GPs they will operate on a level playing field against...

Letter: Spurn commissioning and stick to what we're good at.(Letter to the Editor)
February 2, 2006... From Dr Steve Connolly Anfield, Liverpool Our current Government seems to be so blinkered by its slavish adherence to its choice agenda and modernisation programme that it has failed to recognise the importance of engaging the profession....

Letter: Vision, television and lack of vision.(Letter to the Editor)
February 2, 2006... From affected GP Name and address supplied GPs being switched over to the Vision clinical system from other systems should be aware of a serious gremlin. When prescribing, the computer adds an extra digit in front of the number of...

Letter: The importance of consent.(Letter to the Editor)
February 2, 2006... Dr John Sampson Poringland, Norwich I am astonished at the view of Dr Gillian Braunold, clinical lead at Connecting for Health, that seeking explicit consent to include patients in a national electronic record would be difficult (News, 26...

Letter: LBC has meant fewer repeat smear tests.(Letter to the Editor)
February 2, 2006... From Chris Hughes Practice nurse, Widnes, Cheshire I was surprised to read about the Australian study that suggested the inadequate smear rate was no lower in liquid-based testing than in the conventional pap smear (News, 19 January). ...

Letter: The real cost of PMETB education.(Letter to the Editor)
February 2, 2006... PMETB fee rise - blatantly unfair or the price of independence through financial self-sufficiency? From Dr Nathan Goldrick Westboughton, Bolton What a great start for the PMETB! When it took over, it had people answering the phones...

Letter: True meaning of the word `dignity'.(Letter to the Editor)
February 2, 2006... From John Wiles, chair, Association of Palliative Medicine; Jane Campbell, Not Dead Yet UK; Dr Anthony Cole, chair Medical Ethics Alliance; Jared O'Mara, development officer, British Council of Disabled People; Dr Rob George, consultant in...

Letter: Opioid myths need tackling.(Letter to the Editor)
February 2, 2006... From Dr Paula Powell, palliative care doctor, Dr Karen E Groves, medical director, Mr Steven Simpson, pharmacist, Queenscourt Hospice, Southport We read with interest the article Black cloud over GP palliative care (News, 5 January). We...

Letter: Sore eye causes thigh of relief for ophthalmologist.(Letter to the Editor)
February 2, 2006... From Dr Richard Lindmer Attleborough, Norfolk I thought you might like to publish this splendid typographical error which I received recently in a letter from one of our local ophthalmologists. `He had been seen as part of the EPIC...

Mine's a double (standard).(doctors alcohol consumption)
February 2, 2006... Why don't doctors fulminate about alchohol as much as they do about other substances? Charles Kennedy was forced to resign last month after he admitted to a bit of a problem with booze. And while I'm sorry that the pressures of his job and...

Second Opinion: No time like the present.(practice-based commissioning analysis)(Column)
February 2, 2006... This is certainly a time of opportunity and change for general practice. We have got rid of our out-of-hours commitment. We have got to grips with performance-related targets. Our pension dynamising factor has been boosted in a most...

WHY I DECLINED A COMMERCIAL TAKEOVER OF MY PRACTICE.
February 2, 2006... A business enterprise run by a GP recently offered to take over Dr Dinah Roy's single-handed practice. Dr Roy explains whey she refused the offer, despite its very real attractions I am a single-handed GP with some salaried support. I was...

Get childhood immunisation back on target.
February 2, 2006... Thanks not least to Pulse's efforts, MMR will count for 25 per cent of target pay calculations instead of 50 per cent. But practices should beware of sitting back and assuming future top targets are now assured, warns Dr John Couch The...

PULSE CLINICAL: Need to know childhood eczema.
February 2, 2006... 1. What are the causes of eczema in childhood? What other conditions is it related to? The types of eczema for which causes are known are atopic eczema and allergic contact eczema. Identifying the offending allergen by patch testing and...

Pulse Clinical: Neuropathic pain.
February 2, 2006... Dr Brian Crichton passes on his tips for understanding and management 1Neuropathic pain has big implications. Neuropathic pain has a prevalence of up to 1.5 per cent in the published literature and can have a huge effect on patients' and...

Pulse Clinical: Treating oral diseases.(recurrent aphthous stomatitis)
February 2, 2006... Professor Michael Lewis gives a brief pictorial guide to diagnosis and initial treatment for oral conditions likely to be seen in general practice The large majority of patients with RAS will present with a single or small number of...

PulseClinical: Hip and knee surgery.
February 2, 2006... Advances in hip arthroscopy Mr Sam Oussedik and Mr Fares Haddad look at a technique that is having a renaissance Case history A 28-year-old accountant presented to his GP during a busy Monday morning surgery complaining of right...

Pulse Register: Last gasp.
February 2, 2006... Case history John Smith is 21 and has severe and unpredictable asthma. He regularly turns up asking for an immediate prescription for his bronchodilator; in return he agrees to make an asthma clinic appointment, which he cancels or misses....

PulseCareers: Men in black.(first aid charity )
February 2, 2006... Put your GP's working week into perspective with voluntary shifts for the St John Ambulance. It won't make you rich but it will broaden your horizons and raise your morale, says Dr Robert Jaggs-Fowler, who has risen to the top in the charity...

CV: Dr Douglas Fleming.(Royal College of General Practitioners director interview)(Interview)
February 2, 2006... CV: Dr Douglas Fleming What/who made you decide to go into general practice? I did not fancy years of living in hospital residential accommodation. What would you have done if you hadn't been a doctor? I think I would have...

Let's practise in Pembrokeshire.(facts )(Brief Article)
February 2, 2006... Factfile Resident population: 113,700 Area: 620 sq km Coast path: 299km Each week we take a GP's-eye view of an area of the UK. This time we visit Pembrokeshire Where? Pembrokeshire Coast National Park - designated as such in...

Two new vaccines prompt overhaul of child schedule.
February 9, 2006... Three doses of pneumococcal and a combined Hib/Men C vaccine join the programme By Susan Mayor Pneumococcal vaccination will be added to the childhood schedule as part of a major overhaul of the immunisation programme, the Department...

Private takeover of practices sparks storm of protest.(UnitedHealth Europe General Medical Service contract)
February 9, 2006... United Health gets top GMS score - despite never running a UK practice EXCLUSIVE By Ian Cameron The takeover of two Derby practices by the giant US-based firm UnitedHealth Europe is at the centre of a mounting storm of protest...

Our anger is not sour grapes.(UnitedHealth Europe primary care trust contract)(Brief Article)
February 9, 2006... Dr Elizabeth Barrett is among the GPs who lost out to UnitedHealth Europe in the bidding process, but she says local GPs' concern over its victory is not sour grapes. `This is far bigger than me throwing my toys out of the pram,' she says....

Scots alone in getting new CVD pay.(cardiovascular disease)(Brief Article)
February 9, 2006... Scottish GPs will be paid for implementing new guidance on cardiovascular disease - but not GPs elsewhere in the UK. The average Scottish practice will earn #7,600 under a new directed enhanced service for setting up a cardiovascular risk...

NHS Lift condemned as `costly' flop.(National Health Service General Practitioners permises)
February 9, 2006... EXCLUSIVE NHS Lift is too expensive, overly bureaucratic and fails to deliver good enough GP premises, two damning reports conclude. A review of Lift in three pilot areas in London found most PCTs had `expressed concerns about the...

Referral centres anger GPs.(General Practitioners)(Brief Article)
February 9, 2006... GPs are growing increasingly concerned over the trend for PCTs to set up referral management centres as part of cost-cutting moves. LMCs have reported worries over threats to confidentiality, unclear liability and the failure of PCTs to...

In Brief: Variations in MMR uptake.(Measles-mumps-rubella vaccines)(Brief Article)
February 9, 2006... The extent of variation in MMR uptake is exposed by a new study. The Chartered Society of Physiotherapy research, published in The Lancet, found uptake ranged from 91 per cent in Chelmsford to just 12 per cent in Westminster. Average uptake for...

In Brief: Nursing homes failing GPs.(General practitioners)(Brief Article)
February 9, 2006... Nearly half of all nursing homes in England fail to reach minimum standards for managing medicines prescribed by GPs, the Commission for Social Care Inspection reports. Inadequate staff training and failure to implement best practice means...

In Brief: New MRCGP deadlines.
February 9, 2006... GP registrars have until 31 July 2008 to complete the current MRCGP examination or face the prospect of re-taking modules to qualify. The new mandatory MRCGP starts for all new GP registrars from 1 August 2007, but current registrars are...

In Brief: Flu warning in youngsters.(Brief Article)
February 9, 2006... The Health Protection Agency is warning of a rise in rates of influenza B, particularly among children. Overall rates of influenza-like illness among children aged five to 14 almost doubled in a week, from 24 per 100,000 to 42 per 100,000,...

In Brief: GPs' demos save the day.(General Practitioners demonstrations for community hospitals)(Brief Article)
February 9, 2006... GPs in Cumbria have won a temporary reprieve for nine community hospitals after the biggest local demonstrations since World War II. A consultation on PCT plans to save #2.4 million has been postponed for six months in light of the recent White...

In Brief: MPs' choices on smoking.(Members of Parliament)(Brief Article)
February 9, 2006... The Government will give MPs three choices in the free vote on whether to ban smoking in public places. They will be able to vote on a total ban in all public places, on exceptions only for private members clubs or the original proposals to...

In Brief: How to deal with coroner.(Medical Defence Union guide to coroners)(Brief Article)
February 9, 2006... The Medical Defence Union has produced a step-by-step guide to coroners' inquiries, including practical advice about writing reports for coroners, appearing at inquests and which deaths to report. Copyright: CMP Information Ltd.

In Brief: GPs are the only answer.(General Practitioners)(Brief Article)
February 9, 2006... Only GPs can safeguard the traditional values of general practice, the Government's primary care tsar has claimed. In an online question-and- answer session this week, Dr David Colin-Thome defended every aspect of the new community services...

Study lays bare acute shortage in therapists.(psychiatrists deficit)
February 9, 2006... Pulse launches a major survey of GPs to find out the extent of problem By Nerys Hairon A new study exposes just how far the Government will have to travel to meet its pledge for universal access to psychological therapies. ...

My patients just will not wait.(Cognitive behavior therapy not manageable)(Brief Article)
February 9, 2006... Dr Neil Statham is often forced to prescribe antidepressants because his patients are unwilling to wait up to six months for CBT. Dr Statham, a GP in Newport, Gwent, said his area had `a very limited service', even with a practice-based...

Changes to home oxygen in chaos.(oxygen supply complications faced by General Practitioners)(Brief Article)
February 9, 2006... GPs have endured a frantic start to the changeover of home oxygen supply with many warning patients are being left at risk. Fax machines and phone lines have been constantly jammed since the 1 February transition to provision by one of four...

GPs' medicolegal work threatened.(General Practitioners claims)(Brief Article)
February 9, 2006... GPs could lose as much as a two-thirds of their medicolegal reporting work following a High Court ruling. The ruling in the Wollard versus Fowler case last month means reporting agencies, which provide GPs with 90 per cent of the work,...

New quality cash could end MPIG.(Minimum Practice Income Guarantee)(Brief Article)
February 9, 2006... Putting extra cash into the quality framework could be one way of getting rid of the minimum practice income guarantee, the lead negotiator for NHS Employers has speculated. Dr Barbara Hakin said the Government's determination to end the...

Are you worth extra PMS cash?(Personal Medical Services)
February 9, 2006... Efforts to squeeze GP income now turn to PMS practices By Ian Cameron PMS practices face an investigation into whether they have made best use of the growth money they were given to switch contracts. The Government review will...

Signing on dotted line was all that mattered.(Personal Medical Services)(Brief Article)
February 9, 2006... Ministers are `naive' if they expect PMS practices to offer radically different services compared to GMS, Dr Gavin Jamie believes. He says his practice in Swindon took on salaried staff with its growth money, but is still `not much different'...

New CVD ethnicity risk tool.(Cardiovascular diseases)(Framingham score by ethnic group)(usage of Innovative risk calculator )
February 9, 2006... Innovative risk calculator will allow GPs to adjust Framingham score by ethnic group By Daniel Cressey UK primary care experts have developed a new online risk calculator to allow GPs to accurately adjust Framingham for different...

White Paper thinking flawed.(chronic disease management schemes )(Brief Article)
February 9, 2006... Assumptions that better-quality primary care will drive down `avoidable' hospital admissions are flawed, say GP researchers. Last week's White Paper threw its full weight behind chronic disease management schemes to curb the ever-increasing...

GPs using longer antibiotic courses.(General Practitioners)(Brief Article)
February 9, 2006... GPs are prescribing longer courses of antibiotics than a decade ago - in conflict with latest advice - new research warns. Figures for December 2004 reveal that 66 per cent of GPs' antibiotic scripts within one strategic health authority...

Use PBC to keep private firms out.(practice-based commissioning )
February 9, 2006... GPC urges GPs to get involved for `political reasons' By Rob Finch GPs should take on practice-based commissioning for `political' reasons rather than to make money, GPC negotiators are advising. Dr Laurence Buckman, GPC deputy...

GP has last laugh to win our super car.(General Practitioners)(Brief Article)
February 9, 2006... Dr Janet Dennison had the last laugh over cynical colleagues when she became the lucky winner of an Audi TT Coupe in Pulse's prize draw. Dr Dennison said fellow GPs at her practice in Nelson, Lancashire, had scoffed at her odds of winning....

PCTs abandon appraisals.(Primary Care Trusts)(Brief Article)
February 9, 2006... Two primary care trusts have stopped GP appraisals for the rest of the financial year in an effort to stave off potential deficits. Maidstone Weald and South Kent PCTs insisted the move was temporary and would not affect GPs' revalidation...

MediaWatch: `That curry can kill you'.(Salt intake high in Indian and Chinese cooking)(Brief Article)
February 9, 2006... The story Indian curries and Chinese takeaways could be killing people, the Sun claims. The source New research from the pressure group Consensus Action on Salt and Health showed one takeaway dish contained 15.8g of salt - nearly...

MediaWatch: `Dream insomnia drug'.(orexin-RA-1 developed by Actelion)(Brief Article)
February 9, 2006... The story A `dream' drug could help people sleep, boost memory power and even tackle weight problems and addiction, the Guardian, Daily Mail and Daily Express report. The source The biotech company Actelion is developing a drug...

MediaWatch: `Women shun risky HRT'.(Hormone Replacement Therapy )(Brief Article)
February 9, 2006... The story Women are shunning `health-risk' HRT, the Daily Mail, Daily Telegraph and BBC News Online report. The source A survey by Health Plus magazine found 60 per cent of menopausal women had tried HRT, but a third of those...

QOF shows its mettle.(Quality and Outcomes Framework)
February 9, 2006... GPs' strong QOF performance translates into significant clinical benefits By Daniel Cressey New research has provided the strongest indication yet that GPs' impressive performance in the QOF is translating into concrete clinical...