Pulse articles from February 2007

Pulse archives from February 2007

GPs face red tape hell over VAT rules.
February 1, 2007... Changes to medical reporting for insurance companies to force GPs to register for VAT By Helen Crump Tax legislation that will force thousands of practices to register for VAT is set to plunge GPs into a bureaucratic nightmare. ...

What the new tax laws will mean.(Brief article)
February 1, 2007... WHAT WILL BE VAT-ABLE FROM MAY * All services provided by a medical professional that are NOT related to medical care EXCEPT access to health records WHAT IS EXEMPT, INITIALLY, UNDER THE UK `MORGANASH' RULING* * Medical services to...

Pensions cap appeal `not binding'.(Brief article)
February 1, 2007... Ministers will be free to ignore a judicial review decision in GPs' favour over the pensions cap, writes Helen Crump. Confirming the GPC would pursue a review to challenge the legality of the cap, chair Dr Hamish Meldrum conceded the...

QOF depression screening tools `next to useless'.(uality and outcomes framework)
February 1, 2007... Use of two questions criticised amid growing disquiet on QOF indicators By Daniel Cressey The depression screening tools employed in the quality and outcomes framework are little better than useless, a new systematic review concludes....

Depression and CKD targets hit income.(chronic kidney disease)(Brief article)
February 1, 2007... GPs are facing a sharp drop in income through the quality and outcomes framework after struggling to hit new targets on depression and chronic kidney disease. Eighty-four per cent of GPs approached by Pulse said their QOF points would drop...

GPs `to take on complex CKD cases'.(Brief article)
February 1, 2007... General practice will increasingly take over from specialists in the management of complications of chronic kidney disease, the Government's new renal tsar has predicted. Speaking to Pulse following his appointment this week, Dr Donal...

Glitches hit Choose and Book.
February 1, 2007... Technical problems and increasing restrictions on referrals are proving major barriers to GPs using Choose and Book, writes Helen Crump. Latest figures from strategic health authorities show fewer than one- third of GP referrals were made...

Controlled drugs access widened.(Brief article)
February 1, 2007... Nurses and pharmacists are set to get even wider prescribing access under new proposals to loosen restrictions over controlled drugs. Pharmacist independent prescribers could gain access to controlled drugs for the first time under the...

Glitazone scrutiny over fracture risks.(Brief article)
February 1, 2007... European regulators are reviewing the safety of the diabetes drug rosiglitazone after a major study suggested it raises women's risk of fractures. It follows discussions by the UK's pharmacovigilance expert advisory group, which noted...

InBrief: MDU subscription rise.(Brief article)
February 1, 2007... The Medical Defence Union has indicated it may be forced to raise its annual subscription because of the rising cost of clinical negligence settlement awards. A recent ruling changing the way payouts can be made, and a law change this week...

InBrief: Opioid dependence guide.
February 1, 2007... NICE has issued new guidance for management of opioid dependence, recommending methadone and buprenorphine as maintenance therapies, and naltrexone as an option in those detoxified and formerly opioid- dependent. The guidance comes in the same...

InBrief: Practices' IT package.(Brief article)
February 1, 2007... Connecting for Health has released a standard specification detailing the IT requirements of practices now and in the future. The GP IT infrastructure specification aims to ensure performance of systems supplied by Connecting for Health is...

InBrief: Licence for ranibizumab.(Brief article)
February 1, 2007... The European Medicines Agency has approved Novartis's ranibizumab (Lucentis) for treatment of wet age-related macular degeneration. The company will launch the drug in Europe throughout 2007 and 2008. Copyright: CMP Information Ltd.

InBrief: Support for oseltamivir.(Brief article)
February 1, 2007... Oseltamivir is `highly effective at reducing the spread of influenza' in households exposed to the flu virus, data published this week in the American Journal of Epidemiology reveals. Oseltamivir reduced the chance of contracting the virus by...

InBrief: CHD targets reiterated.
February 1, 2007... The National Prescribing Centre has reiterated that national targets for cholesterol are those recommended in the national service framework for CHD, and not those recommended by the new Joint British Societies' guidelines. The NSF set a target...

InBrief: Easter Care Record trial.
February 1, 2007... Trials of the summary NHS Care Record will begin at Easter, Connecting for Health has confirmed. Six PCTs are to pilot the summary record, which will contain patients' major diagnoses, procedures, current and regular prescriptions,...

Men top GP working hours league table.
February 1, 2007... New workload study finds that men work longer, but PMS GPs don't Men top GP working hours league table By Katherine Haywood Male GPs work longer hours than their female counterparts and longer than their equivalents in other...

PMS pay gap set to be reviewed.(Brief article)
February 1, 2007... A finding that PMS GPs work the same hours as their GMS counterparts, yet earn far more, is likely be taken into account in the Government review of PMS. Professor Hugh Gravelle, professor of health economics at the York Centre for Health...

We're all flexible here.(Brief article)
February 1, 2007... Dr Blythe Wilkinson's practice in Oxford is a bastion of part-time working, with all 14 GPs working flexibly. Dr Wilkinson says that although she has children, her decision to work four sessions a week was a lifestyle choice. She said:...

BIDDING FOR PRACTICES.
February 1, 2007... Pulse's popular seminar programme introduces Bidding for Other Practices in London on 25 February - a one-day seminar on the mechanics of taking over and running another practice. Full details on page 53. Copyright: CMP Information Ltd.

MediaWatch: `Traffic linked to asthma'.(Brief article)
February 1, 2007... The story Children who grow up near roads with heavy traffic are at increased risk of developing asthma and other respiratory diseases, according to the Times, Daily Telegraph, Daily Mail and Daily Express. The source A study published in...

MediaWatch: `Mobiles raise tumour risk'.(Brief article)
February 1, 2007... The story Using mobile phones raises the risk of tumours 40 per cent, suggests a report in the Daily Mail. The source A study published in the International Journal of Cancer found `no evidence of increased risk of glioma related to regular...

MediaWatch: `Bathing can lead to Ca'.(Brief article)
February 1, 2007... The story Low levels of chlorine in tap water used for bathing can almost double the risk of bladder cancer, warns the Daily Mail. The source Researchers at the Municipal Institute of Medical Research in Barcelona compared 1,200 men and...

`Open all hours' call.(one patient in four is unhappy with surgery opening times)
February 1, 2007... Survey finds one patient in four is unhappy with surgery opening times By Katherine Haywood Ministers have stepped up the pressure on GPs to extend their opening hours after a national survey found patients increasingly felt surgeries...

Patients ambivalent on choice.(Brief article)
February 1, 2007... Most patients are ambivalent about the Government's drive to introduce choice into the NHS, the results of the National Survey of Local Health Services suggest. The survey reported an increase in the number of patients being given a choice...

Prescribing error alert system for GPs' computers.(Brief article)
February 1, 2007... GPs' computers are set to be furnished with a new prescribing alert system designed to cut drug-related morbidity by as much as 80 per cent. A team commissioned by NHS Connecting for Health has developed a raft of new alerts focusing on...

Key alerts in the new system.
February 1, 2007... * Prescribing and dosing errors - reduce initial doses of beta-blockers in heart failure * Contraindications - avoid prescribing NSAIDs to patients with previous peptic ulcer * Monitoring errors - do not prescribe steroids for longer...

Renal alert on lithium.
February 1, 2007... Under-reporting of reactions as a quarter suffer renal impairment By Daniel Cressey As many as a quarter of patients on lithium therapy suffer renal damage even when maintained within the non-toxic range, a new study warns. The...

Antidepressant side-effects.(Brief article)
February 1, 2007... Antidepressants used in general practice are similarly effective but differ in side-effects, a major new analysis concludes. The review by the US Agency for Healthcare Research and Quality found 60 per cent of patients on second-generation...

Acute trusts to compete with GPs.
February 1, 2007... GPs warn that `predatory' behaviour by hospitals could put practice- based commissioning at risk By Helen Crump Acute trusts will be allowed to bid to take over community services as part of the next tranche of Government NHS reforms....

QOF will cut strokes.
February 1, 2007... Dr Prit Buttar has calculated that almost 7,000 people will avoid a heart attack or a stroke this year because of the quality and outcomes framework. His estimate of 3,400 fewer heart attacks and strokes respectively is based on a 3 per...

#73m earmarked for social enterprises.(Brief article)
February 1, 2007... A #73m ringfenced fund has been set up to help GPs and other NHS staff set up non-profit making companies providing health and social care. Health minister Ivan Lewis has set aside the money for businesses with environmental and...

GP-led social enterprises.
February 1, 2007... * Principia Partners in Health, a coalition of GPs, community professionals, community pharmacists. Will provide primary care including extended hours access to a population of 118,000 in Rushcliffe, Nottinghamshire. * Willow Bank...

PCT curbs GPs' pharma links.
February 1, 2007... GPs in cash-strapped Cambridgeshire PCT asked to get consent for meeting sponsorship By Helen Crump GPs in one of the most cash-strapped PCTs are being asked to severely limit their links with pharmaceutical companies. The rules...

The curbs on links with pharma.(Brief article)
February 1, 2007... * Hospitality `is not the norm' and should only be provided where necessary and justifiable * Hospitality of more than #25 should be for the benefit of the PCT and must be recorded in a register * Line manager approvals required for...

Call for practice staff to be offered profit shares.(Brief article)
February 1, 2007... GPs should issue shares to practice staff and pay a dividend each year on profits, a leading health academic is arguing. Professor Chris Ham, a former head of the Department of Health strategy unit, said the NHS should adopt the partnership...

New patient forums `will not have enough money'.(Brief article)
February 1, 2007... The organisations that will replace patient forums will not have enough money to operate efficiently, doctors and patients are claiming. The BMA's patient liaison group is warning that the annual subsidy of up to #150,000 planned for each...

Trust scraps plans to set up its own version of the QOF.(Brief article)
February 1, 2007... A PCT has abandoned proposals to withdraw GPs from the quality and outcomes framework and set up a two-year local initiative. North Essex PCT had asked GPs to take part in the programme and defer this year's QOF achievements for a month to...

GPs up in arms at nuclear base.(Brief article)
February 1, 2007... More than 20 GPs joined other healthcare workers in a protest at the Faslane nuclear submarine base in Scotland last week. The protest group, which is linked to the Medact charity, opposes the Government's plan to replace Trident with a new...

New stroke predictor tool for GPs.
February 1, 2007... Risk score identifies patients most vulnerable to a stroke within 90 days of a transient ischaemic attack By Lilian Anekwe GPs will be able to focus care at patients at greatest risk of a stroke using a new prediction tool, its...

Exception `abuses' blur diabetes picture.(Brief article)
February 1, 2007... It is impossible to use the GP contract to track improvements in diabetes care because of apparent `abuses' in exception reporting, a new report has claimed. The charity Diabetes UK called for a review into the reasons for the wide...

Hysterectomy should be last option.(Brief article)
February 1, 2007... GPs should regard hysterectomy as the `last option' for women with heavy menstrual bleeding, new NICE guidelines recommend. Researchers estimate that as many as 60 per cent of women with the condition are currently treated by hysterectomy....

Rimonabant's benefits `unclear'.(Brief article)
February 1, 2007... The benefits of a new anti-obesity drug under review by NICE are still unclear, according to a new briefing. NHS prescribing advisers cautioned that although the evidence on rimonabant does appear to show modest weight loss compared with...

Home medication reviews too costly.(Brief article)
February 1, 2007... The current drive to implement home-based medication reviews by pharmacists is not cost-effective, a new study concludes. An economic analysis of the HOMER trial of reviews conducted by pharmacists found they cost #1,695 per patient,...

Alzheimer's all-clear for antipsychotics.
February 1, 2007... Latest research refutes suggestions that drugs speed cognitive decline By Eleanor Goodman A UK study appears to have cleared antipsychotics from speeding the progression of dementia in patients with Alzheimer's disease. ...

Dementia fears eased.(Brief article)
February 1, 2007... * There have been suspicions antipsychotics might increase cognitive decline in patients with Alzheimer's - although there had been no previous cohort studies * Researchers studied 224 patients with Alzheimer's disease with matched...

GP alcohol advice `overly cautious'.(Brief article)
February 1, 2007... The advice GPs currently give to pregnant women on alcohol and caffeine intake may be excessively cautious, new research suggests. Two separate studies have questioned Government guidance, which recommends against drinking more than two...

JournalWatch: Combined inhaler benefit.(Brief article)
February 1, 2007... Use of combination inhalers improves symptom control in patients with asthma, but not with COPD, according to a Dutch study. The 12-week trial at 41 GP practices recruited 137 adults with asthma and 41 with COPD. They received...

JournalWatch: SSRIs raise fracture risks.(selective serotonin reuptake inhibitors)(Brief article)
February 1, 2007... Use of SSRIs long-term appears to double the risk of fractures, US researchers report. The population-based cohort study followed 5,008 adults aged 50 or older, 137 of whom were users of SSRIs. The researchers assessed the number of...

JournalWatch: Asthma: selenium no use.(Brief article)
February 1, 2007... Selenium supplements do not benefit adults with asthma, a UK study concludes. The researchers recruited 197 patients with asthma, 75 per cent of whom were using inhaled steroids. They randomised them to either a high- selenium yeast...

JournalWatch: Anticoagulation risks.(Brief article)
February 1, 2007... The risks of anticoagulation outweigh the benefits in patients with minor, non-cardioembolic stroke, an international trial concludes. The Esprit trial randomised 1,068 patients with minor stroke or transient ischaemic attack to either...

JournalWatch: Fish don't cut stroke risk.(Brief article)
February 1, 2007... Fish consumption does not appear to reduce the risk of stroke, although consumption of oily fish may do, a UK study concludes. Researchers studied a UK cohort of the European Prospective Investigation into Cancer, following 24,312 men and...

Obesity referral crisis.(Brief article)
February 1, 2007... GPs are left unable to refer to paediatric obesity services because of a lack of provision in secondary care, MPs have warned. A Public Accounts Committee report on childhood obesity found a lack of care pathways for children with obesity...

Green light on safety for rosuvastatin.(Brief article)
February 1, 2007... Rosuvastatin is safe and being prescribed correctly by GPs, the UK drug safety research unit concludes. There have been several media scares over the safety of rosuvastatin, but the report found the drug was `reasonably well tolerated' in...

Analysis: GPs' options for a pay and pension fightback.
February 1, 2007... There appears little doubt that a concerted campaign is under way, stoked by ministers, to push GPs off their lofty perch as the most trusted professionals. So what can the GPC and individual GPs do to shore up public trust and strike back...

Letter: Care Record will have big benefits.(Letter to the editor)
February 1, 2007... From Dr Andrew Perry GP registrar, Sheffield I cannot be the only person fed up with the plethora of articles (especially in the GP press) in which GPs are negative about the NHS IT projects. Many hark on about patients not having...

Letter: Choose and Book may stop me saying sorry.(Letter to the editor)
February 1, 2007... It's hospitals, not Choose and Book, that prevent named consultant referrals From Dr Stephen Earwicker, Nottingham Dr Christopher Lisk believes Choose and Book is `breaking down the liaison between consultants and GPs' (Letters, 11...

Letter: Anger over smear test age cut-off.(Letter to the editor)
February 1, 2007... From Clare Farr Chair, Western Cheshire Practice Managers' Group I read with interest your story `GPs under fire over smear test fall' (News, 25 January). Dr Anne Szarewski from Cancer Research UK said it was a `big worry' that young...

Letter: How drug switch saved us #10,000 in just 40 minutes.(Letter to the editor)
February 1, 2007... From Dr David Metson Bracknell, Berkshire I was interested in your article about the potential savings to be made from drug switches (News, 18 January). I would like to share with other GPs how 40 minutes of our practice nurse's time saved...

Letter: Do GPs know nothing of newer lung cancer therapies?(Brief article)
February 1, 2007... From Professor K Moghissi, consultant cardiothoracic surgeon and clinical director, Yorkshire Laser Centre My son is a GP and showed me your recent article on lung cancer (Clinical, 21 December). The issue of newer therapies such as...

Letter: Dump work back on PCTs!(Letter to the editor)
February 1, 2007... GPs' fury grows over continuing criticism from ministers and the media over their earnings From Dr Phil Brookes, Newcastle-upon-Tyne So GPs have been overpaid, according to Mrs Hewittless? No problem - let's all stop all QOF work as of...

Letter: My action plan over access.(Letter to the editor)
February 1, 2007... From Dr Anita Sharma, Oldham So a random selection of our patients is being asked to complete a postal questionnaire about how easy it is for them to see their GP. Posters are up in the surgery because we have been asked to do so. GPC...

Letter: When it's time for GPs to say `it's not our problem'.(Letter to the editor)
February 1, 2007... From Dr Alex Milne, Wishaw, Lanarkshire Regarding Dr Lal Mandal's letter about the poorly completed dentist's prescription he was asked to complete properly (Letters, 18 January), I sincerely hope that Dr Mandal did not issue a replacement...

Letter: Post-splenectomy sepsis.(Brief article)
February 1, 2007... From Dr Vivek Shrivastva, medical SHO, Royal Sussex County Hospital I would like to remind readers regarding management of post-splenectomy sepsis, in view of two patients I have seen on acute take over the past eight months. Recognising...

Allo! Allo! We're doomed.
February 1, 2007... Phil's back - and Big Brother is not the only thing worrying him about the English language Over the years I've come to regard myself as a fairly well-educated Englishman. Disregarding certain unimportant cultural backwaters such as...

Dinah'sDiary: Dinah Roy.
February 1, 2007... Dinah's on a pet topic - fat patients and their equally fat dogs Monday Late for PCT meeting. Had to take cat to vet - tail hanging by a thread, blood everywhere (violent mouse chase). Tail had been injured before Christmas but cat...

PulseFinance: HOW TO PLAN EXTENDED OPENING IN PRACTICE.
February 1, 2007... Practice are likely to have to stay open longer in the not too distant future, so get your act together now, urges Dr John Couch In a recent article I pointed out that the Government's intention to introduce extended opening hours is clear....

HOW TO MAINTAIN GOOD OUT-OF-HOURS COMMUNICATIONS.(Brief article)
February 1, 2007... The removal of out-of-hours responsibilities from daytime family doctor services lessened, but did not remove, a GP's responsibility to their patients. Instead the burden of that responsibility shifted from direct contact to ensuring that...

PulseFinance: A PAIN-FREE GUIDE TO CHOOSE AND BOOK.
February 1, 2007... Dr Richard Vautrey puts Choose and Book in context and weighs up the pros and cons Choose and Book (C&B) has had a troubled history. Although many practices are now using it routinely to make referrals, many more have found it frustrating...

PulseFinance: SHOULD YOU CERTIFY PATIENTS FIT FOR PURPOSE?
February 1, 2007... Dr Michael Devlin of the MDU advises on the often tricky problem of certifying patients as being fit for various activities Patient certificates, for example, where a GP is asked to certify a patient fit for a particular activity or indeed...

PulseClinical: NEED TO KNOW - PALLIATIVE CARE.
February 1, 2007... Take-home points * Controlled drugs need to be kept in a locked cupboard so the best solution is to stock emergency drugs at the out-of-hours centre * As nausea may have many causes the most broad-spectrum antiemetic is...

PRACTICAL LOWDOWN ON EFFECTIVE ANALGESIA IN CANCER PATIENTS.
February 1, 2007... Principles of analgesic use Use an effective drug in adequate doses and at regular intervals. Route of administration: give drugs orally by choice; if this is not possible then give drugs rectally or transdermally; or give drugs...

PulseClinical: ESSENTIAL GUIDE TO RHEUMATOID ARTHRITIS.
February 1, 2007... In the second part of our series on musculoskeletal problems, rheumatology experts Dr John Jackman, Dr Louise Warburton and Dr Raashid Luqmani give an update on RA treatment Rheumatoid arthritis (RA) affects 1 to 2 per cent of the...

PulseClinical: MENOPAUSE.
February 1, 2007... Dr Sally Hope passes on her insights gained from working as a GP witha clinical interest in female health 1 Don't forget to give health promotion advice More than 80 per cent of women do not want HRT, but do seek a consultation with a...

PulseClinical: INHALED STEROIDS AND ANTIBIOTICS FOR BRONCHIOLITIS.
February 1, 2007... Summaries of two new Cochrane reviews thatcould apply to your next consultation How effective are inhaled steroids in acute bronchiolitis in the prevention of post-bronchiolitic wheezing? Acute bronchiolitis in infants and young...

PulseClinical: SPECIFIC HEADACHE CRITERIA USEFUL FOR MIGRAINE DIAGNOSIS.
February 1, 2007... Q What components of the history and physical examination are helpful in determining which patients with a headache have a migraine or need neuroimaging? Synopsis These investigators hoped to determine which components of the history...

PulseRegistrar: CASE HISTORY - RECEPTIONIST SNOOPS ON MEDICAL RECORDS.
February 1, 2007... It is with horror that you discover that a member of staff has been accessing the electronic records of patients who are her neighbours. This member of staff had no need to do this in the course of her duties but was curious to see what their...

PulseRegistrar: CLINICAL SKILLS ASSESSMENT - WHAT'S IT ALL ABOUT?
February 1, 2007... After months of preparation and piloting clinical skills assessment for the nMRCGP, Dr Mei Ling Denney can finally reveal what it's all about Clinical skills assessment (CSA) is part of the nMRCGP, the licensing test for general practice....

PulseRegistrar: MRCGP HOT TOPICS - CKD.
February 1, 2007... Dr Matt Doyle gives a round-up of the latest thinking on another key nMRCGP subject area The renal services national service framework recommendation for the routine reporting of estimated glomerular filtration rate (eGFR) with requested...

PulseComment: A depressing waste of time.(Brief article)
February 1, 2007... GPs were already pretty sceptical about the contract's new depression screening targets, so the latest research really won't help. Not only does screening of patients with heart disease and diabetes soak up time, send consultations off on a...

LAST WORD.(Brief article)
February 1, 2007... Dr Mary Hawking... on healthcare IT, political logic and single malt The best thing about my practice is the amazing people working here and my wonderful patients. And the worst is the paperwork! The trait I most dislike about...

Row as GPs landed with post-op checks.(General Practice)
February 8, 2007... GPs get up to three-quarters of a million checks dumped on them with no promise of pay By Katherine Haywood GPs are to have up to three-quarters of a million post-operative checks dumped on them every year for conditions such as...

CKD work surge benefits patients.(Chronic Kidney Failure)(Brief article)
February 8, 2007... Soaring workload from introduction of eGFR into the GP contract will at least bring tangible improvements in patient outcomes, a pilot study reveals. Research by the Government's new renal tsar has revealed a raft of benefits, including...

GPs warned not to chase CHD targets over cost fears.(Coronary Heart Disease)
February 8, 2007... Guidance U-turn rules out tougher QOF but puts policy at odds with JBS2 By Daniel Cressey GPs have been issued with official guidance telling them not to chase aggressive cholesterol targets amid fears the costs would cripple the NHS....