Pulse articles from February 2009

Pulse archives from February 2009

GPs face six-monthly performance checks.
February 4, 2009... Ministers order PCTs to ramp up competition and allow patients to switch practice online By Gareth Iacobucci GPs face twice-yearly contractual reviews and measures to allow patients to move more easily between practices, under...

Competition drive.(Patient Care Technology Systems)(Brief article)
February 4, 2009... WHAT ARE THE DH PLANS? The document is aimed at forcing PCTs to promote competition between practices and to give patients more choice of services. AREN'T TRUSTS DOING ENOUGH? Initial figures from the first year of World Class...

Ban urged on gifts from drug firms.
February 4, 2009... A new report set to be launched this week is expected to call for a blanket ban on drug company gifts to doctors. The report by the Royal College of Physicians is understood to describe a `culture of gifts' from pharmaceutical companies...

Private firm puts brakes on GP care plans.
February 4, 2009... A company with links to almost 1,000 GP partners has been forced to put the brakes on some of its plans for primary care. The Circle Health partnership said it had made a `small number' of staff on its business development side redundant...

Boost for GP dementia training.
February 4, 2009... GPs will receive more training on diagnosing dementia and better access to specialist services under a Government strategy released this week. The National Dementia Strategy pledges dedicated funding for GP training and a nationwide...

DARZI CENTRES: Centres to rely on nurses and salaried GPs.
February 4, 2009... Workforce projections show some GP-led centres will have three nurses to every GP, and others be dominated by newly qualified GPs Exclusive By Gareth Iacobucci The rollout of Lord Darzi's GP-led health centres is ushering in...

Square root split GPC.
February 4, 2009... Exclusive By Lilian Anekwe The GPC was divided over how to remove the controversial square root formula, with the decision to scrap it from April the subject of fierce debate, Pulse can reveal. News of a split within the committee...

DARZI CENTRES: Johnson `couldn't care less' which GP he sees.
February 4, 2009... Health Secretary Alan Johnson sparked outrage among GPs at the launch of one of the first of the new wave of GP-led health centres - by claiming he `couldn't care less' which doctor he saw. Opening the Resolution Health Centre, in North...

Patients join with GPs to oppose local QOF plans.
February 4, 2009... Patient groups have lined up beside the GPC in opposition to plans for local QOFs, claiming they could be detrimental to patient care. David Pink, chief executive of National Voices, an umbrella organisation representing over 150 patient...

GPC guidance outlaws referral incentive schemes.(General Practical Competence)(Brief article)
February 4, 2009... GPs must not sign up to targets or accept direct payment to reduce referrals, says strict GPC guidance released this week. The document fires a shot across the bows of LMCs and practice-based commissioning groups who have signed up to...

CARE RECORD: U-turn denies researchers full access to patient records.
February 4, 2009... Government backtracks on plans to allow researchers to access records without consent By Andrew Bracey Ministers have scrapped plans that would have granted researchers access to identifiable medical records without patient consent...

CARE RECORD: How the constitution's wording has changed.
February 4, 2009... JULY 2008 DRAFT VERSION `Patients can expect a health professional or a research professional with the same duty of confidentiality to use care records, in confidence, to identify whether they are suitable to participate in approved...

CARE RECORD: PCT pursues patients who opt out.
February 4, 2009... NHS managers leading the rollout of the Summary Care Record are refusing to take no for an answer from patients who say they want to opt out. GPs in the first wave of the rollout are being asked to send their PCT a list of patients who...

Ireland woos British GPs in recruitment drive.
February 4, 2009... GPs disillusioned with their career prospects in the UK are being targeted in a major recruitment drive by the Irish Government. The Irish Health Service Executive is to launch a campaign in the GP press in a bid to tempt British GPs to...

Alert over PPIs with clopidogrel.
February 4, 2009... FDA launches safety review of clopidogrel as study finds PPIs `turn off' the drug and raise risk of MI recurrence By Nigel Praities GPs should take immediate steps to review all patients taking clopidogrel amid concerns that it...

What could the impact be?(Report)(Brief article)
February 4, 2009... * The authors estimate PPIs are responsible for 14% of all readmissions for an MI after 90 days of discharge in patients taking both clopidogrel and a PPI * This raises concern over the 520,000 patients in England prescribed clopidogrel in...

JOURNAL WATCHl: Antibiotics in otitis media.
February 4, 2009... Treating children with otitis media with antibiotics halves the risk of a diagnosis of mastoiditis in the subsequent three months, an analysis of UK data concludes. A team at the School of Pharmacy in London analysed the records of 2.6...

JOURNAL WATCHl: Antipsychotics death risk.
February 4, 2009... Users of antipsychotic drugs are at twice the risk of sudden death of non-users, according to US researchers. The analysis of 44,218 patients on a single typical antipsychotic and 46,089 on a single atypical compared their risk to 186,600...

JOURNAL WATCHl: BP weather warning.
February 4, 2009... Blood pressure measurements should be carefully monitored in cold or hot weather, concludes a French study in elderly patients. The study followed 8,800 subjects aged 65 or older over two years and found systolic blood pressure decreased...

GPs to ration care under Tory plans.
February 4, 2009... Conservatives would also hold GPs responsible for outcomes after referral, says shadow health secretary By Steve Nowottny GPs would be asked to take the lead in rationing treatments for patients under a Conservative Government as part...

Tory plans for GPs.
February 4, 2009... Practice-based commissioning: GPs to have a far bigger role in commissioning services - but this would also mean a bigger role in rationing care Out-of-hours provision: Would hand responsibility for commissioning back to GPs - although GPs...

IN BRIEF: Flagship CVD project.(cardiovascular disease)(Brief article)
February 4, 2009... Lord Darzi has launched England's biggest cardiovascular disease prevention project in Westminster PCT, which could serve as a model service for other initiatives across the country. The programme, which comes in advance of the launch of...

IN BRIEF: Cherry-pickers' charter.(Brief article)
February 4, 2009... Forcing GPs to publish quality accounts may lead to cherry-picking of patients, the Department of Health has admitted. It announced earlier this month that as part of the proposed Health Bill, all GPs in England will have to publish annual...

IN BRIEF: Sham acupuncture works.
February 4, 2009... `Sham' acupuncture is just as good at relieving pain as traditional methods and only has a small pain-relieving effect, according to research in the BMJ. The systematic review of 13 trials concluded that any pain relief from acupuncture is...

IN BRIEF: GPs face heart failure rankings.
February 4, 2009... GPs face increased scrutiny of their management of heart failure, including league tables of their performance, under new recommendations for the NHS. Guidance from the NHS Institute for Innovation and Improvement aims to reduce...

MEDIA WATCH: THIS WEEK'S TOP... Miracle cure.
February 4, 2009... Asthma patients could soon have to decide which is the lesser of two evils - being short of breath or letting their bodies be invaded by blood-sucking parasites, says a gruesome Daily Telegraph report. Researchers from the University of...

MEDIA WATCH: Scare story.(Report)(Brief article)
February 4, 2009... Along with engine malfunctions, terrorist attacks or an unexpected encounter with North American geese, a bad choice of seat could also increase your risk of dying in a plane. Dutch researchers quoted in the Daily Mail and Daily Telegraph found...

MEDIA WATCH: Most pointless research.(Report)(Brief article)
February 4, 2009... An impressive array of geosatellite imaging, town planning data and a multivariate logistic regression of 14,595 homes generated this study's finding: that the more off-licences located close to home, the more young people will drink. A US...

Study casts doubt on SSRI guidance.
February 4, 2009... Meta-analysis finds sertraline and escitalopram work better than antidepressants recommended first-line by NICE By Lilian Anekwe Two antidepressants not recommended by NICE work better than approved first-line treatments in patients...

Shingles vaccine proposal.
February 4, 2009... A vaccination programme against shingles in older people would be cost- effective, according to a study to be submitted to a Government advisory committee. Researchers found a vaccination programme against herpes zoster for over-65s would...

Study questions value of GP mental health workers.
February 4, 2009... An international gold-standard review has questioned the value of having primary care mental health workers delivering psychological therapies at GP practices. Primary care mental health workers are increasingly deployed in primary care to...

INVESTIGATION: GP-LED HEALTH CENTRES - Who's leading Darzi centres?(general practitioners)
February 4, 2009... Pulse delves behind the proposed staffing models and finds `GP-led health centre' is something of a misnomer By Gareth Iacobucci When Lord Darzi named his new brand of supersurgery the `GP-led health centre', he did so because...

How centres are shaping up.(Brief article)
February 4, 2009... SHEFFIELD PCT (ONE MEDICARE) 5 GPs (all salaried) 8 nurses One session a week from a medical director Services: obesity, substance misuse, STI/HIV screening DERBY CITY PCT (ONE MEDICARE) 4 GPs (all salaried) 7...

EDITORIAL: Is choice crusade really what patients want?(Editorial)
February 4, 2009... Professor Allyson Pollock, in her book NHS plc, makes a number of key criticisms of the internal market within the health service. She claims introducing tendering processes will be hugely expensive. She wonders whether private providers will...

What do you think of model of care planned for GP-led health centres?
February 4, 2009... Dr Malav Bhimpuria GP in Alconbury, Cambridgeshire `Yes, you're talking about access from 8am until 8pm, seven days a week, but I have major concerns. I am a GP trainer. I have concerns about the kind of training those practices would...

LETTER: We need C&B guarantees.(Letter to the editor)
February 4, 2009... From Dr John Orchard Alfreston, Derbyshire Offering dummy appointments is a widespread practice used particularly by hospitals in Nottinghamshire (`Patients given dummy appointments through Choose and Book', pulsetoday.co.uk/news). A...

LETTER: AF software can help NHS go greener.(Letter to the editor)
February 4, 2009... From Dr John Havard Saxmundham, Suffolk A `greener' NHS is about much more than just telephone and internet consultations in primary care and reusing surgical instruments, as reported in the national press this week. Huge savings could...

LETTER: It's unrealistic to expect a pay rise.(Letter to the editor)
February 4, 2009... From Dr William Delaney Worksop, Nottinghamshire With the country practically bankrupt I'd be delighted if I had a 1.6% uplift in my PMS budget, which is more than I have received for the past three years. For the BMA to complain would...

LETTER: Leave your ivory towers and find solutions on GP surgery.(Letter to the editor)
February 4, 2009... From Dr John Tisdale Probus Surgical Centre, Cornwall I have been following with interest the recent discussions about GP minor surgery (`Minor surgery row fuelled huge leap in referrals', pulsetoday.co.uk/ news). It appears an intellectual...

LETTER: RCGP had its chance for input on guidance.(Letter to the editor)
February 4, 2009... From Dr John Charlton, Derby The RCGP was invited, on two occasions, to send a representative to NICE when guidelines for improving outcomes for people with skin tumours were being drafted (`College weighs in on row over safety of GP minor...

DEBATE: Should the BMA model contract be rewritten?
February 4, 2009... YES Only radical changes to the model contract for salaried GPs will make it attractive to partners while preventing a two-tier general practice, warns Dr Clarissa Fabre The BMA model contract for salaried GPs needs to be seen in the...

PULSECLINICAL: LUTS IN MEN.(Report)
February 4, 2009... Take-home points * Don't assume lower urinary tract symptoms are because of an enlarged prostate - even in older men * Overactive bladder syndrome in particular is underdiagnosed * Overactive bladder syndrome presents with storage,...

PULSECLINICAL: MIGRAINE AND CONTRACEPTION.(Report)
February 4, 2009... In the third article in a series of five, migraine specialist Dr Anne MacGregor explores some dilemmas around family planning For most women - including those with migraine - combined hormonal contraceptives (CHCs) are a highly effective...

PULSECLINICAL: ELDERLY MAN WITH RASH AND FEVER.
February 4, 2009... The fever had gone on too long and was followed by a rash - Dr Mike Wyndham looked for the clues The patient This 74-year-old retired teacher had suffered a myocardial infarction three years previously but had made a very good...

ASK THE EXPERT: EMPLOYMENT LAW.
February 4, 2009... Does the community hospital's action amount to constructive dismissal? As a partnership we have provided clinical assistant cover for our local community hospital. The employment has been on an individual doctor basis and we have been paid...

BUSINESSBRIEFING: THE PENALTIES OF GETTING TAX RETURNS WRONG.
February 4, 2009... In a couple of months' time a new, fiercer penalty regime will be introduced to deal with anyone who files incorrect tax returns, warns Bob Senior The British have a love-hate relationship with authority and legislation. We are often the...

Until death do us fall apart.
February 4, 2009... Phil is feeling his age this week, but it has given him a fresh insight into the rise in GP referrals I had one of my regular patients in this morning, a lovely old lady of around 80. Her joints were giving her grief. `I usually walk here...

Offer choice or face sanctions, GPs told.
February 11, 2009... Government plans to include choice in GP contract, with no extra pay but penalties for failure Exclusive By Steve Nowottny Ministers are planning to force GPs to offer patients a choice of hospital at every referral by making it a...

How ministers plan to impose choice.(Primary care trust)(Brief article)
February 11, 2009... * NHS Constitution to make choice a legal right for every patient - and promoting it a legal duty for PCTs * Department of Health to press negotiators for inclusion of choice within the GP contract * Extension of libraries project,...

Warning over rising tide of liver disease.
February 11, 2009... Provision at specialist liver units is insufficient to meet demand from a surge in cases of hepatic disease, top doctors have warned. A study published in Clinical Medicine also found most hospitals were ill-equipped to deal with the...

Call for GPs to increase fiscal awareness.
February 11, 2009... GPs and other clinicians need to take more interest in, and have more knowledge about, NHS finances and the need to use resources wisely. A statement by the Department of Health and medical colleges, including the RCGP, warned that it was...

Darzi urges NHS to learn from Starbucks.
February 11, 2009... Health minister Lord Darzi has called for patients to be offered a Starbucks-style NHS. In an interview in The Times, he said NHS staff should learn from the coffee giant's approach as they strived to offer patients greater choice. `While...

Call for Government control of GP partner recruitment.
February 11, 2009... Medical Practices Committee should be re-established to tackle lack of partnerships, say GP leaders Exclusive By Steve Nowottny and Andrew Bracey GP leaders want the Government to take central control over which practices are...

What was the Medical Practices Committee?
February 11, 2009... * Established in 1946 to ensure a fair, even distribution of GPs across England and Wales, the MPC identified `underdoctored' areas and had powers to prevent vacancies being advertised in `overdoctored' areas * Under the MPC, funding was...

A third of GPs `may quit' over abortion.
February 11, 2009... Up to a third of GPs are threatening to quit their practices if they opt to provide early medical abortion under Department of Health plans, Christian doctors are warning. At least eight areas of the country are considering providing...

GPs face having to prove quality before getting paid.
February 11, 2009... PCTs will be able to withhold pay from GPs if they cannot demonstrate the quality of their services, under plans unveiled by the Government. Full payment of practices' core funding would only be made once they had submitted satisfactory...

How quality accounts will work.(Brief article)
February 11, 2009... * All GPs will be expected to produce quality accounts from 2012, in an attempt to createkey quality standards for all providers * Organisations including NICE, the Department of Health and the Care Quality Commission are drawing up...

PCTs want to set most QOF targets locally.
February 11, 2009... NHS Confederation demands national QOF be reduced to a small core Exclusive By Lilian Anekwe The national QOF should be reduced to just a `small core', with the majority of targets locally determined, health service managers are...

QOF battlelines.
February 11, 2009... GPC Concerned GPs will be cut out of decision-making process. Opposed to local QOFs, warning they would lead to postcode lotteries and undermine care. NHS ALLIANCE Called for QOF points to be differentially weighted by area to...

PMS practices hit hard by clawbacks.
February 11, 2009... Savage PCT clawbacks are biting into the profits of PMS practices, Pulse can reveal. Accountants' figures show the plunge in profits among PMS practices is greatly outstripping falls across general practice as a whole. The figures,...

Cull of surgeries planned under integrated care scheme.
February 11, 2009... NHS managers have drawn up plans to dramatically cut the number of GP surgeries as part of the Government's latest flagship health initiative. South East Essex PCT is proposing to cut the number of local surgeries from 81 to 48 under plans...

One GP in five will be a registrar.
February 11, 2009... Radical training shake-up proposed by the RCGP will see number of GP registrars quadruple By Gareth Iacobucci GP registrars would make up as much as a fifth of the general practice workforce under plans for a radical training shake-up....

What the RCGP is proposing.
February 11, 2009... * Extend training from three years to five, including three years in general practice setting * Assessment over two years instead of one * Improve the knowledge GP trainees acquire from training in areas such as dermatology and ENT ...

CEPHALOSPORINS: High-risk antibiotic scripts cut by a third.
February 11, 2009... GP prescribing of high-risk antibiotics can be reduced by targeted primary care interventions, an analysis concludes. A study found nearly three-quarters of GPs prescribed cephalosporins as first-line antibiotics, despite the antibiotics...

AMOXICILLIN: Delayed prescribing scheme successful in otitis media.
February 11, 2009... GPs have shown delayed prescribing can dramatically cut antibiotic prescriptions for children with otitis media. The scheme has run in two Hertfordshire practices since 1999 and has more than halved amoxicillin prescriptions. It has...

U-turn on asylum seeker care.
February 11, 2009... Health secretary attacks `sheer inhumanity' of moves to deny failed asylum seekers primary care By Steve Nowottny The Government looks certain to abandon plans to deny free GP treatment to failed asylum seekers, after the health...

MEDIA WATCH THIS WEEK'S TOP... Miracle cure.( )(Brief article)
February 11, 2009... Pregnant women who boost the amount of the `sunshine' vitamin D could save their unborn child from multiple sclerosis in later life.A UK and Canadian study found vitamin D taken as either a daily supplement or sun exposure helps control the...

MEDIA WATCH THIS WEEK'S TOP... Scare story.(Brief article)
February 11, 2009... One child a week is made deaf by antibiotics, claims the Independent. The claim comes from a UK study that showed one child in 520 has a genetic mutation that results in hearing loss if they are exposed to aminoglycosides. The findings...

MEDIA WATCH THIS WEEK'S TOP... most pointless research.(Brief article)
February 11, 2009... Women are interested in weight loss and healthy eating but men are not, according to a study on different attitudes to health and exercise. The US research, which assessed the views of more than 700 young people, was published in the...

NHS IT: Legislation opens data access.
February 11, 2009... Fears for patient trust in GPs as adviser reveals care records could even be used to track terrorists By Steve Nowottny Controversial new legislation will allow patients' electronic care records to be freely circulated among Government...

NHS IT: Opt-out window gets smaller.(United Kingdom. National health services information technology)(Brief article)
February 11, 2009... Connecting for Health has cut the amount of time it will give patients to opt out of the Summary Care Record, amid concerns the rollout is taking too long. It has knocked a month off the consultation period, giving patients 12 weeks rather...

NHS IT: What the draft legislation allows.(national health service information technology)(Brief article)
February 11, 2009... * Any secretary of state, minister in charge of a Government department (including in Scotland, Wales and Northern Ireland) or the Treasury can issue an `information-sharing order' * The information has to be necessary to `secure a relevant...

NHS IT: Choose and Book raises DNA rates.
February 11, 2009... Patients referred through Choose and Book are 50% more likely to miss their appointment than those referred through traditional means, researchers warned today. A pilot study at the University Hospital, Lewisham, found a `significant...

IN BRIEF: Measles at record high.
February 11, 2009... Measles cases have leapt to record levels in a `very worrying' development, according to experts from the Health Protection Agency. The agency said most of the cases were in children aged three to 11 and were a direct result of not...

IN BRIEF: Call to ban glossy reports.(Brief article)
February 11, 2009... GPs have called on the Government to ban the use of glossy and expensive NHS reports, which they say are a huge waste of taxpayers' cash. A motion to be tabled by GPs at the upcoming Scottish LMCs conference calls for all costs of reports...

IN BRIEF: Learning disability GPSIs.
February 11, 2009... The Department of Health has pledged to increase the number of GPSIs working with people with learning disabilities. A new three-year strategy for people with learning disabilities follows a damning independent inquiry in July, which found...

COMMUNITY PILOTS: Pharmacy to access records.
February 11, 2009... Pharmacists will gain access to the Summary Care Record for the first time under plans by NHS IT chiefs, Pulse can reveal. In a key step towards Government proposals for pharmacies to take on more clinical work, pilots are being considered...

DARZI REFORMS: GPs excluded fromtop Darzi positions.
February 11, 2009... Profession shunned as not one SHA medical directorship goes to a GP By Gareth Iacobucci General practice has been completely excluded from a new wave of leadership appointments made to drive forward Lord Darzi's reforms. A raft of...

DARZI REFORMS: DH did call shots on polyclinic rollout.(United Kingdom. Department of Health)(Brief article)
February 11, 2009... Health secretary Alan Johnson has admitted the Department of Health did `dictate' terms to PCTs on its rollout of polyclinics - but defended the decision. In a keynote address to BMA members, he said instructing all PCTs to commission a...

Expert patients see GP less.
February 11, 2009... The expert patient programme should be expanded after proving capable of cutting GP visits and emergency admissions, a Department of Health evaluation concludes. Researchers found the programme was cost-saving for the NHS, and recommended...

REORGANISATION: Call for PCT shake-up to end `third-world standards'.(United Kingdom. National Health Service. Primary Care Trusts)(Brief article)
February 11, 2009... Ministers should cut the number of PCTs in a large-scale reorganisation of the NHS to tackle `third-world standards' in some trusts, RCGP chair Professor Steve Field has said. In a stinging attack on PCT managers, Professor Field claimed a...

JOURNAL WATCH: Aspirin cuts stomach Ca.(Clinical report)
February 11, 2009... Aspirin and other NSAIDs may lower the risk of stomach cancers, a US study concludes. The prospective cohort study followed 311,115 people for seven years and found people who used aspirin at least once in the preceding 12 months were 36%...

JOURNAL WATCH: Benefits of stopping HRT.
February 11, 2009... The increased risk of breast cancer associated with use of combined HRT declines markedly soon after women discontinue treatment, a US analysis of data from the Women's Health Initiative reports. Some 15,387 original participants who had...

JOURNAL WATCH: Rapid treatment of TIA.(Transient ischemic attack)(Report)(Brief article)
February 11, 2009... Rapid initiation of treatment in transient ischaemic attack and minor stroke reduces the risk of a repeat stroke and healthcare costs, say UK researchers. The EXPRESS study compared 1,300 patients who received immediate outpatient...