Pulse articles from January 2002

Pulse archives from January 2002

Ministers order GPs to give 3m meningitis jabs.(general practice physicians)(Brief Article)
January 7, 2002... Ministers are to order GPs to launch an urgent New Year campaign to vaccinate three million young adults against meningitis C. A Department of Health announcement is due this week instructing GPs to implement the first stage of the campaign...

6.1% increase to GP pay.(general practice physicians)
January 7, 2002... Delighted GP leaders have spoken of renewed confidence in future negotiations after GPs were effectively awarded a 6.1 per cent pay rise. The rise comes after the Review Body's exceptional decision to award a 4.6 per cent increase in gross...

Radical moves by Review Body mean more pay in GPs' pockets.(general practice physicians)(Brief Article)(Statistical Data Included)
January 7, 2002... Applying the pay increase to gross and not net income, and waiving clawback means this year's 4.6 per cent rise amounts to much more - Steve Toon and John Robinson report GPs' pay will effectively rise by an average of 6.1 per cent this...

Big rise in PMS income `was just a blip'.(general practice physicians)(Brief Article)
January 7, 2002... A 10 per cent rise in income for first-wave PMS GPs reported by the Review Body was probably a temporary blip, according to Dr Patricia Abbott. A survey by the Review Body's technical sub-committee of the Inland Revenue accounts of GPs who...

GPs get to keep expenses overpayments.(general practice physicians)(Brief Article)
January 7, 2002... GPs have been `overpaid' a total of #3,447 in the past three years, but they are unlikely to have the money clawed back from future pay awards. Overestimates of practice expenses were the main cause of the overpayments. The current...

Your 2002 pay award: Fees and allowances from April.(Brief Article)(Illustration)(Statistical Data Included)
January 7, 2002... Your 2002 pay award: Fees and allowances from April BASIC PRACTICE ALLOWANCE 2001 2002 first 400 patients 3,640 3,800 from 401 to 600 (per patient) ...

Ministers set out GP diabetes standards.(general practice medicine)(Brief Article)
January 7, 2002... The Government has outlined minimum standards of diabetes care that every GP will be expected to achieve - but has pledged extra resources to help with implementation. GP negotiators and diabetes experts have criticised the standards - set...

NICE issues GP referral guidelines.(National Institute for Clinical Excellence)(general practice physicians)(Brief Article)
January 7, 2002... The National Institute for Clinical Excellence has finally issued its controversial GP referral guidelines. Referral Advice - commissioned by the Department of Health in 1999 - covers 11 common conditions including acne, low back pain and...

New Year honours awarded to GPs.(general practice physicians)(Brief Article)
January 7, 2002... Two OBEs and five MBEs were awarded to GPs in the New Year honours list. OBEs went to Dr George Shirriffs, from Aberdeen, for services to the Scottish Council for Postgraduate Medical and Dental Education; and to Dr Prasanta Bhowmik, who...

GPs `misjudge urgency of Ca referrals'.(general practice physicians)(cancer)(Brief Article)(Statistical Data Included)
January 7, 2002... A Government report has prompted GP criticism of referral guidelines - Shaoni Bhattacharya and Jo Carlowe report GPs are misjudging the urgency of referrals for suspected cancer in more than a quarter of cases, despite the introduction of...

Appeal Court backs GPs on confidentiality.(general practice physicians)(Brief Article)
January 7, 2002... A practice has won its bid to protect patient confidentiality after a landmark Court of Appeal ruling barred health authorities from obtaining unfettered access to patient records. The Appeal Court upheld a High Court judgment that placed...

GP mortgages his surgery for scanner.(general practice physician purchases ultrasound imaging equipment)(Brief Article)
January 7, 2002... Dr Anthony Jones has taken out a #70,000 mortgage on his surgery to buy an ultrasound scanner. `It was either buy the scanner or quit the NHS,' said Dr Jones, who practises in Wolverhampton. He said the local NHS waiting time for a scan...

GP in police investigation over dihydrocodeine scripts.(general practice physicians)(Brief Article)
January 7, 2002... GP leaders have hit out at the media for being too quick to castigate GPs facing police investigations, following a probe into a singlehanded GP's prescribing habits. Dr Ian Rawlings, a GP in Coningsby, Lincolnshire, was suspended by the...

GPs miss orthopaedic diagnoses.(general practice physicians)(Brief Article)(Statistical Data Included)
January 7, 2002... Failed or delayed diagnosis of orthopaedic conditions by GPs is now one of the top reasons for successful negligence claims. Latest figures from the Medical Defence Union gave orthopaedic claims as the second most common reason for a claim,...

GPs show strong support for MMR.(general practice physicians)(measles-mumps-rubella vaccine)(Brief Article)(Statistical Data Included)
January 7, 2002... GPs continue to back strongly Government policy on MMR despite falling uptake and parental concerns, a Government report reveals. The Health Promotion England study of 202 GPs and 480 practice nurses showed 80 and 64 per cent respectively...

Risk of fatal asthma attack may be revealed by a family history.(Brief Article)
January 7, 2002... GPs have been urged to take a family history in all patients with asthma after research revealed that genetic factors may help explain why some asthmatics run an increased risk of life-threatening attacks. The pilot study, involving 170...

Practice clinics prove fruitful.(free fruit giveaways used to promote nutritious food habits)(Brief Article)
January 7, 2002... Dr Maria Read's practice has won Government recognition for a scheme to give out free fruit at the baby and child health clinic. The idea came from the practice patient representative group, which has won the Sheffield surgery beacon status for...

How pain perception affects care.(Brief Article)
January 7, 2002... Paper reviewed Br J Gen Pract Patients' versus general practitioners' assessments of pain intensity in primary care patients with non-cancer pain Mantyselka P et al 2001;51:995-7 (December) This short study from Finland evaluates...

What motivates frequent attenders?(general practice medicine)(Brief Article)(Statistical Data Included)
January 7, 2002... Paper reviewed Br J Gen Pract Psychosocial, lifestyle, and health status variables in predicting high attendance among adults Little P et al 2001;51:987-94 (December) You probably have a fair idea of who fills waiting rooms week...

Be aware of suicide attempts after stroke.(Brief Article)(Statistical Data Included)
January 7, 2002... Paper reviewed Br J Epidemiol Community Health Suicide after stroke: a population study Teasdale TW, Engberg AW 2001;55:863-6 (December) Depressive symptoms and clinical depression are not uncommon among stroke patients and the...

Letter: #45 an hour for GP specialists is way too low.
January 7, 2002... I refer to your report `#45 an hour demand for GP specialists' (December 15). I am horrified at this as once again I see the profession undervaluing itself and selling itself cheaply. The whole purpose is to get value for money in providing...

Pay award is one small step in helping to restore GPs' morale.(general practice physicians)(Brief Article)
January 7, 2002... The Government's decision to implement the Review Body's headline 4.6 per cent pay award for GPs is welcome - as far as it goes. The award is at least higher than inflation, although this year's rise in GPs' expenses, particularly locum fees,...

Letter: Why I'll continue to refer IBS patients.
January 7, 2002... I was disappointed by comments about IBS by Professor Greg Rubin, professor of general practice at the University of Sunderland (News report, November 3). His view that referral of patients is inappropriate unless they have `alarm...

Letter: Must GPs act as travel reps?
January 7, 2002... Newspapers have trumpeted the news that heart patients waiting more than six months could be offered the opportunity of having their operation in a hospital abroad. This puts GPs in pole position for doling out travel itineraries to...

Is practice manager defrauding partners?(Brief Article)
January 7, 2002... The problem I joined our practice when the average parity income was well above average. The other two partners and the practice manager ran a very tight ship. Both partners have now retired, but the practice manager remains - in sole...

You suspect that train driver is misusing alcohol.
January 7, 2002... Case history During morning surgery, Michael, a 42-year-old who has been a train driver for 15 years, comes in with a sore throat. While examining his throat you notice he smells of alcohol. You also notice his hands are shaking and he...

How to recognise when winter gloom becomes an illness.
January 7, 2002... By Dr Erin Michalak, Professor Clare Wilkinson and Professor Chris Dowrick Seasonal affective disorder (SAD) is now a well-recognised subtype of major depressive disorder. The condition is frequently, but not always, characterised by a...

Single mother wants home visit for her hot, sick child.(Brief Article)
January 7, 2002... Dr Martin Pucci offers advice on how to approach this call CASE HISTORY Carol Jones, a single, separated mother with three children aged two, four and seven, calls at 8pm to tell you that the four-year-old is `hot, has been sick and...

SURVIVOR'S GUIDE TO MRCGP: Tackling the written paper of the exam.(general practice physicians examination)(Brief Article)
January 7, 2002... It may seem daunting, but Dr Penny Reid's practical advice will ease your panic This gruelling, three-and-a-half hour exam (formerly known as Paper 1) is a real test of virtually all areas of the curriculum as defined in the examination...

Emergency contraception request from a girl under 16.
January 7, 2002... CASE HISTORY 15-year-old Samantha came to reception one lunchtime, asking to see a doctor but not keen to say why. As she looked very anxious, the receptionist asked the emergency doctor to see her; it turned out she had requested...

ANSWER BACK: How does pregnancy affect the eyes?(Brief Article)
January 7, 2002... Q: What are the eye changes in pregnancy and does breast-feeding make any difference? A: Changes in the tear film lead to contact lens intolerance, especially in the second and third trimesters. These revert to normal post-partum or after...

ANSWER BACK: Advising a patient on paternity testing.(Brief Article)
January 7, 2002... Q: A patient has asked me if he can have a test to determine whether he is the father of his child. What should I tell him? A: First, discuss with the patient whether the test is in the interests of the child. This will need to be...

GPC fury as GP attacker walks free.(general practice physician)(Brief Article)
January 14, 2002... The GPC has accused the courts of going soft on violent patients after a man who attacked a GP received a suspended sentence. Kieran Nayer - found guilty last week of common assault after grabbing a GP by the throat and hurling him against...

`E-mail key to Men C campaign'.(meningitis C vaccine)(Brief Article)
January 14, 2002... Dr Christine Rajah says e-mail and the internet will be her key tools in trying to reach the 2,000-plus under-25s on her list who now require meningitis C vaccine. As GPs round the country received unsolicited supplies of vaccines which...

Co-op bails out NHS Direct.(Brief Article)
January 14, 2002... A GP out-of-hours co-operative took over NHS Direct calls on Boxing Day because it feared the telephone advice service would fail to cope with increased demand. Hampshire and Isle of Wight NHS Direct diverted callers un-triaged to Island...

All GPs forced to work with Government team on access.(Brief Article)
January 14, 2002... GPs will be compelled to work with a flagship modernisation team to ensure they meet the Government's deadline for 48-hour access under a surprise new NHS Plan target. The target - buried in an NHS Plan progress report published last week...

Out-of-hours palliative care plea.(Brief Article)
January 14, 2002... Professor Jeremy Dale has urged GPs not to admit patients with palliative care needs to general medical wards out of hours if specialist palliative care services are available. A survey by Professor Dale, professor of primary care at the...

Overhaul plan for GP co-op prescribing.(Brief Article)
January 14, 2002... GPs working out of hours will be required to prescribe full courses of drugs from a core national formulary under sweeping changes planned by the Government. A draft Department of Health document on the supply of medicines out of hours,...

Chaos as GPs swamped with old Men C vaccines.(Brief Article)
January 14, 2002... GPs are claiming the Government's order to extend the meningitis C vaccination campaign to all under-25s is a `cynical ploy' to get rid of surplus vaccines before they expire. A picture of chaos unfolded last week as some practices were...

MMR uptake is starting to recover from all-time low.(Brief Article)
January 14, 2002... The first signs have emerged of a recovery in MMR uptake, figures from the Public Health Laboratory Service reveal. Vaccination rates could be back above 90 per cent within three or four years if the trend continues, said Dr Mary Ramsay,...

Open-access MRI reduces GP referrals.(Brief Article)
January 14, 2002... GPs given open access to a neuro-imaging service avoided hospital referral in 30 per cent of cases, Dr Jacqueline Halliday-Pegg has found. The service allowed 179 GPs from 75 practices in Lothian to refer patients directly for MRI and CT scans....

CMO plans to extend flu vaccination drive.(Brief Article)
January 14, 2002... The Chief Medical Officer has recommended extending the annual flu vaccination campaign to `larger numbers of people'. The call came in Sir Liam Donaldson's Strategy for Combating Infectious Diseases, launched last week. The strategy warns...

Campaign to curb sicknotes.(Brief Article)
January 14, 2002... The Doctor Patient Partnership has launched a publicity campaign to cut requests for sicknotes, which account for 2.4 million GP appointments and 37,000 hours of GP administrative time a year. Employees only need sick-notes when they have...

GPs' emergency referrals vindicated.(Brief Article)
January 14, 2002... Powerful evidence has emerged from new research to undermine the Prime Minister's controversial claim that GPs misuse emergency referrals to jump hospital waiting lists. The study into factors behind variations in emergency referrals found...

GPs claim a `first' over CHD register.(Brief Article)
January 14, 2002... Dr Raymond Hunter's practice in Northern Ireland claims it is the first in the province to have set up a fully functional coronary heart disease register. Dr Hunter, a GP in Craigavon, Armagh, hoped other GPs would now follow suit to help...

GP casts doubt on `cot death murders'.(Brief Article)
January 14, 2002... A GP who acts as a senior Government adviser on infectious diseases has offered to testify on behalf of solicitor Sally Clark who was jailed for the murder of her sons, should she launch a new appeal. A jury convicted Clark in 1999 after...

French GPs in strike over fees.(Brief Article)
January 14, 2002... More than 55,000 French GPs took part in a three-day strike last week demanding a 14 per cent increase in consultation fees and 46 per cent more for home visits. The strike was the latest in a series of stoppages in protest at state-...

New jab for at-risk infants.(Brief Article)
January 14, 2002... The Government is ordering GPs to vaccinate all at-risk under-twos with Prevenar, the new conjugate pneumococcal vaccine from this month. GPs have been told to immunise just under 10,000 children who would otherwise be offered the...

GP in `golden hello' dispute gets backing.(Brief Article)
January 14, 2002... Dr Jerzy Bem's PCT is backing his fight to secure a `golden hello' payment totalling #10,000 for taking up a PMS salaried post in one of the worst GP recruitment troublespots. Dr Bem threatened to resign from his job in Washington, Tyne and...

Study casts doubt on CHD risk factors.(Brief Article)
January 14, 2002... Single measurements of standard coronary heart disease risk factors underestimate dramatically the true long-term risk of developing CHD, according to latest results from an influential study. New unpublished findings from the British...

NHS LIFT scheme to be extended.(Brief Article)
January 14, 2002... Health Secretary Alan Milburn said the NHS LIFT initiative will be extended to 12 further areas, amid criticism from the Commons health select committee for failing to evaluate the six existing schemes. The Government aims to use NHS LIFT...

GPs could TB-screen UK entrants.(Brief Article)
January 14, 2002... Screening new entrants to the UK for tuberculosis in general practice is feasible and cost-effective, research led by Professor Gene Feder has concluded. GP screening is cheaper than the current hospital-based port of arrival scheme, said...

Flu vaccinations for GPs and staff could reap `huge savings'.(Brief Article)
January 14, 2002... GPs have been urged to follow Government advice to get themselves and practice staff immunised against flu after research revealed the vaccine is highly cost-effective among health care workers. The study found that NHS trusts could save...

Asian GPs' children shun general practice.(Brief Article)
January 14, 2002... The GP shortage is set to worsen as the medical student children of Asian GPs opt for hospital posts - by Ann Warburton The demise of the family-run Asian corner shop is being mirrored by a decline in family-run inner-city practices as...

GP's son prefers career in hospitals.(Brief Article)
January 14, 2002... Dr Bharat Bhasin, a singlehanded GP in Huddersfield, plans to retire some time in the next year. Originally from India, he has practised in the town since 1976. His father and grandfather were both doctors. Dr Bhasin's youngest...

So much change puts students off.(Brief Article)
January 14, 2002... Dr Hemachendra Pai came to Britain from India in 1972 and has practised as a singlehanded GP in Hodge Hill, Birmingham, for more than 20 years. He plans to retire in about four years. Dr Pai's son and daughter have followed him into medicine....

Call for GP sexual health IoS fee.(Brief Article)
January 14, 2002... The RCGP is demanding item-of-service payments to help meet the controversial demands of the Government's proposed HIV/sexual health strategy. The Department of Health has allocated #16,000 for each health authority to review its current...

St Paul GPs face #4k run-off bills.(Brief Article)
January 14, 2002... GPs who have medicolegal cover with The St Paul could face bills for run-off cover of over #4,000 after the beleaguered organisation's decision to quit medical malpractice. The St Paul, which insures around 3,000 UK GPs, is pulling out of...

Eradicate H. pylori before long-term NSAIDs.(Brief Article)
January 14, 2002... Papers reviewed Lancet Eradication of Helicobacter pylori and risk of peptic ulcers in patients starting long-term treatment with non-steroidal anti- inflammatory drugs: a randomised trial Chan FKL et al 2002;359:9-13 Role of...

TB screening most effective at GP new patient checks.(Brief Article)
January 14, 2002... Paper reviewed Thorax Screening for tuberculosis: the port of arrival scheme compared with screening in general practice and the homeless Bothamley GH et al. 2002;57:45-9 (January) Tuberculosis is on the increase again with 50...

Letter: National service framework for CHD.
January 14, 2002... The national service framework for coronary heart disease seems to make a major error in wanting to concentrate secondary prevention resources on patients whose 10-year CHD risk is 30 per cent. This takes no account of the age of patients...

EDITORIAL COMMENT: GP records are not a resource to be plundered.(Brief Article)
January 14, 2002... The Appeal Court's ruling that health authorities have no automatic right to trawl GPs' records is reassuring. The health authority's attempt to bypass clinical confidentiality was outrageous, but not an isolated occurrence. Many of the...

Letter: Bogus appointments study wastes my time.
January 14, 2002... My PCT contacted my surgery in September to inquire about availability of appointments, but we already had had one full week's advance notice of the inquiry - plenty of time to cook the books if necessary. A few weeks later I received a...

Letter: Expose 48-hour GP access as false idol.
January 14, 2002... What is going on with 48-hour access? Despite the drum-beating that it could not be achieved without more resources, it gains pace without any. GPs are struggling with hospital waiting lists of up to 75 weeks, departments are asking us not...

Aciclovir treatment.(Brief Article)
January 14, 2002... The article `Managing adult chickenpox to minimise complications' (Pulse Clinical, October 20, 2001) contained the algorithm `Does the patient require oral aciclovir?'. The at-risk patients improving or following normal course, with rash...

Junior staff allege bullying by the senior receptionist.(Brief Article)
January 14, 2002... The problem Two of our newest receptionists claim they are being bullied by the senior receptionist. She can be abrasive and doesn't suffer fools gladly, but she does her job magnificently. When asked about the allegations, she admitted...

Family of terminally ill patient are unaware of the prognosis.(Brief Article)
January 14, 2002... Case history You have recently started seeing a woman at home who has been diagnosed with terminal gastric cancer. She has had palliative chemotherapy, but her outlook remains poor. It transpires that her consultant has been less than...

Life as a new principal.(Brief Article)
January 14, 2002... Dr Kate Kirkwood's diary For the past six months I have been, in chronological order: normally pregnant; then abnormally pregnant; then abruptly no longer pregnant at all but mother of a `prem'. So thoughts of work have been languishing on...

New clinics offer instant referral for chest pain.(Brief Article)
January 14, 2002... Swifter diagnosis of coronary artery disease reduces uncertainty for both patient and GP - with the NSF for coronary artery disease the Government has set out to increase the availability of rapid access chest pain clinics The rapid access...

When GPs should suspect meningococcal disease.(Brief Article)
January 14, 2002... GPs must remain vigilant for meningococcal disease despite this week's announcement of expansion of meningitis C vaccination - Dr Nelly Ninis and Dr Simon Nadel clarify what GPs should look out for Meningococcal disease is caused by the...

When are grommets a must for glue ear?(Brief Article)
January 14, 2002... BACKGROUND It's a familiar dilemma - the anxious parent, the child with an audiogram indicating a mild hearing loss. Do you wait and watch or opt for surgery? BOTTOM LINE It seems acceptable to wait in younger children (under...

Tips on management of verrucae and alopecia.(Brief Article)
January 14, 2002... Can you confidently diagnose these conditions? Find out with our clinical quiz VERRUCAE Questions 1 What is the cause of verrucae? 2 How can verrucae be distinguished from corns or areas of hyperkeratosis? 3 What is the...

SURVIVOR'S GUIDE TO MRCGP: Tackling the oral exam.(Brief Article)
January 14, 2002... Advice on preparation for the oral, by Dr Chris Hall who gained a pass with distinction in 1999 Unlike other components of the MRCGP examination, the oral lends itself to a limited amount of preparation. The scope of topics is so wide, and...

Understanding slapped cheek syndrome.(Brief Article)
January 14, 2002... In the second of a series on common dermatological presentations, Dr John McCarthy looks at slapped cheek syndrome Slapped cheek syndrome is caused by parvovirus B19, a small DNA virus discovered by chance in 1975. The virus is spread by...

Husband and wife make you piggy-in-the-middle.(Brief Article)
January 14, 2002... Case history Mr Brown is complaining of insomnia and blames his wife. `There's nothing wrong with me, Doctor; she's the one who needs pills, as you know.' You remember that Mrs Brown came in last week to complain (among other things) about...

ANSWER BACK: Who should be screened for hepatitis C?(Brief Article)
January 14, 2002... Q: If one in 200 of the UK population has hepatitis C and the source of infection is not always clear, who should we consider at-risk and screen? A: Initial data from blood donors using early generation antibody tests suggested the...

ANSWER BACK: Can patient complain if not given appointment?(Brief Article)
January 14, 2002... Q: We run a busy surgery using pre-booked appointments. Recently a patient threatened to make a complaint because we could not offer a routine non-emergency appointment within two days. Would such a complaint be upheld? A: At present...

GPs face acute locum shortage in lists chaos.(substitute physicians in general practice medicine)(Brief Article)
January 21, 2002... Health authority delays in drawing up new supplementary lists for non- principals will create acute locum shortages this year, the GPC has warned. Supplementary lists that control who can work as a non-principal come into force on April 1....

Plea for help with Men C vaccine `lake'.(meningitis C surplus stock)(Brief Article)
January 21, 2002... The GPC is seeking urgent Government clarification on what GPs should do with the large quantities of meningitis C vaccine delivered to them with an expiry date of January 31 as part of the drive to immunise 20- to 24-year-olds. As Pulse...

GPC attacks move to put GPs in the frontline over obesity.(general practice physicians)(Brief Article)
January 21, 2002... The GPC has attacked a parliamentary report for putting GPs at the forefront of a national crusade against obesity. The report by the House of Commons' public accounts committee criticised GPs for not seeing the `identification and...

GP gathers the fax on hospital non-admissions.(general practice physicians)(Brief Article)
January 21, 2002... Dr Lisa Silver has collected a year's worth of faxes telling GPs not to admit patients to the local hospital. The GP in Henley on Thames has amassed dozens of letters from John Radcliffe Hospital in Oxford warning that patients are waiting...

GP entrepreneurs may run their PCT.(general practice physicians, primary care trusts)(Brief Article)
January 21, 2002... GPs could join together to take over high-performing primary care trusts and run them as independent `foundations' under radical plans for the NHS announced by Health Secretary Alan Milburn. Mr Milburn last week revealed that the...

Attacked GP is `forced to retire' through his injuries.(Dr Julian Colledge)(Brief Article)
January 21, 2002... Dr Julian Colledge has spoken of his anger and resentment at being forced to retire through injuries caused by an assailant who escaped with a suspended sentence. Dr Colledge, a GP in Ashford, Kent, was grabbed by the throat and hurled...

GP leaders draw line at diamorphine for addicts.(general practice physicians)(Brief Article)
January 21, 2002... The GP profession last week resisted Home Office plans to increase the number of GPs prescribing diamorphine to heroin misusers. Home Secretary David Blunkett wants a five-fold increase in the number of heroin misusers prescribed...