Pulse articles from January 2003

Pulse archives from January 2003

New contract delay but pay rise is safe.
January 6, 2003... GPs will have to wait until well into 2003 before most of the new contract comes into force after a six-week delay in publishing the deal was announced. GPC chair Dr John Chisholm blamed the setback on the Government's tardiness in...

Don't expect rush of new year quitters.
January 6, 2003... Dr Daryl Freeman says GPs will not be overrun with smokers who are using the new year as an excuse to quit. Dr Freeman, a member of Smoking Cessation in Primary Care, said research for its latest campaign, Smoke Free in 2003, found only 3...

GPs face HIV and hep C tests.
January 6, 2003... GPs who want to specialise in areas such as sexual health, A&E and intravenous drug misuse, will have to be screened for HIV and hepatitis C under new Government proposals. The proposals, out for consultation until the end of April, stop...

GPs hit target in flu campaign.
January 6, 2003... GPs have managed to meet the 70 per cent flu vaccination uptake target for the over-65s ahead of schedule. A Department of Health spokesman said full results of the flu campaign were expected this month. He said: `It's certainly gone well...

Milburn attacked by his advisers on diabetes NSF delay.
January 6, 2003... Government advisers on the delayed national service framework for diabetes are demanding the Health Secretary publish the strategy immediately or face years of delay in implementation. Advisers on the framework's implementation group fear...

GPs honoured by the Queen.
January 6, 2003... Six GPs have been made MBEs in the New Year's honours: Dr Joginder Cheema, a singlehanded GP and GP appraiser in Lambeth, south London; Glasgow GPs Dr David Ferguson and Dr Brendan Sweeney; Birmingham LMC secretary Dr Charles Zuckerman;...

What GPs want to say.
January 6, 2003... GPs' dearest wish is to be able to tell patients to wash before they come to the surgery, demand that they lose weight or confront them for not taking their medication. A survey for Reader's Digest has revealed GPs are deeply frustrated...

`Miracle' GP returns.
January 6, 2003... A GP who almost died in a freak diving accident is set to return to practice after making a miraculous recovery. Dr Paul Thomas was without oxygen for 10 minutes and spent three weeks in a coma as a result of the accident at a Leicestershire...

GP consultation rates decline.
January 6, 2003... GP consultations have fallen, an official survey has revealed. In 2001, 13 per cent of people interviewed said they had seen an NHS GP in the last two weeks, compared with 14 per cent in the previous year. The `Living in Britain - 2001...

Pension row GP gets ear of minister.
January 6, 2003... Dr George Stein has received a reply from Health Secretary Alan Milburn after he complained to his MP that he was too old to get the Government's #10,000 delayed retirement cash. Dr Stein, a GP in Sutton in Ashfield, Nottinghamshire, wrote...

GPs may lose 25% of pensions under Government plans.
January 6, 2003... GPs could lose up to a quarter of their pensions if they retire at 60 under Government plans for the public sector. In a green paper released last month, ministers revealed plans to force public sector workers to retire at 65 in order to...

Practice candid over MMR error.
January 6, 2003... Dr Andrew Carson found openness was the best policy when his practice nurse accidentally gave an eight-week-old the MMR vaccine. Dr Carson, a GP in Birmingham, commended the nurse for behaving `extremely responsibly' by informing them...

Government snub over chlamydia angers GPs.
January 6, 2003... GPs will be largely excluded from the national roll-out of chlamydia screening because of Government funding restrictions. Sexual health experts said the decision was worrying as chlamydia infection rates continue to soar. Ten sites across...

Seroxat set for review by watchdog.
January 6, 2003... The Medicines Control Agency is undertaking an `intensive review' of selective serotonin reuptake inhibitors, with particular regard to withdrawal reactions with Seroxat (paroxetine). The MCA set up a working group to examine the issue...

GP pays out #15,000 to patient.
January 6, 2003... A Bristol GP has paid #15,000 to a patient in an out-of-court settlement for failing to identify a serious side-effect caused by a drug he had prescribed to her. The patient had been taking the painkiller Voltarol for 18 months when she...

GP item-of-service income drop may boost new contract.
January 6, 2003... GP income from item-of-service fees has fallen by as much as 12 per cent in some parts of the UK, according to latest official figures. Department of Health statistics for 2001/2 show income from item-of- service payments for GMS GPs fell...

GP flags raised breast cancer risk gene in Jews.
January 6, 2003... Dr Joseph Spitzer was surprised by results of an impromptu survey on breast problems at his surgery that flagged up a high prevalence of the BRCA breast cancer risk genes in Ashkenazi Jews. Dr Spitzer, a GP in Stamford Hill, north London,...

French GPs targeted as latest saviours of recruitment crisis.
January 6, 2003... France has become the latest country to be targeted by primary care trusts to ease the GP recruitment crisis. Some 15 GPs from across the Channel have now been recruited to south- east London after a drive by Lambeth, Southwark and Lewisham...

GPs fear extra PCT budget will be swallowed up by secondary care.
January 6, 2003... GPs have warned that the Government's much-hyped 30 per cent increase in primary care trust budgets will be eaten up by secondary care. NHS Alliance treasurer Dr Ron Singer said the budget of #148.3 billion over three years seemed large,...

At-risk elderly not receiving adequate statin therapy.
January 6, 2003... Only 2 per cent of elderly patients with a high risk of heart disease are receiving adequate statin therapy, a major study has revealed. The unpublished study surveyed approximately two-and-a-half million people from 60 GP practices in the...

Risk factors can predict CHD deaths.
January 6, 2003... Measuring risk factors for coronary heart disease in middle-aged men can predict their likelihood of dying from the disease over the following 35 years, according to a study. Researchers reviewed data collected in 1960 on age, systolic...

Patients support self-care.
January 6, 2003... Patients with long-term illnesses have reported excellent results from self-management programmes. The programmes are being piloted by 50 PCTs as part of a national Expert Patients Programme. It is expected over 19,000 people could benefit...

Quality markers could mean worse care for many patients.
January 6, 2003... GP major disease experts warn that the quality targets in the contract may not bring about expected improvements - Jack Shamash reports The new quality-based contract could result in worse treatment for many patients, according to GP...

Jobs under Assembly microscope.
January 6, 2003... The London Assembly is to examine recruitment and retention problems for GPs in the capital. The scrutiny by the assembly's health committee follows its investigation into access to primary care services, the final report of which is due...

GP union's website hacked into and linked to porn site.
January 6, 2003... The newly-formed General Practitioners Union has had its computers hacked and its internet homepage redirected to a pornographic website just days after the union was officially launched. Dr Ahmad Risk, the private GP in Brighton, Sussex,...

GPs urged to prevent adolescent PID.
January 6, 2003... GPs are well placed to stem the growing tide of pelvic inflammatory disease in teenagers by raising awareness about chlamydia and gonorrhoea, according to a sexual health expert. Dr Jonathan Ross, consultant physician at the Whittall Street...

Letter: Cost of locums takes up my entire income.(Letter to the Editor)
January 6, 2003... I think the point of your article `Practices face huge losses over locum insurance shortfall' (News, November 11) is very valid, but it woefully underestimates the true costs of locum cover to a practice. I work(ed) in a busy four-doctor...

COMMENT: Our new year resolution for Milburn: give GPs their due.
January 6, 2003... What does 2003 hold for general practice? Who could begin to guess? Six months ago most of us would have said it would all be resolved by now: either GPs would have accepted the contract and be gearing up for its implementation in April, or...

Letter: Stick to original deal and go straight to resignation vote.(Letter to the Editor)
January 6, 2003... Further to your front-page report `Talk not walk if GPs vote No in ballot' (News, December 9), we should go straight to a resignation ballot if the contract is rejected. That was the original `deal'. Dr Jonathan Hamill, East Molesey, Surrey...

Letter: Pay us on a par with the City.(Letter to the Editor)
January 6, 2003... I think the Government's latest `golden hello' scheme is useless, especially as the #12,000 incentive payment is taxed and one-off. My childrens' futures are the most important things in my life. So what would entice me back to general practice...

Close harmony vital in practices to achieve top quality payments.
January 6, 2003... Practices will need to pull together if quality payments proposed under the new contract are to be maximised, says Dr Gary Calver The documents and rumours now in circulation suggest that a key part of the new contract, and the new...

The bottom-line question for all GPs: what about the funding?
January 6, 2003... Dr Lorna Gold discusses what will really decide a Yes or No contract vote for most GPs - the question of funding For most GPs the decision to vote Yes or No on the contract will depend mainly on how it will affect our finances, including...

PRACTICE Q&AS: Should we agree to a drug swap?
January 6, 2003... A drugs company has offered to alter all our repeat prescriptions from one of its recently withdrawn products to the product which has replaced it. This replacement is a few pence cheaper than its competitor and will therefore save us money on...

PRACTICE Q&AS: Would e-mail access increase workload?
January 6, 2003... We are about to set up a practice website. One of the partners has suggested putting partners' practice e-mail addresses on the site to allow patients direct e-mail access. Some of us are worried about the possible workload increase. What are...

PRACTICE Q&AS: Should all partners get sabbaticals?
January 6, 2003... We are drawing up a new practice agreement. One of the younger partners wants the sabbatical clause altered so each partner has the opportunity to take time off every five years. Others feel sabbaticals should be for jaded older GPs. Is there...

Helping patients on new year diets.
January 6, 2003... The new year inevitably starts with the latest diet craze, yet one in five of the population is now obese, says Dr Susan Jebb Who will benefit from weight loss? Anyone with a BMI >30kg/m2 or >25 kg/m and suffering from obesity- related...

Step-by-step treatment of benign positional vertigo.
January 6, 2003... Dr Bill Laughey says curing BPPV is ridiculously easy - and sets out to prove it Benign paroxysmal positional vertigo (BPPV) is the most common type of vertigo we see in general practice. It's ridiculously easy to diagnose and cure, and...

Should you ever give patients your home phone number?
January 6, 2003... Case history Mr Riley has had prostatic cancer for years. He lives with his wife and usually manages to attend surgery. You are called out because he suffered a flare-up of back pain overnight. You increase his analgesics and discuss...

ANSWER BACK: Does nasal mucosa surgery cure snoring?
January 6, 2003... Q: I saw an advert for laser surgery to `remove the nasal lining mucosa which obstructs the air passages and causing snoring and impaired breathing'. What is the benefit in this? A: I would advise caution with adverts for snoring cures,...

ANSWER BACK: Emergency situations in saddle anaesthesia.
January 6, 2003... Q: Saddle area anaesthesia is a sign of cauda equina compression in low back pain. Does this refer to the whole saddle area? In the absence of other symptoms, would an area of anaesthesia constitute a surgical emergency? A: The...

GPs' date with destiny is fixed for March 20.
January 13, 2003... GPs are to finally get their chance to vote on the priced contract on March 20. If the profession votes Yes GPs will get their first pay increase and practice investment money in the first quarterly payment after April, the GPC has...

Gun killers force GP to work in car.
January 13, 2003... Singlehanded GP Dr Prema Iyengar works just two doors away from the place where two Birmingham teenagers were gunned down on New Year's Eve. When she returned to work she had to see patients in the back of her car because of a police...

GPC smokescreen over contract delay.
January 13, 2003... A dilemma over whether to spend extra Government cash on GPs' income or on pensions is the real reason for the delay to the GMS contract. GPC chair Dr John Chisholm has maintained that lack of key data and the need for a legislation...

Meningitis warning for Hajj pilgrims.
January 13, 2003... Dr Syed Raza Hussain is urging GPs to vaccinate Muslim patients against meningitis if they plan to make the annual Hajj pilgrimage to Mecca. Two years ago, 20 people from the UK died after a meningitis outbreak at the pilgrimage site,...

GPs to deliver diabetes NSF from April via new contract.
January 13, 2003... The Government is expecting GPs to deliver the new diabetes national service framework through the new contract. Under the framework published last week, GPs in England will be told to start setting up practice-based diabetes registers from...

`Act on out-of-hours opt-out or we're off'.
January 13, 2003... GPs are issuing trusts with an ultimatum to implement the out-of-hours opt-out this year or they will quit general practice, Pulse has learned. The demands have been prompted by the contract delay and fears that trusts could prevent GPs...

Fears new contract will drive down locum pay.
January 13, 2003... Non-principals are threatening to vote No in the new contract ballot, fearing the deal will drive down locum pay rates. Dr Peter Harvey, former joint-chair of the GPC's non-principals sub- committee, said abolition of the basic practice...

GPs driven into decision on PMS after contract delay.
January 13, 2003... Thousands of GPs who applied to PMS as insurance against an unacceptable new GMS contract have had their plans stymied by the delay in pricing the deal. Some 4,000 GPs who submitted expressions of interest in the next PMS wave will now...

PMS GPs may work to quality markers.
January 13, 2003... PMS GPs are set to work towards the same quality markers as GMS GPs once the new contract is adopted, the NHS Confederation has revealed. Mike Farrar, chair of the confederation's contract negotiating team, said PMS GPs would get the same...

GPs force action to reduce red tape.
January 13, 2003... The Government has moved to answer GP criticism of its efforts to cut practice red tape by setting up a new taskforce to speed up change. The taskforce will oversee ways of cutting red tape generated by repeat prescribing, sickness...

GPs may have to vaccinate all children against hep B.
January 13, 2003... Government vaccine advisers are poised to recommend universal hepatitis B immunisation in children in a bid to stem spread of the disease. The Joint Committee on Vaccination and Immunisation has set up a hepatitis B subgroup to consider...

BMA in legal battle on fee scales ban.
January 13, 2003... The BMA has stepped up its battle for the right to publish fee scales for locums by bringing in lawyers to handle negotiations with the Office of Fair Trading. The OFT stopped the BMA publishing the fee scales in 2000 after ruling it was...

`GPs cannot meet the NSF for mental health'.
January 13, 2003... GP services are too stretched to give patients the level of care demanded in the national service framework for mental health, claims a new report. Primary Solutions, an independent review from the Sainsbury Centre for Mental Health in...

PCTs warned over violence.
January 13, 2003... The GPC has given PCTs until the end of January to implement schemes for violent patients after its research found 64 trusts had no action plan in place. The GPC will carry out another survey on compliance after the deadline has passed and...

Assembly worried by vaccine uptake.
January 13, 2003... The London Assembly wants action taken to boost flagging uptake rates of childhood vaccines. A report by the Assembly said the number of children being vaccinated in the capital has fallen since 1996. Only 73 per cent of London's...

GP fumes over fire safety spotcheck.
January 13, 2003... Dr Anne Dyson is angry her PCT will not help her practice meet an unexpected #4,500 bill for fire safety improvements. Maldon and South Chelmsford PCT refused the GPs discretionary funds to help them comply with the 1997 Work Place...

Armed forces try to tempt GPs with #50,000 bonus.
January 13, 2003... GPs are being offered #50,000 `golden hellos' to join the armed forces as Britain prepares for war against Iraq. The financial inducement paid to doctors joining as medical officers dwarfs the #12,000 incentive payment available to GPs who...

GPs urged to request HDL-cholesterol test to assess CHD risk.
January 13, 2003... Measuring HDL-cholesterol is essential for accurately assessing a patient's coronary heart disease risk, according to a new study showing more than 40 per cent of high-risk patients are missed by only using total cholesterol levels. The...

GPs who sell substandard surgeries set for windfall.
January 13, 2003... GPs who sell substandard surgeries through NHS Lift could receive an unexpected windfall, it has been claimed. The scheme - set up by the Government to improve poor GP premises - was primarily designed to help compensate GPs stuck in...

GP warns of snowboarder's ankle.
January 13, 2003... GP Dr Mike Langran is keen to improve awareness of an ankle fracture common among snowboarders returning from holidays. Dr Langran, a GP in Aviemore, Scotland, and ski patrol doctor for the Cairngorm mountains, said `snowboarder's ankle' -...

PCT ups GP incentives.
January 13, 2003... A PCT has upgraded incentive payments to practices following protests from GPs. Sutton and Merton PCT in Surrey improved its prescribing incentives after GPs said drug budgets were set at levels that failed to reflect the true cost of...

GMC cases quadruple.
January 13, 2003... GPs are making up a smaller proportion of the GMC's caseload compared with hospital doctors and other specialists, new research has found. A Medical Defence Union analysis of GMC cases between 1999 and 2001 that involved its members found...

Insurer fighting fund is closed.
January 13, 2003... The Small Practices Association has closed its campaign fund for GPs fighting for compensation from insurance company St Paul. The campaign was set up in 2001 to help 100 members left without run- off or medical indemnity cover after the...

Over-65s get pneumococcal jab.
January 13, 2003... The Scottish Executive is to introduce pneumococcal vaccination for all the country's over-65s from this year. Unlike the flu jab, pneumococcal vaccine protects patients for 10 years. Copyright: CMP Information Ltd.

Government scheme to cut scripts in older people hailed as success.
January 13, 2003... A pacesetting Government scheme to cut the number of drugs prescribed to the elderly has been hailed a success. A report by the National Prescribing Centre, in charge of developing the medicines management scheme, showed GPs who signed up...

Reducing risk factors could eradicate CHD.
January 13, 2003... A major study has shown that reducing population levels of high total cholesterol, high blood pressure and smoking could effectively `eradicate' coronary heart disease. The results, from the British Regional Heart Study, found more than 75...

`Expand the GP's role in infertility'.
January 13, 2003... The RCGP has called on GPs to get more involved in managing infertility. Dr Lindsay Smith, the college's maternity spokesman, told a Royal College of Obstetricians and Gynaecologists conference last month that primary care should play a...

GPs on poison terror alert.
January 13, 2003... The NHS has been put on alert after police found traces of ricin poison at a London flat last week, raising concerns of a biological terrorist attack. The Department of Health warned GPs to be on the lookout for the early effects of ricin...

EDITORIAL COMMENT: Funding is the key if GPs are to help patients.
January 13, 2003... The Government appears keen to consult groups of selected patients to discover what they want from the NHS. How ironic then that its policies neglect those groups whose need is most pressing - those with chronic diseases. The delay to...

Letter: Easing pressures for cancer referral.(Letter to the Editor)
January 13, 2003... I refer to your report `GPs pressured into making referrals for breast cancer' (News, December 16). There is no evidence two-week referral for breast cancer makes any difference to outcomes. It is merely another arbitrary political target....

Premises and staff.
January 13, 2003... To conclude our series on key areas of the new contract, Dr Melanie Wynne-Jones looks at the proposals on premises and staff The options on your premises The contract promises to encourage the provision of modern primary care premises,...

Being open and honest defused a bad blunder.
January 13, 2003... Dr Andrew Carson examines the aftermath of a vaccine given in error The child health clinic had been much like any other, apart from the fact that the regular nurse was away on an immunisation update course and her place had been taken by...

Will nicotine replacement prevent new infant tragedy?
January 13, 2003... Case history Tina, 19, had a sudden infant death six months ago when her (unplanned) son was eight months old. She and her partner Terry live in a one- bedroom flat with little hope of moving to somewhere bigger. Terry has been off work...

Life as a new principal.
January 13, 2003... Dr Aran Gillespie on a meeting with a customer in the local shop that made him wonder what is going to happen to his job Practice denigrated by bloke in shop Where is the motivation to improve when you are told your best isn't good...

Modern management of Parkinson's disease.
January 13, 2003... Dr Richard Davenport explains recent advances in the management of this neurodegenerative disease Parkinson's disease (PD) is one of the commonest, and certainly most treatable, of all the neurodegenerative disorders. It is eminently...

Asthma treatments.
January 13, 2003... GP Dr Alex Williams asks consultant Dr David Halpin for an update on the mangement of asthma What's in this article * Choosing treatment and when to refer * Significant differences between inhaled steroids * Overcoming problems...

Pregnant patient is positive for hepatitis C.
January 13, 2003... Case history Lisa Taylor is 24, single and in her first pregnancy. She admitted to injecting drugs in the past and after counselling decided to have screening tests. The results show she is HIV and hepatitis B negative but positive for...

ANSWER BACK: What is the evidence for dietary salt effect on BP?
January 13, 2003... Q: What is the evidence that dietary salt reduction has a significant impact on blood pressure? A: There is epidemiological evidence that populations with high sodium intake have higher blood pressures than populations with lower sodium...

ANSWER BACK: Adult attention deficit disorder treatment.
January 13, 2003... Q: I've had a number of American students studying in the UK with a diagnosis of depression (with an `element' of adult attention deficit disorder) asking for bupropion and an amphetamine. These have been started by psychopharmacologists. Is...

Blair stands defiant over 48-hr access.
January 20, 2003... Prime Minister Tony Blair has sent the strongest signal yet that he will not allow 48-hour access to be dropped from the GP contract. Mr Blair found time between top-level meetings on Northern Ireland and terror in the Middle East last week...

I quit to spend more time with patients.
January 20, 2003... Dr Geoffrey Smith is the latest GP to quit his post as principal so he can spend more time with patients. Dr Smith, a GP in Gateshead, Tyne and Wear, a recruitment troublespot, is prepared to take a pay cut - working for an out-of-hours...

GPs face five years of prescribing overspends.
January 20, 2003... GPs face `half a decade' of prescribing overspends despite Government investment, primary care experts have warned. National service frameworks, National Institute for Clinical Excellence guidance and the contract mean prescribing costs...

US-style assistants to combat GP jobs crisis.
January 20, 2003... The Government has given trusts the green light to employ American- style physicians' assistants to ease the GP recruitment crisis. The go-ahead comes after a nurse-led PMS practice in the West Midlands hired a physician's assistant from...

GP clinic dramatically cuts minor surgery wait.
January 20, 2003... Dr Jeremy Tankel is one of three GPs working at a pioneering community- based minor surgery unit, which opened last week. The unit in Salford, Greater Manchester, had slashed the area's waiting list for minor surgery by 76 per cent during a...