Pulse articles from January 2004

Pulse archives from January 2004

MMR pressure builds on GPs.
January 5, 2004... GPs are to come under renewed pressure from primary care trusts to convince parents of the safety of MMR after uptake of the vaccine was made a star ratings indicator. The move came in an overhaul of PCT performance indicators for 2004...

GP founds first new Scottish practice for 10 years.
January 5, 2004... Dr Ed Russell-Smith has started work at the first entirely new GP practice in Scotland for a decade. The singlehanded practice has been set up in Livingston, West Lothian, because of a rapidly expanding population in the town - a hub for...

GPs to get vital GMS pages mid-January.
January 5, 2004... GPs will not be sent full guidance on the new GMS contract until mid- January because the Government missed at least two self-imposed deadlines to release it. The document includes details about MPIG, disease prevalence weighting, opting...

Doubt cast on diagnostic criteria for pelvic inflammatory disease.
January 5, 2004... There is insufficient evidence to support existing diagnostic criteria for pelvic inflammatory disease, concludes a study by the Health Protection Agency. And the authors say future efforts should go into developing a quick and easy...

Urgent new investigation into curbs on antibiotics.
January 5, 2004... An urgent investigation into antibiotic prescribing is under way since Government advisers learnt that patients with lower respiratory tract infections might be dying after failing to receive vital drugs. Experts have been given three...

GPs keep it in the family.
January 5, 2004... Dr Richard and Dr Julia Pickworth watched proudly as their father Kenneth, a retired GP, opened their new premises in Butterknowle, County Durham, last month. Dr Pickworth senior, now 81, practised in nearby Barnard Castle for more than 40...

GPs to hit flu target.
January 5, 2004... GPs look set to meet the Government's 70 per cent uptake target for flu vaccination among over-65s, official figures suggest. But data available to the Health Protection Agency suggesting that few at-risk children have been immunised has...

Experts warn of flu danger to children.
January 5, 2004... Doctors are seriously under-estimating the risk of influenza to children despite the fact they are three times more likely to be infected than adults, according to a new report. Leading influenza experts from across Europe called for...

NICE recommends new bisphosphonates role.
January 5, 2004... The National Institute for Clinical Excellence is set to recommend the use of bisphosphonates to treat a million post-menopausal women with severe osteoporosis. A technology appraisal consultation document released by NICE recommends...

`Don't just treat high BP - treat high risk' GPs urged.
January 5, 2004... GPs should give antihypertensives to patients at high risk of heart attack and stroke, not just those with high blood pressure, says a leading expert. Following the recent debate fuelled by a Government report recommending giving blood...

Special interest GPs `not cost-effective?'.
January 5, 2004... The Government's drive to increase the number of GPs with special interests may not be cost-effective and is not guaranteed to cut waiting hospital waiting lists either, according to experts in primary care. A review on GPwSIs published in...

PCTs `being ordered to create a surplus'.
January 5, 2004... A strategic health authority has put pressure on primary care trusts to create a surplus in case it needs to bail out their struggling neighbours. South West Peninsula SHA wrote to all NHS organisations in Devon and Cornwall warning them...

GPs meeting 48-hour target are criticised for restricting access.
January 5, 2004... GPs meeting the Government's 48-hour access target have been criticised by the Commission for Health Improvement for running appointment systems that restrict patient access. A CHI report into Doncaster East and Doncaster Central PCTs,...

NHS sues for #30m over `price fixing' on generics.
January 5, 2004... The NHS is suing seven drug companies for #30 million, claiming they colluded to fix the price of commonly prescribed generic medicines between 1997 and 1998. The NHS Counter Fraud and Security Management Service has alleged the companies...

Keeping on top of access problems.
January 5, 2004... Dr Shabbir Ahmad's practice has progressively amended its advanced access appointments system in order to solve the problems raised by the Commission for Health Improvement. For a month before it set up the system in July 2002 the practice,...

Up to #100m in Scots NHS fraud.
January 5, 2004... Family health practitioners, including GPs, are responsible for between #40 and #100 million in fraud from the NHS in Scotland, a report has concluded. Audit Scotland estimated between 3 per cent and 8 per cent of claims by GPs, opticians,...

Improve communication or face disputes, Ombudsman warns.
January 5, 2004... Improving communication with patients and other NHS services and noting the details of what has been said will help GPs avoid disputes, according to the Ombudsman. Poor communication and documentation were highlighted by the Ombudsman in a...

Contract and prescribing put pressure on Scottish trusts.
January 5, 2004... Primary care trusts and NHS boards face severe financial pressure as a result of rising prescribing costs and the new GMS contract, according to the Scottish Executive's spending watchdog. Audit Scotland's annual report into NHS expenditure...

20-or-more-a-day women are at greatest risk of colorectal cancer.
January 5, 2004... Women with a long history of smoking are at highest risk of colorectal cancer, according to a US study of 39,299 men and women. Results from an average 26 years of follow-up showed the relative risk for women who smoked 20 or more...

Isolated systolic hypertension treatment cuts cardiovascular risk.
January 5, 2004... Treating isolated systolic hypertension (ISH) in older patients cuts cardiovascular risk - and those without advanced atherosclerosis benefit most, new research shows. US researchers found ISH patients given placebo were twice as likely to...

Thrombophilia and the Pill greatly increase VTE risks for fliers.
January 5, 2004... Fliers with thrombophilia and those taking oral contraceptives are at greatly increased risk of venous thromboembolism, a new study reveals. Italian researchers found air travel in the month before thrombosis doubled the risk of VTE but...

Triple therapy improves glucose metabolism in type 2 diabetics.
January 5, 2004... Triple therapy with insulin aspart (a very short-acting insulin analogue), rosiglitazone and metformin greatly improves glucose metabolism in type 2 diabetic patients without inducing severe hypoglycaemic events, a study suggests. Danish...

Why there is a north-south divide over heart disease and stroke.
January 5, 2004... Established clinical risk factors for heart disease and stroke, including blood pressure, smoking and social class, largely explain the `north-south' divide in the disease, with highest incidence in Scotland and lowest in southern England. ...

Lack of confidentiality wouldn't deter patients from giving information.
January 5, 2004... GPs' patients say lack of confidentiality would not deter them from giving information to their doctors - but they feel it might deter others from seeking treatment. A UK questionnaire tested on 30 consecutive patients attending a GP...

Doubt over aspirin use for heart disease in diabetics.
January 5, 2004... New research has cast doubt on the use of aspirin for the primary prevention of cardiovascular disease in patients with diabetes. The researchers claim the risks associated with aspirin use may outweigh any benefits in diabetics. There was...

Cost rules out major hep B immunisation.
January 5, 2004... The Government is set to reject growing pressure to add hepatitis B vaccine to the childhood schedule and opt instead for the cheaper strategy of targeted immunisation in high-risk groups. The cost-based decision, signalled by the deputy...

Haslam attacks `irresponsible' MMR drama.
January 5, 2004... A Channel 5 docudrama about MMR and autism was `extremely irresponsible' and will reinforce the worries some parents have about the vaccine, warns Professor David Haslam, chair of the RCGP. A statement from the RCGP, signed by Professor...

Patients get twice as long to complain about their GP.
January 5, 2004... Government plans to reform the NHS complaints procedure will double the length of time open to patients to complain about their GP. Patients will also be able to take a grievance directly to their primary care trust under the Department of...

Now wash your hands - as often as your nurse.
January 5, 2004... Nurses are far more likely to wash their hands than GPs after seeing patients, research by Dr Alan Stone's Cardiff practice finds. An audit of soap use at the practice revealed its two nurses used more than twice as much soap in a year than...

Suicide rate falling.
January 5, 2004... Suicide rates are continuing to fall, new figures show. The first annual report of the National Suicide Prevention Strategy showed suicides fell by 3.2 per cent to 8.9 deaths per 100,000 of the population in 2000/3, down from 9.2 per 100,000 in...

Shipman: GMC would reject fishing expeditions.
January 5, 2004... It would be unfair for the GMC to carry out `fishing' expeditions to find further evidence against GPs after a single complaint against them, the Shipman Inquiry has been told. GMC member Dr Krishna Korlipara, a GP in Bolton, rejected...

NICE issues new draft guidance on epilepsy.
January 5, 2004... GPs should never initiate anti-epilepsy drug treatment without the recommendation of a specialist, according to new draft guidance from the National Institute for Clinical Excellence. The draft guidance - which follows a damning national...

Patients accept closure of Saturday surgeries.
January 5, 2004... Replacing Saturday surgeries with out-of-hours cover is acceptable to most patients, a study suggests. GPs at an eight-partner PMS practice in East Mosely, Surrey, surveyed 75 patients attending Saturday surgeries over a six-week period....

GPs are to get training in conflict resolution.
January 5, 2004... Every GP in England is to be given a one-day training course in conflict resolution as part of a Government plan to reduce the chances of violent incidents. A total of 730,000 frontline NHS staff will take the course, which shows how to...

TALKING POINTS.
January 5, 2004... Dr Richard Vautrey practises in Leeds - he has been a GP for nine years. Jo Carlowe spoke to him about the hot topics in his practice. Quality pay Patient experience accounts for #7,500 under the quality framework. Is this the right...

Patients writing in records `a silly idea'.
January 5, 2004... The GPC has slammed Government plans to allow patients to write comments in their medical records as `an extremely silly idea'. Under the proposals in a white paper on increasing patient choice, patients would be able to advise on the type...

Act prompts GP concerns over confidentiality.
January 5, 2004... Government plans to make it easier for organisations to access patient records without gaining consent raise `real concerns' over confidentiality, GPs are warning. The Department of Health has launched a consultation over extending section...

EDITORIAL COMMENT: Happy new year - expect 2005 to be even better.
January 5, 2004... We wish all our readers a happy and prosperous 2004, but to be honest 2005/6 is likely to be more prosperous. The average GP is likely to earn about #14,000 from quality points in 2004. However, with all the extra work involved - 10-minute...

NHS Direct Wales `missing key targets'.
January 5, 2004... NHS Direct Wales is missing key Government targets for out-of-hours calls but 99 per cent of patients are satisfied with its service, a Commission for Health Improvement report finds. Between November 2002 and May 2003 NHS Direct Wales...

`Cross-border care will cost us millions'.
January 5, 2004... Three primary care trusts are complaining planned changes to NHS funding will mean they have to find millions of pounds to care for Welsh patients registered with GPs in England. Shropshire, Herefordshire and South Cheshire PCTs have said...

GP links to care home patients' vital signs.
January 5, 2004... Dr Russell Jones has linked his surgery to two local care homes via a wireless broadband IT system which transmits patients' vital signs to his PC. The e-Vital mobile monitor transmits patients' heart rate, temperature and pulse to a...

Health spending tops #67bn.
January 5, 2004... Government spending on health care rose 8 per cent in 2002 to more than #67 billion. But the #5.1 billion rise was slightly down on the 10.9 per cent, #6.1 billion increase in health spending in 2001, according to figures from the Office...

Letters: Poor prescribing may be a problem but GPs are not the culprits.
January 5, 2004... I fully agree with Professor Sir Michael Rawlins that doctors' prescribing is a major problem and that people should be worried, but I completely disagree with his premise that GPs are the culprits (News, December 8). The vast majority of...

Letter: Contract pension problems ahead.(Letter to the Editor)
January 5, 2004... I have been in contact with my PCT and LMC regarding pension arrangements and problems I foresee under the new contract. Two months on I have received no satisfactory answers. I feel the questions that have been raised about cost of accountants...

Letter: GPs need software tools designed to help safeguard prescribing.(Letter to the Editor)
January 5, 2004... When I went to medical school it was considered bad practice to prescribe more then three long-term medications to the average patient (say 50-plus). Nowadays it is the other way round. But with every additional drug we prescribe the chance of...

Letter: My guidelines for treating children's asthma.(Letter to the Editor)
January 5, 2004... The BTS guideline out this year recommends Beta2 agonist as step one and the addition of a steroid inhaler as step 2. If after four weeks adequate response is obtained, then maintain children on that steroid dose for six months and then maybe...

Letter: Why is our time zero-rated?(Letter to the Editor)
January 5, 2004... I recently received a request from the Industrial Injuries Agency for a medical report on a patient, wanting to know about previous significant medical history, the nature of the injury, effect on capacity to work, what treatment so far...

Letter: Continuity of care much appreciated.(Letter to the Editor)
January 5, 2004... I believe continuity of care is paramount to providing quality care to our patients. Once we stop providing this, patients will lose their `advocate' as they see different doctors and nurses who will often give varying interpretations of...

JANUARY CONTRACT CALENDAR.
January 5, 2004... In the first of a new series of monthly planners, Dr Bob Button looks at the key new contract dates in January for GPs and their practice managers JANUARY 7 Return your capitation figures, carefully checked, to the PCT so your...

Letter: I surprised myself with Atkins.(Letter to the Editor)
January 5, 2004... Dr Gill Jenkins may have been misled as to the nature of the Atkins diet (News, December 8). It is purely carbohydrate restrictive.There is no limitation on green vegetables, on root vegetables apart from potatoes or on fruit apart from...

Letter: Standardised letters make our life easier.(Letter to the Editor)
January 5, 2004... We would like to make a plea for standardised clinic letters from our hospital colleagues. Here in Nottingham we are increasingly using standardised (often online) referral letters - the decision to change procedures seemingly made unilaterally...

Cash-flow and the contract: it pays to be on your guard.
January 5, 2004... Many GPs are concerned that, far from getting a substantial pay rise this year, money will be slow coming in, practice costs will rocket, and a real cash-flow problem threatens - accountant Richard Vickery offers his advice GPs are...

Current thinking on management of infertility.
January 5, 2004... With media interest bringing more infertility problems to GPs and NICE guidance due imminently, Mr Julian Jenkins and Ms Liz Corrigan begin our series to help guide you through the maze of problems and investigations The National Institute...

Basic digital photography in the surgery.
January 5, 2004... Many GPs will already have dabbled in the wonderful new world of digital photography, if only for family snaps. This article is aimed at enthusing those who thought it was perhaps too complicated or expensive or indeed of too poor quality...

ANSWER BACK: Is it safe to swim with grommets?
January 5, 2004... Q: How safe is post-operative swimming with grommets inserted? A: This question can provoke conflicting responses. In a survey of British otolaryngologists, 14 per cent of the 301 respondents advised their patients not to swim and 66 per...

ANSWER BACK: Testosterone patch for female low libido.
January 5, 2004... Q: Are testosterone patches for women with low libido better than oral treatment? Can they be given with HRT? A: In the past three years good randomised controlled trials have clearly demonstrated a benefit in well-being and libido in women...

PCOs to miss key deadlines for contract.
January 12, 2004... Key GMS contract deadlines will be missed by many primary care organisations because the Government has bounced them into an impossible timetable, GPs warn. LMCs said a strict 11-week series of deadlines set in comprehensive Department of...

GP says `sorry' for being partner short.
January 12, 2004... Dr Keith Tattum has written to the 4,300 patients on his list asking for their `understanding and support' while he struggles to find a new partner. `I have a nurse practitioner and locum cover, but since October I've been doing the lion's...

GPs `bribed' to shop NHS tourists.
January 12, 2004... GPs will get to keep the money they save the health service if they blow the whistle on suspected `NHS tourists', under new Government plans. A Department of Health official told Pulse the Government intended the move `to be another income...

Rush to PMS slows as GPs predict an end to the pay gap.
January 12, 2004... More than two in five GPs are now in PMS practices, new Government figures show. But the attraction of switching to the local GP contract is fading with far fewer practices making the move in the latest 5b wave. GPs predicted PMS...

Row over quality pay in Scotland and Wales.
January 12, 2004... GP negotiators have sparked a row after claiming that Scottish GPs will be overpaid for quality work under the new contract - and those in Wales and Northern Ireland underpaid. The GPC negotiating team made the claim after the Government...

Vacancy rule risk to staff.
January 12, 2004... GP negotiators have admitted some practices may have to cut staff because primary care organisations could refuse to cover the cost of vacancies in their global sum. Practices that had a vacancy in the baseline year used to calculate their...

GP calls for slimming clubs on prescription.
January 12, 2004... Dr Julie Parsons has called for the NHS to subsidise GP referrals to commercial slimming schemes after her practice was involved in a successful pilot. Two practices in Greater Derby PCT referred more than 100 patients with a body mass...

Soaring autism rate caused by shift in diagnostic habits.
January 12, 2004... The massive rise in autism cases over the past decade has been caused by a shift in diagnostic habits - and not by MMR vaccine, according to a new study of records from 250 GP practices across the UK. The analysis of data on boys aged two...

Aspiration pay change to benefit most GPs.
January 12, 2004... Quality aspiration payments for the second year of the contract will be 60 per cent of the practice's achievement in 2004/5 in a change expected to benefit most GPs. The change contrasts with the first-year system in which practices get...

500 walk-in centres.
January 12, 2004... The Government plans to open 500 walk-in centres and minor injury units as part of its drive to increase patient choice. Emergency care tsar George Alberti said he wanted to see one centre per 100,000 population. His comments came...

GPs aim high on quality framework.
January 12, 2004... Practices are submitting bold predictions for their achievement against the quality and outcomes framework, with many aspiring close to the maximum 1,050 points. GPs have to submit their aspiration level for 2004/5 to their primary care...

How we'll get 1,050 points.
January 12, 2004... Dr Stephen Fox plans to aspire to maximum points after setting up an annual recall system for all patients on disease registers covered by the framework. Dr Fox, a singlehander in Leigh, Lancashire, said: `If you get them all done in their...

`No antibiotic for cough without fever'.
January 12, 2004... Children with a cough but no fever or chest signs are unlikely to develop complications and are less likely to need antibiotics, a study shows. The researchers, from the University of Bristol, said they hoped the finding would help GPs cut...

Urinary albumin link to heart risk.
January 12, 2004... Patients with diabetes are up to eight times more likely to suffer from cardiovascular events if they have microalbuminuria, a meta-analysis has shown. The researchers said they intended to conduct further research to clarify the potential...

GPs urged to step up testicular referrals.
January 12, 2004... Many deaths from testicular cancer could be prevented by earlier ultrasound referral by GPs, a new study claims. It found testicular cancer can be extremely difficult to diagnose with GPs confusing cancerous lumps with cysts and failing to...

GPs urged to use statins in every patient with diabetes.
January 12, 2004... Every diabetic patient - including those with normal cholesterol levels - should be treated with a statin, according to a key Government adviser. The call came from GP academic Professor Mike Pringle, who has been handed the task by...

Breast Ca risk in smokers.
January 12, 2004... Smoking increases the risk of breast cancer, according to hard evidence from a major Californian study of 116,000 women over four years. The study, published in January's Journal of the National Cancer Institute, showed that the rate of...

Family history is key to one in 10 consultations.
January 12, 2004... Family history is `highly relevant' in one in 10 GP consultations, suggests research by Dr Ian Hopkinson. Half of such cases relate to coronary heart disease risk, warns Dr Hopkinson, a GP in north London who works for the London IDEAS...

NICE's `hard to follow' depression guidance.
January 12, 2004... Mental health experts have welcomed new national guidelines on treatment of depression but warn they will be hard for GPs to follow without more education, training and greater support from specialist services. A key requirement of the...

Check suicide risks with SSRIs, GPs told.
January 12, 2004... GPs must be vigilant in monitoring patients taking SSRIs and tricyclic antidepressants concurrently, researchers warn after finding the vast majority of deaths from SSRIs occurred when patients were taking other drugs as well. The study,...

GPs to face surprise visits from NHS fraud busters.
January 12, 2004... Practices whose achievement on the quality and outcomes framework is thought to be suspicious could receive an unannounced visit from NHS fraud busters. One in 20 practices chosen at random each year will also face a thorough audit of...

GP routine checks cut.
January 12, 2004... GPs must still provide over-75 and new patient checks, but no longer have to write to patients to offer them. Checks for patients who have not attended for three years also must be provided but do not have to be offered. The change...

New guidance on GP practice boundaries.
January 12, 2004... Practices with open lists will be required to write to patients if they refuse to take them on, giving reasons for their decision. The new requirement came in guidance stating practices have until the end of February to agree with their PCO...

Most PMS practices to use GMS quality framework for now.
January 12, 2004... Most PMS practices are planning to ignore the opportunity to develop their own quality and outcomes framework this year and plump for the GMS version. But PMS GPs say they will make changes in future years when they have collected evidence...

Specialist options revealed.
January 12, 2004... Specialist PMS practices will focus on providing care for older people living in care homes, people with learning disabilities, the homeless and children in care. The Department of Health said its vision for the scheme, unveiled last year,...

196 quality points to be docked.
January 12, 2004... PMS practices that follow the GMS quality and outcomes framework will have 196 points deducted from their achievement. The figure has been calculated as the amount that PMS GPs already get in the baseline budget. The deduction equates...

Locum cover payments will rise 6.5 per cent to maximum #948.
January 12, 2004... GPs will get a maximum of #948 per week to cover locum costs for partners on maternity, paternity and adoptive leave or long-term sickness absence - a 6.5 per cent rise on Red Book payments. But primary care organisations will retain the...

Your missing partner loses you #19,931.
January 12, 2004... A missing partner is worth #19,931 a year to a practice in lost fees and allowances. The sum will be added to the global sum equivalent of practices that were a GP short during the one-year period in which their minimum practice income...