Pulse articles from January 2006

Pulse archives from January 2006

More work, same pay.
January 5, 2006... * Global sums and quality pay frozen * 138 points of indicators added to QOF * `Unaffordable' pensions under threat * NHS Employers hail 6-8% saving * Four new enhanced services * Victory in vaccine pay campaign By Pulse reporters...

Contract review could been much worse.(Brief Article)
January 5, 2006... The results of the contract review are `far from ideal' but could have been much worse, Dr Hamish Meldrum has told GPs. Dr Meldrum, GPC chair, said negotiations with NHS Employers were dominated by the Government's belief that GPs' pay had...

GPC agrees to the goalposts being moved.
January 5, 2006... New QOF targets `sensible' but break contract pledge By Daniel Cressey The GPC has been forced to agree to a swathe of new clinical indicators in the revised quality framework. The new QOF will include seven extra clinical areas...

QOF depression drive.(quality and outcomes framework )(Brief Article)
January 5, 2006... GPs will have to screen all patients with diabetes and CHD for depression under the new QOF. The revised framework also provides points for assessing the severity of illness in all depressed patients - among a total of 33 for the new...

30 points for atrial fibrillation.(Brief Article)
January 5, 2006... GPs will get 30 points for diagnosis and treatment of patients with atrial fibrillation under the new QOF. Pulse understands the points will be divided between setting up a register, ensuring accurate diagnosis by ECG or specialist and...

Experts welcome renal move.(Brief Article)
January 5, 2006... GPs will have to screen all their hypertension patients for chronic kidney disease to score points in the new framework. Pulse understands that the proportion of hypertensive patients tested for serum creatinine will be a key indicator in...

Government bid to rein in `double-benefit' pensions.
January 5, 2006... The Government has launched a desperate bid to claw back money from GPs' pensions. Ministers claim rises brought about by the new contract are `unaffordable' and `unfair' and have demanded urgent talks with the GPC. Under pressure...

I would quit over unfair pension deal.(Brief Article)
January 5, 2006... Dr Martyn Walling says he will retire as soon as possible if the Government is successful in its bid to downgrade GPs' pensions. Dr Walling, who deferred retiring from last April because of the benefits of the new contract said: `The...

Campaign victory on GP vaccine pay.(Brief Article)
January 5, 2006... PULSE VACCINE PAY campaign GPs have scored a sensational victory in the campaign to reverse changes to the pay rules for childhood vaccination. The Government has caved in to Pulse's demands to restore the weighting of MMR as...

GPs revolt over choice.(hospital choice)
January 5, 2006... GPs to boycott plan for choice of four hospitals - Ian Cameron reports Thousands of GPs plan to snub the Government's demand that they offer patients needing a referral a choice of at least four hospitals. A Pulse snapshot survey...

Booklets short on key data.
January 5, 2006... Booklets sent to every practice to enable GPs and staff to help patients choose a hospital do not contain enough information, GPs believe. GPs said the booklets needed to give details of individual consultants to enable patients to make a...

We will wait to see GP, say patients.(Brief Article)
January 5, 2006... Patients are prepared to wait up to eight days on average to see their GP about minor ailments such as back pain, a survey reveals. The British Attitude survey also shows almost two-thirds were prepared to wait longer than the current...

GP rides off to beat stress.(Brief Article)
January 5, 2006... Dr Sheila Montgomery is riding away from the stresses of being a full-time principal into a new life running cycle tours. Dr Montgomery, a GP in Bristol, plans to lead tours in her native South-West, as well as in Italy and the Pyrennees,...

MediaWatch: `Sweetener link to cancer'.
January 5, 2006... The story There are demands to ban more than 6,000 food and drink products because they contain a sweetener linked to cancer, the Daily Express and Guardian report. The source A special debate took place in the House of Commons on...

MediaWatch: `Car travel risks deadly clots'.(Brief Article)
January 5, 2006... The story Long car journeys can give people lethal blood clots, warn the Daily Express and Times. The source A joint Government-EC report concluded journeys lasting longer than four hours on all forms of transport tripled risk of...

MediaWatch: `Mind can blot out pain'.(Brief Article)
January 5, 2006... The story Pain sufferers can train themselves not to feel it by watching images of their brain activity, report the Daily Mail and Guardian. The source In a US study published in the Proceedings of the National Academy of...

MediaWatch: `Food additives harm young'.(Brief Article)
January 5, 2006... The story Food additives in processed foods combine to create a `chemical cocktail' which can harm development in young children, the Daily Mail and Guardian report. The source A study published in Toxicological Sciences found...

Government to bring in aneurysm screening.
January 5, 2006... GPs welcome routine screening but question the omission of women Exclusive By Emma Wilkinson The Government plans to introduce a national screening programme for abdominal aortic aneurysm, Pulse has learned. The National Screening...

But diabetes screening is ruled out.(Brief Article)
January 5, 2006... The National Screening Committee has decided against recommending a national screening programme for diabetes after discussing results from nine pilots around the UK. Instead the committee wants to include identification of people at risk...

Black cloud over GP palliative care.
January 5, 2006... Is practice being affected as GPs worry that police and patients are looking to find fault - and the next Shipman? By Rob Finch Harold Shipman's murders ensured GPs' palliative care practice would forever remain under a spotlight. ...

JournalWatch: Antipsychotics a VTE risk.(venous thromboembolism)(Brief Article)
January 5, 2006... Atypical antipsychotics seem to increase the risk of venous thromboembolism, Italian researchers report. They retrospectively analysed data from 19,940 new users of antipsychotic drugs and 112,078 non-users, assessing hospitalisations with...

JournalWatch: Vit C can curb steroid use.(vitamin C)(Brief Article)
January 5, 2006... Vitamin C supplements appear to have a modest effect at reducing the requirement for steroid treatment for asthma. UK researchers analysed the success of a steroid-reduction protocol in 92 patients with asthma who had taken part in a...

JournalWatch: Raising risk of C. difficile.(clostridium difficile infection)(Brief Article)
January 5, 2006... Gastric acid suppressants significantly increase the risk of Clostridium difficile infection, a US study suggests. Researchers analysed 1,672 cases of C. difficile infection recorded on the UK general practice research database, finding the...

JournalWatch: Pill is safe in SLE women.(systemic lupus erythematosus)(Brief Article)
January 5, 2006... Oral contraceptives are safe in women with systemic lupus erythematosus, a Mexican study reveals. Researchers conducted a single-blind clinical trial of 162 women with systemic lupus erythematosus, assigning patients to combined oral...

JournalWatch: Pancreatic Ca insulin link.
January 5, 2006... High insulin concentrations and insulin resistance increase the risk of pancreatic cancer in male smokers, US and Finnish researchers conclude. The prospective study followed up 29,133 male Finnish smokers participating in the...

Letter of the week: Really useful - so NHS stopped it!
January 5, 2006... From Dr Patrick Craig-McFeely Salisbury, Wiltshire Just occasionally there is an NHS innovation that is useful without requiring huge effort for anticipated future gain. One rare example is the patient appointment card supplied free on...

LETTER: GPSIs dearer than the hospitals? No way!(Letter to the Editor)
January 5, 2006... From Dr Scott Davison Sheffield Would you not agree it is rather misleading to say `GPSIs are dearer than outpatient services' based, as far as I can tell from your article, on a study that looked at one clinic in Bristol (News, 17...

LETTER: Taking overview of GPSI cost.(Letter to the Editor)
January 5, 2006... From Professor Chris Salisbury Professor of primary health care University of Bristol Dr Davison is correct that our results are based on one study of one GPSI service in one specialty, so cannot necessarily be generalised to all other...

LETTER: We mustn't lose out over VAT change.(Letter to the Editor)
January 5, 2006... From Dr Charles McEvoy Ripon I read with alarm your article discussing the forthcoming change in VAT regulations (Financial Pulse, 17 December). Our practice has only recently VAT de-registered following the Beynon ruling, which means that...

LETTER: Don't deride colleagues.(Letter to the Editor)
January 5, 2006... From Lindy Turnbull Nurse prescriber and lecturer Ripon, North Yorkshire While reading Dr Phil Peverley's article (Columnists, 26 November) I was reminded of a word I came across recently: `testiculating'. It means, apparently, to wave...

LETTER: PTEMB testing my patience.(Letter to the Editor)
January 5, 2006... From Dr Anna Benson Via e-mail I am dissatisfied over becoming certified as a qualified GP by the PTEMB. I am a GP registrar due to qualify in February. I have worked hard, and been consistently enthusiastic about my career choice;...

LETTER: My clinics saved PCTs thousands.(Letter to the Editor)
January 5, 2006... From Dr Robert Koefman Binfield, Berkshire I am astounded by the report (News, 17 December) that we are up to 75 per cent more expensive than hospitals. I have now seen more than 8,000 patients in my ENT clinics which have been running...

SecondOpinion: Sort this mess out, Patricia.(Column)
January 5, 2006... The new year is a time for resolutions, and I have some for Patricia Hewitt who has now been in post for six months. First, sort out the NHS's financial chaos. Despite spending being boosted in the past year by #7 billion to #76 billion,...

PULSE CLINICAL: Need to know smoking cessation.(Column)
January 5, 2006... A GP's burning questions for an expert - this week Dr Melanie Wynne- Jones quizzes Dr Tim Coleman 1. GPs have little spare time in the consultation and often have to limit advice to the obvious `don't smoke'. What scenarios or cues...

COMPETING INTERESTS - A TRANSPARENT APPROACH.
January 5, 2006... The clinical features published in Pulse are written by expert authors. Authors might be GPs or specialists, but all of them are selected and commissioned to write because of their expertise in a particular clinical area Until now authors...

PULSE CLINICAL: Initiating insulin.
January 5, 2006... Dr Azhar Farooqi passes on his top tips gained from working as a GP with an interest in diabetes 1 Mention the possibility of insulin therapy early Where appropriate patients should have the target HbA1c explained to them and advised...

PASS notes: The video exam.
January 5, 2006... Putting together a video for summative assessment is a significant hurdle of your registrar year. Dr Mei Ling Denney explains how it will be marked and what the examiners are looking for The video component of summative assessment is often...

Clinical casebook: Newly diagnosed angina.
January 5, 2006... An HGV driver's `chest pains' may be angina - Dr Melanie Wynne-Jones discusses Case History Mr Jones is 54, overweight and an HGV driver. He says he has started getting central chest tightness, particularly when loading his lorry. He...

Pulse Comment: Negotiators' score draw.(Brief Article)
January 5, 2006... Global sums frozen. No increase in pounds per quality point. Easy quality indicators scrapped and replaced with new markers. Pensions under threat. When the bald facts of the contract review are stated, it's clear the deal can never be...

BMA fights to delay VAT registration nightmare for GPs.
January 12, 2006... April 2006 start date would cause 'severe difficulties' for practices, Government is warned By Ian Cameron The BMA is making a desperate attempt to delay new tax rules which will force three-quarters of GPs to register for VAT. ...

We're scared of VAT man.(value added tax)(Brief Article)
January 12, 2006... Registering for VAT in time for April would be a 'major headache', says Dr Eugene Hughes. Dr Hughes said his seven-partner practice in Ryde, Isle of Wight, would be well above the #60,000 VAT threshold. He said: 'As we've had no...

Brown scuppers dual registration.(Brief Article)
January 12, 2006... Dual registration has been ditched from the forthcoming Community Health White Paper because of vehement opposition from Gordon Brown, Pulse has learned. The chancellor is understood to have vetoed the policy because he believed it would...

In Brief: Fewer flu patients.(Brief Article)
January 12, 2006... The annual influx of flu patients to GP surgeries has failed to materialise this year, RCGP figures show. In the week ending 1 January 2006, fewer than 10 people per 100,000 visited a GP in England complaining of flu or flu-like illness,...

In Brief: Major drive on rhinitis.(Brief Article)
January 12, 2006... International respiratory experts have released new guidelines designed to force a major new focus on allergic rhinitis. The guidance, produced by the International Primary Care Respiratory Group, includes questionnaires for diagnosing and...

In Brief: Stress advice scheme.(Brief Article)
January 12, 2006... A scheme in Scotland which places Citizens Advice Bureau advisers in GPs' surgeries and allows GPs to refer patients for advice on issues which may be the cause of stress and depression, has been given a #185,000 grant to expand. A new...

In Brief: APMS contract signed.(alternative providers of medical services)(Brief Article)
January 12, 2006... A former nurse-led practice in Derby has been taken over by United Health Europe, the firm behind the Evercare scheme, on an APMS contract. There are 7,500 patients at the Cresswell Primary Care Centre. NE Derbyshire PCT cancelled the...

In Brief: Cameron's test promise.(Brief Article)
January 12, 2006... Every practice will offer genetic testing under a Conservative government, the party's leader David Cameron has promised. He also said the Tories wanted GPs to have more power within the NHS. Copyright: CMP Information Ltd.

In Brief: Mental health plea.(Brief Article)
January 12, 2006... The Sainsbury Centre for Mental Health and the NHS Confederation have called for more investment in talking therapies and employment support for patients with mental health problems. Copyright: CMP Information Ltd.

In Brief: Angina care lapses.(Brief Article)
January 12, 2006... Angina patients appear to be missing out on optimal treatment, a BMJ study shows. It found patients with angina were less likely than those who had had a myocardial infarction to receive antiplatelet medication and treatment for high...

In Brief: NHS loyalty cards fury.(Brief Article)
January 12, 2006... The Department of Health has written to a Southampton-based company warning it not to use the NHS logo on supermarket-style `loyalty cards'. The cards allow the public to donate a proportion of their shopping bills to the NHS. The...

Warning over PSA test.
January 12, 2006... GPs advised not to run PSA test on healthy men, Emma Wilkinson reports A Government adviser has warned GPs not to use PSA testing in healthy men, after new research showed the test was `fraught with problems'. The NHS study, published...

SSRIs not linked to suicide.
January 12, 2006... SSRIs do not appear to increase the risk of suicidal behaviour in adults or children, a major new epidemiological analysis concludes. The researchers warned patients could be missing out on the benefits of drugs because of unfounded fears...

GPs' visions of practice life in 2015.(Brief Article)
January 12, 2006... Larger practices, fewer independent contractors and a mainly female workforce battling to maintain pay rates will characterise general practice in 2015, Dr Hamish Meldrum predicts. But on the positive side, GPs will have fought off the...

Relaxing patients is an art.(Brief Article)
January 12, 2006... Dr Gillian Rice's practice has commissioned #38,000-worth of art for its new premises to help reduce patients' anxiety levels. Works include a 10-foot-long fish tank into which patients' poetry is projected; a mural that depicts their old...

GI protection advised in all NSAID patients.(gastro-intestinal)
January 12, 2006... Health Technology Assessment recommends H2 receptor antagonists By Daniel Cressey All patients requiring NSAIDs should be prescribed gastroprotectants to safeguard them from adverse events, an NHS-funded study concludes. The...

HPV `cost-effective' for borderline smears.(human papillomavirus )(Brief Article)
January 12, 2006... Triaging women with borderline cervical smear results using human papillomavirus testing would be feasible and cost-effective, researchers conclude. The NHS research, published online by the BMJ as two separate studies, is likely to...

Health plans for Scotland.(Brief Article)
January 12, 2006... Longer opening hours, dual registration and commuter walk-in centres could be coming to Scotland. The Labour Party said all were under consideration for its manifesto for the 2007 Scottish parliamentary elections. The controversial...

`Cut pensions and we'll quit'.(Brief Article)
January 12, 2006... As negotiators begin talks with the department, GPs dig their heels in over NHS pensions By Emily Twinch Government plans to cut GPs' pensions will trigger a wave of retirements which will decimate primary care services, warn GPs. LMCs...

GP software glitch scrambles patients' records.(Brief Article)
January 12, 2006... A glitch in the clinical software used by GPs in Scotland has resulted in parts of patient notes being deleted or attached to other patients' records. Free text longer than 255 characters entered into medical records held on the GPASS system...

GP confidentiality fear at child record checks.(Brief Article)
January 12, 2006... Inspectors spark concern on confidentiality and doctor-patient relationship By Emily Twinch A national scheme to improve child protection services is putting patient confidentiality and the doctor-patient relationship at risk, GPs are...

Suspend PLAB tests' plea.(professional and linguistic assessment board)(Brief Article)
January 12, 2006... Dr Prasad Rao, chair of the British International Doctors Association, is calling on the GMC to suspend its professional and linguistic assessment board (PLAB) tests. Dr Rao, a GP in Stoke-on-Trent, said the move was needed to curb the...

GPs' morale dips with age.(Brief Article)
January 12, 2006... Older GPs are suffering a dip in morale while younger doctors and part- timers are feeling better about their work, a survey of 80 GPs in Kent has revealed Bromley LMC, which conducted the survey, said there was particular concern among...

Pulse News: What will 2006 bring for GPs?
January 12, 2006... 2006 is set to be a landmark year for general practice. It begins with the primary care White Paper and final proposals for revalidation. Then there's practice-based commissioning, PCT restructuring, the new QOF and Choose and Book. We asked a...

Letter: Failed by catastrophic management at PCT.(Letter to the Editor)
January 12, 2006... From Dr John Cormack South Woodham, Essex With reference to your piece on clamping down on GPs and the GMC in the wake of the Shipman affair (News, 17 December), it's worth pointing out that NHS managers can do a great deal of harm - it's...

Letter: Don't blame GPs for referral delays.(Letter to the Editor)
January 12, 2006... From Dr David Church Machynlleth Regarding your article on referrals that the hospital failed to check up on (News, 3 December), I disagree strongly with the MDU that the GP could be held responsible. Once I have referred a patient to...

FOR THE RECORD: VAT regulations.
January 12, 2006... Further to Dr Charles McEvoy's letter (5 January), alterations in the VAT regulations have allowed for direct reimbursement of practices for the VAT incurred on personally administered items, while also stopping reimbursement of VAT by the PPA...

Letter: Safety differences in arthritis options.(Letter to the Editor)
January 12, 2006... From Chris Walker Senior scientific adviser cox-2s Pfizer, Walton Oaks Further to your report (News, 10 December) of the Hippisley-Cox paper published in the BMJ (3 December), I wish to express my concern that the conclusions of the paper...

Letter: Timely warning for dictators.(Letter to the Editor)
January 12, 2006... From Dr PA Coleman Ventnor, Isle of Wright I was amused to read these annotations at the bottom of a recent discharge summary: Date dictated 24/08/05. Date typed 05/12/05. There followed the note: `Dictated, not read or signed...

Pulse Clinical: Diabetes.
January 12, 2006... Dr Roger Gadsby looks at recent papers on diabetes that have caught his eye recent papers on Diabetes that could change The way you practise 5 questions answered 1 Can people with type 2 diabetes starting on insulin therapy titrate...

Give finance plans a new year overhaul.(personal finance for physicians)
January 12, 2006... It's time for new year resolutions, so give your finances an MOT, says Pulse Independent's Stuart Smith For many, the start of a new year represents the chance to turn over a new leaf, and to undertake boring tasks that we know we should be...

Pulse Comment: PSA choice a folly too far.(Brief Article)
January 12, 2006... There are some areas of health care where an ideological commitment to patient choice appears to have won out against good clinical sense. Allowing healthy men to decide whether they should have a PSA test is one. Most cancers detected...

Pulse Comment: No compromise.(Brief Article)
January 12, 2006... Fresh from their relative success in the contract review negotiations, GPC negotiators are facing an even bigger challenge. They must fight off Government efforts to devalue GPs' pensions. Negotiators have said they will listen to the...

GPs told: `You have no choice over IT system'.
January 19, 2006... PCTs ignore Government promise to give practices clinical software options By Ian Cameron A Government promise 10 months ago to give GPs a genuine choice of IT system is being openly flouted by PCTs. Trusts across the country are...

I will keep what I've got.(Brief Article)
January 19, 2006... Dr Andy Lee is adamant he will not succumb to pressure to ditch his EMIS system - despite being told by Accenture that it was only a `theoretical option' and he would have to switch to its SystmOne offering. He said: `They were saying that...

GPs warned over pre-term risks in use of antibiotics.
January 19, 2006... Researchers advise against treating vaginosis in pregnant women By Emma Wilkinson GPs should not prescribe antibiotics to pregnant women for bacterial vaginosis because of the risk of pre-term birth, UK researchers warn. Their...

NICE: screen for AF.(atrial fibrillation)(Brief Article)
January 19, 2006... GPs should opportunistically screen their patients for atrial fibrillation, new NICE guidance recommends. The draft guidance, which also advises on areas covered by the new QOF including use of ECGs and anticoagulation treatment, was...

GP's manslaughter arrest.(Brief Article)
January 19, 2006... A GP has been arrested on suspicion of manslaughter after allegedly failing to give cardiopulmonary resuscitation to an elderly patient. Dr Shanta Dhar, 70, of the Willow House surgery in Enfield, north London, had reportedly visited the...

GP `proves' homoeopathy does work.
January 19, 2006... Dr Tim Robinson, a GP in Beaminster, Dorset, claims to have proved homoeopathy is of real benefits to patients. He found it was effective in general practice for a wide range of conditions, with three-quarters of patients reporting a...

Negotiators quash GP fears on correction factor demise.
January 19, 2006... The GPC and NHS Employers have furiously denied that they have agreed to phase out the correction factor that protects GPs' basic income from next year, write Rob Finch and Ian Cameron. Negotiators moved to quash worries among GPs after...

Simple tool forecasts on angina risks.(Brief Article)
January 19, 2006... GPs have gained a new aid in the treatment of angina with the development of a simple tool to predict the risk of death or myocardial infarction. The tool, which is based on six key clinical indicators, predicts risk over the course of the...

Anger at pressure for tiny pay rise.(Brief Article)
January 19, 2006... The BMA has lambasted the Government for heaping pressure on the pay Review Body to recommend miniscule pay rises for doctors this year. Health Secretary Patricia Hewitt wrote to the chair of the Review Body in late December demanding it...

In Brief: GMS/PMS costs rocket.(Brief Article)
January 19, 2006... Total Government spending on GMS and PMS rose by 13.9 per cent in 2003/4, latest Government figures reveal. The rise is compared with 9.3 per cent in 2002/3 and only 2.5 per cent in 2001/2. GP pay accounted for 8.5 per cent of all NHS...

In Brief: Doctors snub euthanasia.(Brief Article)
January 19, 2006... Euthanasia is extremely rare in the UK and has almost no support among doctors, a new study reveals. The survey of 857 GPs and hospital doctors found none had been involved in assisted deaths and only 2.2 per cent supported a change in the law....

In Brief: Caution over pioglitazone.(Brief Article)
January 19, 2006... The National Prescribing Centre has urged GPs to be cautious over use of pioglitazone in diabetes after reviewing the results of the Proactive study. Proactive found pioglitazone reduced the combined endpoint of death, myocardial...