Pulse articles from January 2007

Pulse archives from January 2007

Talks collapse over contract pay deal.
January 11, 2007... QOF to remain unchanged after GPC turns down offer of `substantial extra investment' By Daniel Cressey Negotiations on revisions to the GP contract have collapsed after the GPC turned down a final package of proposals from NHS...

PCTs to save millions in QOF pay.(quality and outcomes framework )(Brief article)
January 11, 2007... QOF monitoring PCTs plan to shave millions of pounds off GPs' quality framework earnings by implementing a tough new monitoring regime, writes Christian Duffin. The clampdown will spell the end of `high trust-low bureaucracy' QOF...

GPs under pressure as PCOs put squeeze on prescribing bills.(primary care organisations )
January 11, 2007... Pulse investigation reveals scale of moves to clamp down on prescribing STATINS By Gwynne Dixon GPs are facing stringent curbs on their prescribing in a desperate bid by primary care organisations to rein back deficits. More...

Contract threats over banned drugs.(Brief article)
January 11, 2007... NEW DRUGS Primary care trusts are taking advantage of the `excessive prescribing' clause in GPs' contracts to ban use of a series of potentially useful medicines. GPs are being threatened with breach of contract if they prescribe...

BMA draws up pensions battle plan.(British Medical Association)(Brief article)
January 11, 2007... The BMA plans to launch its legal battle against the Government's cap on GPs' pensions within the next month. Dr Andrew Dearden, chair of the BMA pension committee, said lawyers were readying a damning case. The action could involve a...

Trusts threaten to terminate PMS contracts to save money.(United Kingdom. National Health Service. Primary Care Trusts)(personal medical services)(Brief article)
January 11, 2007... PMS GPs are facing increasing attempts by primary care trusts to cut funding and force them back to GMS, writes Helen Crump. GPs have reported growing numbers of PCTs making bids to reduce growth money, renegotiate terms or force extra work...

GPs condemn post-op check proposal.(Brief article)
January 11, 2007... GPs have condemned Government plans for them to take on post-operative check-ups as `ridiculous'. The Department of Health believes the move would save the NHS #1.9bn each year by freeing up consultants' time. The calculations are...

Choice survey to bring more money.(Brief article)
January 11, 2007... GPs are to get an extra payment for giving out questionnaires for the Choice and Booking directed enhanced service. The money is being awarded because practices will now have to hand out the questionnaires, rather than the Department of...

Even Department of Health predicts a GP shortage.(Brief article)
January 11, 2007... The Department of Health is predicting a shortage of 1,200 GPs in England from next year. Draft documents on the NHS pay and workforce strategy for 2008 to 2011 also forecast a major shortage of nurses and allied health professionals, but...

InBrief: Pulse extends its lead.
January 11, 2007... Pulse is still the best-read weekly medical publication, according to the latest official industry readership survey. The JICMARS survey showed 73 per cent of UK GPs read Pulse in the six months to November 2006 - four percentage points ahead...

InBrief: Malaria advice update.(Brief article)
January 11, 2007... A series of changes have been made to the Malaria prophylaxis advice on Pulse's travel vaccination charts and online Travel Clinic. The changes, which affect a series of countries including Brazil, India and Vietnam, follow new guidelines...

InBrief: Emergency bed day cuts.(Brief article)
January 11, 2007... The Department of Health has met its 2008 public service agreement target to cut emergency bed days by 5 per cent one year early. Emergency bed days have fallen by 5.4 per cent since 2003/04. The department has launched the Combined...

InBrief: Returning GPs guidance.(Brief article)
January 11, 2007... GPs wishing to return to practice should ask a PCO for a `conditional inclusion' on the performers list if they cannot be fully included, new GPC guidance advises. Conditional inclusion allows the GP to work in a supervised setting. GP...

InBrief: Risks of PCT cost-cutting.(Primary Care Trusts)(Brief article)
January 11, 2007... PCT cuts in community services risk disengaging clinicians and patients from NHS reforms, the Institute for Public Policy Research is warning. Its report, The Future Hospital, also raised fears the Government's patient choice and plurality...

InBrief: Late flu drive in Scotland.
January 11, 2007... GPs in Scotland are set to be vaccinating patients against flu well into the New Year after practices finally received sufficient supplies of vaccine. Scotland's chief medical officer last week urged patients to continue to come forward to...

InBrief: NICE faces first legal case.
January 11, 2007... NICE is facing its first judicial review after two drug companies, Eisai and Pfizer, began legal proceedings. The companies formally applied to the High Court for permission to request a review of the institute's ruling on dementia drugs....

GPSIs face rebellion from consultants.(general practitioners with special interest)(Survey)
January 11, 2007... Specialists refuse to co-operate as GPSIs cut referrals to hospital EXCLUSIVE - RESISTANCE By Gareth Iacobucci The Government's drive to shift work into primary care using GPSIs is meeting strong resistance from consultants, with...

Standards are to be toughened.(Brief article)
January 11, 2007... ACCREDITATION GPSIs face having to do as many as 50 clinical sessions with consultants under tough new accreditation guidelines, Pulse can reveal. The recommendation comes in new guidance on dermatology GPSIs, which will apply...

`We need support'.(general practitioners with special interests)(Brief article)
January 11, 2007... Dr Karen Benson, a GPSI in dermatology in Hornsey, north London, believes `strong' support from consultants is vital to make GPSI schemes a success. She said: `You cannot work in isolation - you need good links.' Dr Benson, who has a...

Flu vaccination: no to children.
January 11, 2007... Government advisers unconvinced by evidence on vaccine efficacy and role of children in disease spread By Lilian Anekwe Children will not be added to the flu vaccination campaign after Government advisers ruled there was insufficient...

But yes to poultry workers.(Brief article)
January 11, 2007... GPs will be among the health professionals expected to deliver a programme to vaccinate poultry workers against seasonal human flu. The Department of Health announced that everyone working in close contact with poultry should receive the...

GPs lose out over phone numbers.(Brief article)
January 11, 2007... Practices that use telephone numbers starting `084' could be forced to shift to new `03' numbers because they are cheaper for patients to call. But the switch could mean practices will lose advanced services such as call queuing, a leading...

MediaWatch: `Cervical treatment raises premature birth risk'.(Brief article)
January 11, 2007... The story A routine treatment to remove abnormal cervical cells detected in smear tests doubles the risk women will give birth prematurely, warn the Times, Daily Mail and Scotsman. The source Researchers at the Royal Women's Hospital in...

MediaWatch: `Dental X-rays help bones'.(Brief article)
January 11, 2007... The story Dental X-rays could help women beat osteoporosis, report the Times and Daily Mail. The source A study by a University Of Manchester team used `active shape modelling techniques' to detect jaw cortex widths of less than 3mm, a key...

MediaWatch: `Pill risk for obese women'.(Brief article)
January 11, 2007... The story The health risks associated with the contraceptive Pill are five times higher for obese women, reports the Daily Mail. The source A study by European Active Surveillance looked at women from seven countries, including the UK, and...

GPs `horrified' by PCT cuts.(primary care trusts)(Brief article)
January 11, 2007... GPs in North Yorkshire are `horrified' at new plans by their PCT to cut local health services in a desperate effort to claw back its #24.5m deficit. Changes proposed by North Yorkshire and York PCT include telling about half of all A&E...

Spot checks for GPs under new controlled drugs rules.(Brief article)
January 11, 2007... Concerns that tough new regulations may discourage GP involvement in palliative care By Daniel Cressey GPs face on-the-spot inspections and detailed scrutiny of their prescribing practice under new Government regulations on use of...

Clampdown on controlled drugs.(Brief article)
January 11, 2007... * New arrangements aim to `detect unusual or poor clinical practice or systems, criminal activity or risk to patients' * All PCTs to appoint an `accountable officer' to oversee controlled drugs * Officer must not routinely supply...

GPs told to give antibiotics to at-risk in flu pandemic.(Brief article)
January 11, 2007... GPs have been advised to respond to a flu pandemic by offering antivirals to all adults who show symptoms - and in some cases antibiotics as well. The Department of Health has released new guidance on the management of patients during a...

LBC reducing repeat tests.(liquid-based cytology)(Brief article)
January 11, 2007... The phased introduction of liquid-based cytology for cervical screening has already substantially reduced the number of inadequate tests, NHS statistics reveal. The figures refute the findings of a systematic review published last year in...

GP's warning over CKD misdiagnosis.(chronic kidney diseases)(Brief article)
January 11, 2007... Use of estimated glomerular filtration rates can misdiagnose patients with chronic kidney disease even after repeat testing, GPs are being warned. A GP in Portsmouth raised the alarm after finding one of his patients had been twice wrongly...

GPs' last chance for added years.
January 11, 2007... The added years pension top-up scheme is due to end and financial experts urge GPs not to miss out By Christian Duffin GPs are being warned that 2007 is their last chance to take part in the added years top-up scheme to boost their...

Six GPs receive New Year Honours.(Brief article)
January 11, 2007... Six GPs have received New Year Honours for their services to healthcare. Dr Azhar Farooqi, a GP in East Leicester and member of the NHS Alliance, received an OBE. Dr Ken Aswani, a GP in Waltham Forest, Essex, Dr Iftikhar Ahmed Lone, a...

JournalWatch: Folic acid hearing benefit.(Brief article)
January 11, 2007... Folic acid supplements seem to slow age-related hearing loss, a Dutch study has found. The trial randomised 728 elderly men and women to either 800 g oral folic acid daily or placebo for a period of three years and assessed changes in...

JournalWatch: Alcohol cuts heart failure.(Brief article)
January 11, 2007... Moderate alcohol consumption appears to reduce the risk of developing heart failure, US researchers report. They followed 21,601 participants in the Physicians' Health Study I from 1982 to 2005, analysing questionnaire data and assessing...

JournalWatch: Five years best for bones.(Brief article)
January 11, 2007... Five years of bisphosphonate treatment appears to be sufficient for many women with postmenopausal osteoporosis, a US study concludes. The trial compared the effect of discontinuing treatment with alendronate after five years or continuing...

JournalWatch: Antibiotic effect on quinsy.(Brief article)
January 11, 2007... Low doses of antibiotics commonly used for sore throats do not protect against quinsy, a UK study concludes. The researchers retrospectively analysed 606 cases of quinsy from the UK general practice research database, 192 of whom developed...

JournalWatch: PPIs raise hip fracture risk.(proton pump inhibitors )(Brief article)
January 11, 2007... Use of proton pump inhibitors increases risk of hip fracture, a US study reports. Researchers used the UK general practice research database for a nested case-control study involving 13,556 hip fracture and 135,386 controls. Use of a PPI...

Call for OOH system review.(out-of-hours contracts for general practitioners)(Brief article)
January 11, 2007... PCTs have been ordered to review systems used by out-of-hours providers in an effort to boost patient safety. The demand from the Department of Health follows the death from septicaemia of a patient in London who was seen by eight different...

Christmas cover criticised.(Brief article)
January 11, 2007... A privately-run out-of-hours service in Cornwall has been criticised by GPs for failing to cope with demand over the Christmas period. Many callers were unable to get through to the Kernow Urgent Care Service (KUCS), run by Serco, or faced...

Primetime TV boost for GPs' image.(Street Doctor to improve image of general practice with public)
January 11, 2007... Four GPs take to the streets to consult with patients for new BBC1 reality show Street Doctor By Jacqueline Head Four GPs who took to the streets to consult with patients for a new BBC reality TV series believe it will help improve the...

Choice study taken off NHS website.(National Health Services list)(Brief article)
January 11, 2007... Department of Health-funded research that found no evidence its patient choice agenda improved care has been removed from an NHS website. The study was published on the NHS Service Delivery Organisation's website in November with the...

MP launches website to log 48-hour GP access failures.(Brief article)
January 11, 2007... A Conservative MP has set up a website asking patients to report problems getting an appointment with their GP within the 48-hour access target. Grant Shapps, MP for Welwyn Hatfield, started the www.48HourGP.com site just before Christmas....

`Major reforms needed in make-or-break year for NHS'.(working of National Health Service)(Brief article)
January 11, 2007... The NHS is facing a `make-or-break' year in which it must make fundamental reforms in order to get back on track, an influential think tank claims. The report by Reform, entitled NHS Reform: The Empire Strikes Back, said the NHS had failed...

Chest pain alerts to CVD risk.(causes of cardiovascular diseases)
January 11, 2007... Symptoms provide early warning - predicting coronary events up to seven years in advance By Daniel Cressey Chest pain can predict the risk of a coronary event as much as seven years in advance, a study of general practice concludes....

Peripheral artery care inadequate.(medical research reports)(Brief article)
January 11, 2007... Patients with peripheral arterial disease are being inadequately treated because of a lack of awareness of the condition, researchers warn. A new study of 473 patients found many were missing out on appropriate medication and smoking...

The study - and what it found.(Brief article)
January 11, 2007... * The first study to follow up primary care consultations for chest pain prospectively * Total of 2,229 patients followed up for seven years * Chest pain increased risk of CHD throughout seven-year period * May be early...

Key Down's care standards.(medical standards)(Brief article)
January 11, 2007... CARDIAC DISEASE Examination with a single echocardiogram should be performed in adult life THYROID DISORDERS Biochemical testing should be carried out at least once every two years throughout life HEARING IMPAIRMENT ...

Gaps found in Down's care.(research on down's syndrome)
January 11, 2007... Patients with Down's syndrome are not receiving sufficient levels of care from GPs for preventable complications, a new study concludes. Researchers warned it was essential GPs monitored patients with the condition and made a series of...

Open-door policy urged with symptoms of ovarian Ca.(medical practice policy)(Brief article)
January 11, 2007... GPs should have an `open-door policy' for women who have symptoms consistent with ovarian cancer as one of a series of measures to speed up diagnosis, researchers propose. Their study suggested almost all women with ovarian cancer had had...

The year ahead: GPs forecast a year of uncertainty.(discussions of general practitioners)
January 11, 2007... After a difficult year in 2006 for general practice, we ask GPs what they think 2007 may have in store for them 2006 was a tough year for GPs. No pay rise, a tougher quality framework, more work being loaded on to practices and the pensions...

Letters: Pensions a resignation issue.(Letter to the editor)
January 11, 2007... As anger grows over pensions, GPs are demanding answers - and talking of industrial action From Dr Jim Beatson, Troon, Ayrshire and five other GP signatories Open letter to Dr Hamish Meldrum, GPC chair Primary care `performers',...

Letter: Weighty addition to workload.(Letter to the editor)
January 11, 2007... From Dr Rachel Pryke, Redditch, Worcestershire We have just had our surgery weighing scales calibrated and checked, which has highlighted a bureaucratic irritation: since 2003, new weighing scales for medical use give only metric readings....

Dinah'sDiary: Dinah Roy.(Diary entry)
January 11, 2007... In the first of her new weekly diaries, Dinah Roy ponders on the future of PCTs - and struggles with the hair straighteners Monday Slow start to surgery for 2007 - great! More time to play with new computer, one of many legacies of...

Letter: Choose and Book kills communication.(Letter to the editor)
January 11, 2007... From Dr Christopher Lisk, Newport, Shropshire We were recently circulated by our PCT with a letter saying the software for Choose and Book is not up to scratch and is causing problems. I replied to them telling them that Choose and...

Letter: Stand up to pressure over Care Records.(Letter to the editor)
January 11, 2007... From Dr Peter Brewer, Looe, Cornwall I have just listened to a discussion on the radio between a professor of IT and the almighty Lord Warner about patients' medical information being put on a national database. The premise that it is `all...

PulseFinance: PRE-EMPT YOUR DEADLINE ON SUPERANNUATION.(financial benefits for general practitioners)
January 11, 2007... Reduce your stress levels, and those of your accountants, by facilitating the completion of your GP partner and locum superannuation certificates, says Dr John Couch At this time of year accountants are focused on getting tax returns in...

HOW TO ENSURE GOOD TEAMWORK IN THE PRACTICE.(medical practice teams)
January 11, 2007... Most practices will have GPs, nurses and reception and management staff in loose groupings. In order to increase the performance of these groups the GP partners need to ensure good teamwork. This is how you do it 1 Have a...

PulseClinical: NEED TO KNOW OPHTHALMOLOGY.(dialogue between Mr Scott Fraser and Dr Melanie Wynne-Jones)(Interview)
January 11, 2007... Consultant ophthalmologist Mr Scott Fraser tackles questions on the latest treatments from GP Dr Melanie Wynne-Jones Take-home points * Monoclonal antibodies against vascular endothelial growth factor can have a role in wet AMD but it...

PulseClinical: HOW I SUCCEEDED IN STEPPING DOWN ASTHMA TREATMENT.
January 11, 2007... Dr Sashi Nandakumar explains how she and her second-year GP trainee Dr Neil Chauhan made significant savings and cut side-effects through proactive asthma reviews Stepping down the treatment of asthma patients who are well controlled can...

PulseClinical: GREEN TEA IS ASSOCIATED WITH REDUCED MORTALITY.(health benefits of green tea)
January 11, 2007... Q Can green tea consumption reduce the risk of premature mortality? Synopsis The authors of this study analysed data from a large population-based cohort of 40,530 people living in north-eastern Japan, where green tea is widely...

PulseClinical: 10 TOP TIPS IBD.(tips on Inflammatory Bowel Disease)
January 11, 2007... Dr Roger Henderson passes on his insights gained from working as a GP with a clinical interest in gastroenterology 1 Remember barium enemas are still useful If a diagnosis of colitis is made by a GP at rigid sigmoidoscopy in the surgery, a...

PulseRegistrar: FROM MRCGP WITH DISTINCTION TO THE DOLE OFFICE!(Member of the Royal College of General Practitioners advice)
January 11, 2007... Newly-qualified GP Dr Sarah Wright found herself out of work after falling foul of the certification system - here she offers advice to registrars on how to avoid ending up in the same boat As GP registrars we all work hard and look forward...

CASEBOOK - DEATH IN FAMILY PROMPTS REQUEST FOR EXERCISE ADVICE.
January 11, 2007... Dr Tanvir Jamil discusses how you might proceed Case History Margaret, 55, has diabetes and is overweight. Her diabetes is well controlled but she had a bit of a shock when her cousin recently `dropped dead' from a heart attack at the...

PulseRegistrar: YOUR FIRST COMPLAINT FROM A PATIENT.
January 11, 2007... A quick response, full explanation and prompt apology is often the best course of action, advises Dr Stefan Cembrowicz Take all complaints seriously no matter how trivial they seem. Toyota workers celebrate when a mistake is found as the...

PulseClinical: LITTLE GEMS - HOW HOT ARE YOU ON DEPRESSION?
January 11, 2007... Test your knowledge for the nMRCGP with this little GEM from GPnotebook Q Considering management of mild depression in primary care, what period of `watchful waiting' might be indicated? A Watchful waiting is a treatment option for...

PulseComment: Squeezed to the last drop.(Brief article)
January 11, 2007... GPs, it seems, are being squeezed from all sides. In just a single week, details have emerged of four separate schemes to eke out pennies by restricting GPs' clinical practice or clamping down on their pay. Trusts are doing everything they can...

LAST WORD.
January 11, 2007... Dr Clarissa Fabre... on women GPs, 2007 and Wayne Rooney The best thing about my practice is it's situated in a gorgeous tile- hung building in Sussex. It's warm, friendly and happy. And the worst is we're too squashed in our premises...

Ministers resolve to punish `greedy GPs'.(General Practitioners)
January 18, 2007... GPs face pay freeze for second year amid recriminations over collapse of contract talks By Helen Crump Ministers are growing increasingly determined to punish what they see as `greedy GPs' by imposing a pay freeze for the second year...

Ombudsman may rule on pensions.(Brief article)
January 18, 2007... A GP who has 1,350 signatures for his petition against the pensions cap now wants to take a complaint to the Parliamentary Ombudsman, writes Helen Crump. Dr Mark Oliver has asked his local MP David Kidney to ask the Ombudsman whether the...

Co-proxamol row heats up as MPs demand U-turn.(Members of Parliament)(Survey)
January 18, 2007... MPs have called a special Commons debate to demand the co-proxamol ban be overturned after using a Pulse survey as evidence of opposition among doctors. Labour MPs Anne Begg and part-time GP Dr Howard Stoate are to push the finding that 70...

Chlamydia screening threat.(Brief article)
January 18, 2007... The National Chlamydia Screening Programme is under threat from `lack of funds' in many parts of England, a new report reveals. The Department of Health review, on modernisation of services for pathology and microbiology, admits screening...

QOF targets `could rotate each year'.(Quality Outcomes Framework)(Brief article)
January 18, 2007... Indicators in the quality and outcomes framework could rotate annually to avoid some clinical areas being neglected, a leading expert has suggested. Professor Martin Roland, one of the architects of the QOF, admitted to Pulse that there...

Cuts in GP returners funding may breach equality laws.(General Practitioners)
January 18, 2007... Government cuts in funding for a scheme that allows GPs to return to work after a career break could breach sex discrimination laws, writes Lynn Eaton. The BMA has warned the Department of Health that because women constitute the vast...

Hospital in `cash for surgery' row.(hospital fee for fast treatment)(Brief article)
January 18, 2007... A hospital that asked GPs to tell patients they could jump the queue for surgery by paying for their operation has been forced into a humiliating climbdown. Andrew Riley, chief executive of Northampton General Hospital NHS Trust, wrote to...

Code warning over Care Record.(adding codes to the medical records of patients )(Brief article)
January 18, 2007... GPs will not automatically opt patients out of the NHS Summary Care Record simply by adding a code to their record, Connecting for Health is advising. Many practices have been adding the 93C3 Read Code or XaKRy Clinical Terms version 3...

InBrief: Stick with 084, says GPC.(advice of General Practitioners Council)(Brief article)
January 18, 2007... Practices using an 084 telephone number should resist any attempts by their PCT to get them to change it, the GPC is advising. The Department of Health wrote to trusts last month urging them to persuade practices to move a new 03 numbers...

InBrief: Varenicline for quitters.(smoking cessation products)(Brief article)
January 18, 2007... GPs in Scotland have been given the green light to use varenicline for smoking cessation by the Scottish Medicines Consortium. The SMC said it should only be used as a component of a smoking cessation support programme. Copyright: CMP...

InBrief: Collaborative fees advice.(Brief article)
January 18, 2007... GPs should set their own fees for work under collaborative arrangements and tell PCOs requests received after a set date will be charged at these rates, the BMA is advising. A notice period of at least three months is appropriate, the BMA adds...

InBrief: Inhaled insulin doubts.(diabetes treatment with inhaled insulin)(Brief article)
January 18, 2007... Inhaled insulin provides very few real benefits for patients with diabetes, argues the Drug and Therapeutics Bulletin. A review suggested benefits in needle-phobia were mostly outweighed by safety concerns and expense. Copyright: CMP...

InBrief: Information script pilots.
January 18, 2007... The Department of Health is seeking GP pilot sites to trial `information prescriptions'. Aimed at enabling patients with longer term conditions to self-manage, they could contain addresses of websites, contact details for charities or support...

InBrief: `Start CKD action earlier'.(treatment for Chronic Kidney Disease )(Brief article)
January 18, 2007... GPs should be taking action against chronic kidney disease much earlier than currently, even under new QOF indicators, researchers say. A study of 8,913 patients in the European Heart Journal found even mild renal failure raised...

InBrief: PBC threat to quit services.(Practice-based commissioning )(Brief article)
January 18, 2007... Practice-based commissioning poses a threat to NHS stop smoking services, warn smoking cessation professionals. Experts at the UK National Smoking Cessation Conference said there was a risk GPs would opt for the `cheaper option' of buying in...

InBrief: #7m NHS frauds in 2006.(National Health Service)(Brief article)
January 18, 2007... Frauds costing #500,000 linked to GP surgeries have been uncovered in the past three years, statistics from the NHS Counter Fraud and Security Management service show. Overall, losses from all frauds in the NHS were down by 55 per cent to #76m...