Pulse articles from January 2008

Pulse archives from January 2008

GP contract on the brink of meltdown.
January 9, 2008... BMA considers legal action as Government demands GPs accept `gun- barrel' deal - or else By Steve Nowottny The BMA is considering legal action in a desperate attempt to stop the Government imposing unilateral contract changes that...

GPs given new role in child protection.
January 9, 2008... GPs are to be expected to work closely with other health and social care organisations to protect children in at-risk families. The Families at Risk Review, to be launched by the Government this week, will take a `no wrong door' approach,...

Trusts under scrutiny over discharge info.(Brief article)
January 9, 2008... Trusts are to face scrutiny on the discharge information they give GPs, after concerns were raised over prescribing safety. The Healthcare Commission has announced it plans an in-depth review of prescribing safety in primary care, focused...

PMS GPs get ultimatum over pay cuts.
January 9, 2008... A PCT that issued termination notices on all its PMS contracts has given GPs a final deadline for accepting a revised deal. PMS GPs in Northumberland have been given until 21 January to agree to the terms, which will see a large cut in...

Norovirus rate set to peak this week.(Brief article)
January 9, 2008... The norovirus infection rate is due to peak this week after reaching a five-year high, according to the Health Protection Agency. The season started uncharacteristically early with a large number of cases in the first week of November....

CLINICAL DOMAINS IGNORED: QOF sidelined in obsession with access.
January 9, 2008... Government deal condemned by GPs for freezing clinical QOF points and prioritising extra hours above all else By Steve Nowottny GPs have accused the Government of sacrificing the chance for further dramatic improvements in the quality...

FOR AND AGAINST: Should GPs accept the Government deal?
January 9, 2008... YES Dr Susan Bowie, a GP in Shetland, is happy to offer extra surgeries on Saturday morning and two evenings a week. `The BMA should not have walked away. GPs have lost public support and the negotiators don't seem to have thought it...

CLINICAL DOMAINS IGNORED: The deals in detail.
January 9, 2008... OFFER ON THE TABLE EXTENDED OPENING * Average 6,000-patient practice to offer three extra hours per week * Extra surgeries at least 90 minutes FUNDING * Reallocation of #158m from Access and Choice and Booking DESs to...

Fury over contract `disgrace'.(Survey)(Brief article)
January 9, 2008... Grassroots GPs have reacted with fury to the Government's plans for extended hours and are set to take industrial action if ministers go ahead with a threat to impose even tougher terms. The GPC plans to ballot every UK GP in the next few...

GPs to lead national cardiovascular screening programme.
January 9, 2008... GPs are to lead a huge programme of cardiovascular screening after Prime Minister Gordon Brown announced his intention to press ahead with the controversial plans. The Department of Health will also roll out regular ultrasound tests for...

Official: you've never been happier.
January 9, 2008... Scepticism over official survey showing contract has led to more satisfied, less stressed GPs working shorter hours By Lilian Anekwe The introduction of the GMS contract sent GPs' morale soaring and core working hours plummeting,...

Anger over bias towards private firms.
January 9, 2008... The GPC has accused the Government of paving the way for private firms to dominate the rollout of new surgeries as anger grows over GPs being shut out of the tendering process. Guidance to PCTs on saving costs in procurement of 100 new GP...

Salaried GPs not cutting inequality.
January 9, 2008... The growing rift in the profession between partners and salaried GPs does not appear to have come with the predicted benefits for recruiting in hard-to-reach areas, a study suggests. Researchers found no evidence that the Government's...

How losing bid shattered my morale.
January 9, 2008... A GP who lost out to a private firm in an APMS bid to run his own practice has told of the devastating effect the decision had on the morale of himself and his colleagues. Dr John Edwards had worked at the PCT-run practice in Hounslow,...

GPs are handed key MRSA role.
January 9, 2008... Guidance advises GPs to swab patients with symptoms more often and prescribe empirically in those at risk By Lilian Anekwe GPs are to be drawn on to the frontline of the MRSA battle with new guidance looking to drive an increase in the...

Pharmacist reviews `waste money'.
January 9, 2008... Employing pharmacists to review patients' medication is a waste of time and money and does nothing to reduce hospital admissions, researchers conclude. The introduction of pharmacist medication reviews also had no effect on mortality or...

Trusts warned on PBC transparency.
January 9, 2008... PCTs must ensure any conflicts of interest within practice-based commissioning are `managed transparently', the Government has warned. New guidance published by the Department of Health clarifies a range of issues relating to PBC, with...

Triple inhaled therapy best for COPD.
January 9, 2008... Triple inhaled therapy - two bronchodilators and a steroid - is the best treatment for COPD, say researchers who are calling for the development of a triple inhaler. Data from the INSPIRE trial, comparing salmeterol/fluticasone with...

This week's top - Miracle cure.(Brief article)
January 9, 2008... Just as GPs are getting used to the prospect of bowel screening, along comes a brand-new test for the disease, which the Daily Mail confidently predicts will prevent thousands of deaths a year. It's an over-the-counter urine test, developed...

This week's top - Scare story.
January 9, 2008... Just when you thought it was safe to venture back to the burgers, mad cow disease looks set to terrorise humans once again. That's according to the Daily Mail, Express and Independent, anyway. A post-mortem of a 39-year-old woman who died...

This week's top - and most pointless research.(Brief article)
January 9, 2008... Obesity has been a constant obsession of the media in recent years, but a team at market research firm Synovate has nailed the problem. Researchers questioned 9,000 people in 13 countries across five continents - and concluded people were...

IN BRIEF: Cross-border cost fears.(Brief article)
January 9, 2008... European Union proposals on cross-border healthcare threaten to leave the UK facing rising costs and a heavy bureaucratic burden, warns the NHS Confederation. Elisabetta Zanon, director of the confederation's European office, said: `We welcome...

IN BRIEF: New Beta-agonist advice.
January 9, 2008... Long-acting Beta-agonists are safe but should only be used in conjunction with an inhaled steroid, concludes a safety review carried out by the Medicines and Healthcare Products Regulatory Agency. Combination inhalers should be used to increase...

IN BRIEF: NHS Direct hits record.(National Health Service)(Brief article)
January 9, 2008... Christmas and New Year saw a record number of patients contacting NHS Direct. Figures for phone calls and online traffic to NHS Direct Online from 21 December 2007 to 1 January 2008 topped a million for the first time - up 61% on the same...

IN BRIEF: Mental health drugs soar.
January 9, 2008... Prescribing of mental health drugs has soared in Scotland over the past two years. The number of scripts for attention deficit hyperactivity disorder grew by 20% between 2005/6 and 2006/7, while dementia drug prescribing went up by 14%,...

IN BRIEF: Fall programmes setback.(Brief article)
January 9, 2008... There is little evidence that NHS fall prevention programmes - either in primary or secondary care - have any significant impact on the number of fallers or fall-related injuries, according to a BMJ research review of 19 trials. Although...

Key flaws revealed in QOF depression tools.(Quality and Outcomes Framework)
January 9, 2008... Call to review guidance to address wide variation in diagnostic rates By Georgie Hobbs GPs using a `blunt' QOF assessment tool for depression may be overdiagnosing large numbers of patients, with fears that many are inappropriately...

JournalWatch: Lidocaine works for OM.
January 9, 2008... Topical lidocaine is a fast, effective and safe treatment for children with painful acute otitis media, say Australian researchers. Their study involved randomising 63 children to receive either 2% lidocaine eardrops or saline. Some 52% of...

JournalWatch: Testosterone little benefit.
January 9, 2008... Giving hormone replacement therapy to men with low testosterone levels does not improve cognition or mobility, report the Dutch authors of the largest testosterone supplementation study to date. It included 207 men aged between 60 and 80...

JournalWatch: BP-dementia doubts.(Brief article)
January 9, 2008... There is no evidence that lowering blood pressure prevents cognitive impairment or dementia in patients without a history of cerebrovascular disease, a UK study suggests. Researchers at Queen's University Belfast reviewed data from three trials...

JournalWatch: Steroid warning with RA.(rheumatoid arthritis )(Brief article)
January 9, 2008... Patients with rheumatoid arthritis who need to use medium-dose steroids long term should have their blood pressure regularly monitored and treated aggressively if they develop hypertension, warn UK researchers. They categorised 400...

JournalWatch: Basal/bolus benefits.
January 9, 2008... Patients with type 2 diabetes are more likely to hit a HbA1c target of 7% if they move on to basal/bolus therapy - rather than prandial premixed therapy - after initial treatment with glargine. US researchers randomly assigned 374 patients...

Half elderly set for CKD.
January 9, 2008... Researchers warn eGFR thresholds will mistakenly label elderly as unwell By Emma Wilkinson More than half of elderly patients are set to be diagnosed with chronic kidney disease under QOF guidelines, intensifying scepticism over the...

GPs' electronic records to go live in A&E despite data loss.
January 9, 2008... Electronic patient records held by GPs are to be made available to hospital staff for the first time this month, just weeks after the NHS had to admit to the loss of huge amounts of patient data. Moves to press ahead with the rollout of the...

GPs asked to man reception desks.
January 9, 2008... GPs in practices with poor access satisfaction scores are to be given compulsory `cultural awareness' training and asked to work on reception, Pulse has learned. Tower Hamlets PCT - which achieved one of the lowest satisfaction scores in...

The year ahead: What's in store for 2008?
January 9, 2008... A year to stand up, be counted and put the patient first - top GPs cast their eyes forward to testing times ahead Dr Laurence Buckman, GPC chair and a GP in Barnet, north London The Government is not going to waste energy actually...

The year ahead: `Upheaval, sacrifice but an opportunity for change?'.
January 9, 2008... Dr Tom Frewin, a GP in Bristol and member of Avon LMC `I run a PMS practice. The way things are going, they can renegotiate the contract - just tear it up and say you are not doing it any more - and in some areas chop a third of your budget...

PulseDebate: Is general practice stuck in the past?
January 9, 2008... YES General practice has not responded to the needs of a modern workforce, and must be overhauled urgently, says the CBI's Dr Neil Bentley Last autumn, the CBI argued that the UK's family doctor service is not always delivering what...

Letter: Polyclinics are grotesque edifices set to destroy.(Letter to the editor)
January 9, 2008... From Dr IGV James Bolton, Lancashire I reply to your correspondent `name and address supplied' (`These regulation plans smack of socialist control', pulsetoday.co.uk/letters). I agree wholeheartedly with the examples cited in this...

Letter: Salaried GPs do not appreciate risks of being a partner.(Letter to the editor)
January 9, 2008... Name and address supplied, Greater Manchester I'm writing to respond to Dr Ruth Chapman's article about partners exploiting salaried GPs (pulsetoday.co.uk/careers). It is clear that she does not understand the salary figures she is quoting....

Letter: Nurses must earn their pay rises.(Letter to the editor)
January 9, 2008... From Dr Ila Basu Plaistow, East London It's untrue that GPs are exploiting practice nurses. We have had a practice nurse working with us for 12 years. We pay her at F grade, the highest rate. She is asking us to upgrade her to G. We...

Letter: APMS bias drove me from my practice.(Letter to the editor)
January 9, 2008... Name and address supplied, Lancashire I was interested to read the story on the front page of the last issue of Pulse (`Top GP's APMS bid loses to private firm', pulsetoday.co.uk/news). I have worked as a GP in Lancashire for five years at...

Increasing use but decreasing waste and cost.
January 9, 2008... Genus Pharmaceuticals has introduced a new pump for its emollient cream Cetraben. According to the company, the new `Cetrapump' dispenser offers 98% product evacuation, and therefore offers the lowest level of potential waste (2% wastage). ...

Letter: Square root correction factor is ripping off my practice.(Letter to the editor)
January 9, 2008... From Dr Tim Scott Tibshelf, North Derbyshire I was glad to read your front page a few months ago on the QOF square root correction factor (`GPs face sweeping QOF pay overhaul', pulsetoday.co.uk/news). It was apparent from the word go...

Pulse60-second interview: Dr Michael Dixon.
January 9, 2008... Dr Dixon is chair of the NHS Alliance, adviser on commissioning to health minister Lord Darzi and a GP in Cullompton, Devon * What's the NHS Alliance's priority for 2008? To give GPs and other clinicians a stronger voice in improving...

PulseComment: Brown's bullying tactics.
January 9, 2008... Ever since Gordon Brown's first few days as Prime Minister, his policy on health has been driven by a single obsession - the certainty that GPs' failure to offer evening and weekend surgeries was at the heart of disillusionment with the NHS....

PulseClinical: DEAFNESS IN ADULTS.
January 9, 2008... Otolaryngologist Professor Anthony Wright answers GP Dr Graham Archard's questions on red flags for deafness, grommets for adults and iPods Take-home points * Lip-reading classes and closely observing speakers are helpful but there is...

PulseClinical: MANAGING VULVAL SKIN PROBLEMS.
January 9, 2008... Dermatology GPSI Dr Elizabeth Ogden offers practical advice on managing an often embarrassing problem 1 Vulval skin problems are common but rarely present overtly. One community-based study found 20% of the women interviewed had suffered...

PulseClinical: SNAPSHOT DIAGNOSIS - SHORT FINGER.
January 9, 2008... Dr Mike Wyndham shares a photo of an uncommon diagnosis The patient This 14-year-old girl came to see me about her amenorrhoea. I noticed she was rather short for her age. First instinct A late developer. Differential...

PulseClinical: PALLIATIVE CARE.
January 9, 2008... Dr Chantal Simon, Dr Karen O'Reilly, Dr Robin Proctor and Dr John Buckmaster on dealing with acute problems in this challenging area Some acute events in advanced disease must be treated as emergencies. Although unnecessary hospital...

PulseWorkingLife: A LOOK AT VAT AND GP BUSINESS.(General Practitioners)(value-added tax )
January 9, 2008... Practice management GPs are used to paying VAT on personal spending, but it is fairly new in the context of GP business. In the first of six articles on financial management, accountant Ian Tongue clarifies the situation There have...

How to promote your practice.(Brief article)
January 9, 2008... Business efficiency and clinical excellence in general practice is not enough. Patients must know you are good. Your job is to make this clear in the public domain. Here are some of the strategies you can use. 1 Have a signature house style...

LEGAL LESSONS - EMPLOYEE PILFERING PRACTICE STATIONERY.
January 9, 2008... Advice on a tricky practice problem from barristers Michael Salter and Chris Bryden THE SITUATION I believe that a particular employee is helping themselves to items of stationery, reams of paper and the like. I am concerned that...

PulseWorkingLife: People - MEI LING DENNEY.
January 9, 2008... CV Dr Mei Ling Denney is a portfolio GP, a VTS course organiser, an appraisals lead for Peterborough PCT and an MRCGP examiner with international responsibilities 06:45 I wake up at 6.45am when the alarm goes off and wonder how...

CareerCoach: Occupational medicine.
January 9, 2008... Dr Jim Sherifi gives advice on how GPs can participate in, and get the best out of, occupational medicine Occupational medicine (OM) provides an interesting addition to any portfolio medical career as well as being a full-time career in its...

BRIEF ENCOUNTERS - FAY WILSON.(Interview)
January 9, 2008... CV Dr Fay Wilson is a sessional doctor with a portfolio career. She is secretary of several LMCs covering north-west London, and she is also chair of the LMCs conference and a member of the BMA council. She has a particular interest in...

Banana skins for plantar warts.
January 9, 2008... Q A local chiropodist insists that taping the inside of a banana skin overnight to a verruca is an effective treatment, apparently because of the enzymes released. Is this just an old wives' tale? A Cutaneous viral warts are caused by the...

Indemnity for Good Samaritans.
January 9, 2008... Q Does medical indemnity cover treatment of medical emergencies by doctors in planes in other countries' air space? A MDU members are provided with a professional indemnity insurance policy that extends to clinical negligence claims arising...

Plan for all GPs to quit the NHS.
January 23, 2008... Explosive BMA document braces GPs for `end of the world' scenario EXCLUSIVE By Steve Nowottny The BMA has drawn up a sensational plan for GPs to quit the NHS en masse in response to the Government's plans to force through...

Chisholm firm threatens GP redundancies.
January 23, 2008... A private primary care provider jointly run by former GPC chair Dr John Chisholm has provoked anger by threatening GPs in two practices in south London with redundancy, saying GP-led services were an `inefficient use of resources'. ...

Government under fire over `secret' PBC data.
January 23, 2008... The Government has been criticised for ordering NHS managers to keep quiet about the latest results from its rolling study into the progress of practice-based commissioning. GPs at 1,138 practices were polled about PBC, and only 12% thought...

QOF square root revision still on table.
January 23, 2008... Changes to the controversial QOF square root formula are still being negotiated in an effort to tackle inequalities in payments, the Department of Health said this week. The department quashed fears that changes to the formula would be...

GMC to revise guidance on confidentiality.
January 23, 2008... The GMC is launching a major consultation to review its advice to GPs on the controversial subject of patient confidentiality. The review looks set to spark debate over a series of contentious issues, including the threats versus...

Gulf opens up between salaried GPs and partners.
January 23, 2008... Rift over pay and workload widens as survey finds 74% of salaried GPs accuse partners of exploitation EXCLUSIVE By Gareth Iacobucci A growing divide between GP partners and their salaried colleagues is in danger of destabilising...

PCTs tighten screw over GP referrals.
January 23, 2008... GPs are facing tightening constraints over their referral decisions, with a new analysis revealing that a growing number of PCTs are using practice-based commissioning as a referral management tool. More than a third of PCTs have already...

Lung health checks to form part of DH screening drive.
January 23, 2008... The Government is planning an ambitious screening programme for COPD, in addition to schemes for cardiovascular disease and cancer announced earlier this month, writes Nigel Praities. GPs will be at the forefront of the drive, with a source...

Contract dispute special: LMCs sceptical over GPC militancy.
January 23, 2008... Mood in communities is pragmatic rather than radical, with GPs nervous of implication of improvised deal By Steve Nowottny GPC leaders face an uphill struggle to persuade GPs to reject the Government's contract offer, with early...

ROW OVER QOF - Government advisers rail over QOF inertia.
January 23, 2008... The Government's own advisers are leading a backlash against its decision to ditch a series of clinical changes to the QOF. A string of heavyweight advisers accused the Government of a serious missed opportunity and of not basing its...

THE GREAT DIVIDE - Four countries may go their own way.(Brief article)
January 23, 2008... The contract dispute has opened up divisions between the four countries of the UK, with Northern Ireland the first to confirm it would go a different path than England over the negotiations. GPs in Northern Ireland will not have to offer...

`Uphill battle' to mount legal challenge to the changes.
January 23, 2008... The GPC has been warned it faces a major challenge if it decides to mount a legal battle against the unilateral imposition of contract changes. A leading solicitor has told Pulse that GPs will struggle to mount a challenge unless they can...

GPs landed with complex mental health cases and little support.
January 23, 2008... Shift in Government policy leaves GPs to treat complex cases with only limited access to psychiatrists By Lilian Anekwe GPs are increasingly being forced to deal with complex mental health cases without adequate specialist support as a...

CASE STUDY: My ordeal at hands of mentally ill patient.
January 23, 2008... Dr Sonia Devereux, a GP in Fife, Scotland, told Pulse of her experience struggling to cope with patients with serious personality disorders. She said: `I've had patients I've referred with personality disorders sent back to me because the CMHT...

Polyclinic plans forge ahead.
January 23, 2008... NHS bosses in London are drawing up a blueprint for the introduction of polyclinics across the capital - even though the public has yet to back the plans. The Healthcare for London consultation, which does not close until early March,...

Local councils may be asked to fund practices.
January 23, 2008... Local councils could be asked to help fund the wave of new practices planned as part of the Government's access drive, GPs advising the Government have suggested. The idea was one of several mooted at the first meeting of the primary and...

Aspirin resistance poses major risk.
January 23, 2008... Resistance to aspirin really does exist and dramatically increases risk of heart attack or stroke, researchers claim By Georgie Hobbs Patients who are resistant to aspirin are at a dramatically increased risk of suffering a heart...

Media Watch - This week's top Miracle cure.
January 23, 2008... The same wizardry behind computer game consoles will be used to manoeuvre stroke victim's limbs, says the Daily Mail. The STIMuGRIP bionic arm, developed by UK firm FineTech Medical, stimulates arm muscles so that the fingers open automatically...

Media Watch - This week's top Scare story.(Methicillin-resistant Staphylococcus aureus )(Brief article)
January 23, 2008... Homosexuals are under threat from a lethal flesh-eating MRSA strain, according to the Independent, Telegraph and BBC. `USA 300', as the strain has been named, is reported to attach itself to damaged skin and airways more easily than hospital...

Media Watch - This week's top and most pointless research.(Brief article)
January 23, 2008... Longer is better, say scientists at the University of Wroclaw in Poland, at least when it comes to legs. After asking 218 male and female volunteers to rate the attractiveness of seven males and seven females with varying leg lengths, most...

Prescribing pressures: GPs could be limited to strict drug formularies.
January 23, 2008... MPs advise strict prescribing controls and QOF points for cost savings By Nigel Praities GPs should prescribe from a joint primary-secondary care formulary and be set QOF targets for cost-effective use of drugs, an influential...

Prescribing pressures: Drug switching risks deaths, insists Pfizer.
January 23, 2008... Pfizer has launched a fightback over the national programme to switch patients to generic simvastatin, with the release of a new general practice study claiming switching raises the risk of death or major cardiovascular events. GPs face...

QOF diabetes pay warning.
January 23, 2008... GPs are being warned that their lab's choice of diagnostic test to confirm if a patient has diabetes could affect QOF payments - particularly if HbA1c targets are toughened. Researchers compared two different laboratory techniques - the...

Heart clinic benefits tail off.(Clinical report)
January 23, 2008... Nurse-led clinics for heart disease have no long-term benefits for reducing mortality, researchers report. The results come from a study following more than 1,000 randomly selected Scottish patients with heart disease over 10 years - much...

IN BRIEF: GPs to train for five years.
January 23, 2008... The RCGP has welcomed proposals to extend GP training to five years - but warned it would `not tolerate' the extra training being used as an `excuse to staff hospitals'. The final report of the independent inquiry into Modernising Medical...

IN BRIEF: Aspirin plea with TIAs.
January 23, 2008... Patients with a suspected high-risk TIA should receive immediate treatment with aspirin and be seen by a specialist within 24 hours, say draft guidelines released by NICE. The new guidance, released for consultation, follows criticism of TIA...