Pulse articles from January 2009

Pulse archives from January 2009

GPC in call to arms over QOF changes.
January 14, 2009... Committee demands mass response to DH consultation on `fundamentally flawed' overhaul By Lilian Anekwe GP negotiators have issued a withering and wide-ranging attack on the Government's plans to tear up and rewrite the QOF in a move...

How the DH plans to reshape the QOF.
January 14, 2009... * In October, the DH launched a 12-week consultation on plans to overhaul the QOF by handing responsibility to NICE for a `new, transparent and objective process for developing and reviewing indicators'. Plans include: - a review of...

BMA chair defends bid for GP-led centre.(Hamish Meldrum of the British Medical Association)(general practitioner)(Brief article)
January 14, 2009... BMA chair Dr Hamish Meldrum has defended his decision to bid for one of the new GP-led health centres, insisting `the lesser evil was to get involved'. Dr Meldrum's surgery in Bridlington, east Yorkshire, was part of a collaboration...

`Unprecedented' increase in UK measles cases.
January 14, 2009... The UK is experiencing an `unprecedented' increase in measles, latest figures from the Health Protection Agency show. The number of cases in the first 11 months of last year were up a quarter on the previous year. There were 1,217 cases of...

DH in talks to improve access to new drugs.
January 14, 2009... GPs will be able to prescribe expensive new drugs that are currently unavailable on the NHS, following talks between the Government and pharmaceutical companies. Reports suggest the Department of Health and UK drug manufacturers are set to...

Vascular screening plans in chaos as DH looks to QRISK.(United Kingdom Department of Health)
January 14, 2009... Ministers tell NICE to think again on risk scoring after DH report favours QRISK over Framingham Exclusive By Nigel Praities The national rollout of vascular screening has been plunged into confusion after the Department of Health...

How the risk scores compare.(Brief article)
January 14, 2009... FRAMINGHAM Based on... a cohort study of affluent white patients in Boston, US Advantages... familiar to GPs and its flaws are well-known and can be adjusted for Disadvantages... underestimates risk in people with diabetes, South...

SELECT COMMITTEE: MPs criticise imposition of polyclinics.
January 14, 2009... MPs have savaged the Government's decision to impose GP-led health centres on every PCT, claiming the rollout should have been piloted first and there is no evidence it will improve patient care. A report by the Commons health select...

TENDER PROCESS: OOH providers win a quarter of Darzi contracts.(out-of-hours)
January 14, 2009... Out-of-hours providers have won a raft of contracts for the new wave of GP-led health centres, in a move that looks set to transform their role as providers of primary care. Almost a quarter of contracts announced so far, among responses...

DH to consider RSV immunisation.
January 14, 2009... New advisory group set up to weigh up evidence on respiratory syncytial virus immunisation programme Exclusive By Lilian Anekwe Department of Health advisers are to consider introducing an immunisation programme against...

Effectiveness of palivizumab.(Brief article)
January 14, 2009... * RSV admissions in preterm infants or children with chronic lung disease - 4.8% (48/1,002) in the palivizumab group, 10.6% (53/500) in the no prophylaxis group * RSV hospitalisation rates in children with CHD - 5.3% (34/639) in the...

Children in line for more talking therapies.
January 14, 2009... Exclusive By Lilian Anekwe The Government is likely to widen its psychological therapies programme to include children and adolescents, Pulse understands. Ministers are considering the recommendations of a new report from Lord...

College weighs in on row over safety of GP minor surgery.
January 14, 2009... The RCGP has weighed in to the growing row over GP minor surgery with a warning that the health service would `grind to a halt' if GPs stopped performing operations. The college has fired off joint letters with the GPC to a series of...

Care record's national rollout begins at last.
January 14, 2009... Pilot phase over as first wave gears up to launch by end of March Exclusive By Steve Nowottny The national rollout of the Summary Care Record is finally to begin next week, almost two years after the launch of the first pilot site....

Website to list practice league tables.
January 14, 2009... Patients will be asked to rate their GP practices out of five so practices can be ranked in what will effectively be league tables, under a major drive by the NHS to create more competition. The NHS Choices site will gather feedback on...

GPs handed raft of hospital work.
January 14, 2009... Spending crisis forces PCTs to speed up hospital discharge, delay GP referrals and shift work into primary care By Nigel Praities GPs are to be asked to take on a raft of complex medical cases in the first half of 2009 as PCTs attempt...

IN BRIEF: NICE chair calls for clarity.
January 14, 2009... NICE must revamp the way it presents and communicates its clinical guidelines to GPs, the institute's chair Sir Michael Rawlins has admitted. He said GPs often struggled to cope with the volume of information from NICE and it was a `fair...

IN BRIEF: MMR uptake fears.
January 14, 2009... The UK has one of the worst levels of uptake of the MMR vaccine in Europe, according to the findings of a major study of 32 European countries. The World Health Organization estimates that coverage needs to be at a minimum of 95% for both...

IN BRIEF: Hubs cost #2bn a year.(Policy Exchange)(Brief article)
January 14, 2009... The system being used by many PCTs to procure the new network of GP-led health centres should be scrapped, according to a health policy think tank. A report by Policy Exchange said the collective hubs, which have helped PCTs to procure Lord...

IN BRIEF: Diabetes diagnoses rise.
January 14, 2009... One person is diagnosed with diabetes in the UK every three minutes, according to `shocking' statistics published by Diabetes UK. The charity says the number of people newly diagnosed with the condition is growing at the fastest rate ever, with...

LMCs beat credit crunch by bulk buying supplies.
January 14, 2009... Buying groups set up by LMCs to secure large discounts By Gareth Iacobucci LMCs are setting up buying groups to secure large discounts on medical supplies, in an attempt to help practices survive in the current difficult financial...

GPs face conducting COPD tests on everyone over 25.
January 14, 2009... GPs could be asked to conduct spirometry in everyone over the age of 25 years, under proposals being looked at by ministers to improve the detection of COPD. In an effort to pick up respiratory diseases earlier, experts have called for...

MEDIA WATCH: THIS WEEK'S TOP... Miracle cure.(use of Tetris by patients suffering from post-traumatic stress disorder)(Brief article)
January 14, 2009... It works for countless bored commuters trying to survive the trauma of their daily train journey to and from work. Now researchers reckon the computer puzzle game Tetris may be able to help patients suffering from post-traumatic stress...

MEDIA WATCH: THIS WEEK'S TOP... Scare story.(high-frequency hearing loss attributed to use of titanium golf clubs)(Brief article)
January 14, 2009... Getting the latest golf clubs could score you a double bogey, health- wise that is, after scientists claimed they might send you deaf, according to the Daily Mail, Scotsman and BBC Online. The claims came after an article in the BMJ...

MEDIA WATCH: THIS WEEK'S TOP... most pointless research.(Brief article)
January 14, 2009... How can GPs overcome the language barrier with non-English-speaking patients? The helpful answer is to have a `better dialogue'. Irish GPs were asked in a telephone survey what would help them communicate and 77% said translators would be of...

PCTs to take over in flu pandemic.
January 14, 2009... Neighbouring practices would be expected to join forces, with patients accessing antivirals via national helpline By Gareth Iacobucci GP practices will come under the direct control of PCTs and be be expected to `buddy up' with their...

Pandemic flu plans.
January 14, 2009... * PCTs to set up co-ordination centres, with a named pandemic influenza co-ordinator * GPs expected to `buddy up' with neighbouring practices to share resources and exchange staff as necessary * Patients with flu will get access to...

JOURNAL WATCH: Prior disease a CV risk.
January 14, 2009... Preventive programmes in primary care should prioritise the management of cardiovascular risk factors in patients with prior disease, says a study from New Zealand. The researchers quantified the cardiovascular risk of nearly 36,000...

JOURNAL WATCH: Pneumococcal doubts.(Brief article)
January 14, 2009... Pneumococcal vaccination may not be effective in adults, even in populations for whom the vaccine is recommended, a study concludes. The meta-analysis by UK and Swiss researchers looked at 22 trials of pneumococcal vaccine in 101,500...

JOURNAL WATCH: Bleeding stops drug use.(Brief article)
January 14, 2009... Superficial or nuisance bleeding is a common cause of clopidogrel discontinuation in patients taking antiplatelet therapy after cardiac surgery, according to US researchers. Their observational study looked at the outcomes of more than...

Patient expectations of OOH care `unrealistically high'.
January 14, 2009... Patients have `unrealistically high' expectations of out-of-hours care and achieving high levels of user satisfaction will be `challenging and potentially costly', a study has concluded. The survey of 1,249 patients found patients were...

Study steps up antipsychotics pressure.
January 14, 2009... GPs face fresh pressure over their prescribing of antipsychotics after a study found the drugs substantially raised the long-term risk of mortality in patients with Alzheimer's disease. Patients prescribed thioridazine, chlorpromazine,...

Movers and shakers 2009.
January 14, 2009... We asked a panel of more than a dozen leading GPs from across the profession to predict who would do most to shape general practice in the coming year. Here is their verdict GPs with influence The GPs set to have the greatest impact on...

LETTER: The true heroes are the GPs on the ground.(Letter to the editor)
January 14, 2009... From Dr Andy Black Leominster, Herefordshire I am very flattered to have been named a true champion of general practice in 2008 for my decision to resign from my local PEC in protest at the imposition of a Darzi centre...

LETTER: Square root reform won't make QOF fair.(Letter to the editor)
January 14, 2009... From Dr Peter Wilson Hounslow, London I would like to reply to Dr Alan Keith's letter (`I'm outraged at defence of square root', pulsetoday.co.uk/letters). I found Dr Adam Pringle's debate piece very reasonable. GPs usually choose the...

LETTER: GPs must show they can do minor surgery.(Letter to the editor)
January 14, 2009... From Dr Stephen Hayes GP in Southampton and committee member of the Primary Care Dermatology Society Dr Daniel Burrow is unhappy at being disallowed from removing basal cell carcinomas because of NICE guidance (`Accreditation call is...

LETTER: Minor surgery criticism is insulting.(Letter to the editor)
January 14, 2009... From Dr Joe Devlin, Londonderry I am very disappointed by Professor John Primrose's condescending and negative views on minor surgery in primary care, which unfortunately appear to be representative of many consultant surgeons (`Can GPs...

LETTER: Let's have a ratings website for ministers.(Letter to the editor)
January 14, 2009... From Dr Paul Manjooran Chester-le-Street, Durham Ah, more anti-GP propaganda (`Patients to review GPs on website', pulsetoday.co.uk/ news). When will this Government realise that in fact most GPs are doing a great job? It has already been...

LETTER: Data access for researchers will help everyone.(Letter to the editor)
January 14, 2009... From Dr Mark Walport Director, the Wellcome Trust In response to your article `Researchers want access to patient data without consent' (pulsetoday.co.uk/news), I would like to clarify the Wellcome Trust's position. Access to...

LETTER: Squeeze on PMS contracts is the last straw.(Letter to the editor)
January 14, 2009... From Dr Andrew Hamilton Unst, Shetland The squeeze on PMS contracts is just another example of the Department of Health, having allowed us a reasonable increase a few years ago, now finding it can't afford it and clawing back as much as it...

LETTER: General practice is not as simple as it seems.(Letter to the editor)
January 14, 2009... From Dr Lewis Miller, Belfast Once again in Baroness Young of the Care Quality Commission we see a well-intentioned policymaker coming on strong about the need for GPs to provide the best possible treatment for their patients (`Threat of...

EDITORIAL: Vascular screening descends into farce.(Editorial)
January 14, 2009... The start of the Government's much-trumpeted vascular checks programme is just months away. A series of PCTs have already introduced schemes of their own, as they gear up for the April launch of the national rollout. And still, as we learn this...

VOX POP: How are you feeling about general practice going into 2009?
January 14, 2009... Dr Elka Elston GP in Immingham, Lincolnshire `From a GP perspective, QOF points are going to cause problems. I'm hoping we're going to get less negative media coverage and pressure from the Government. In 2008, it was getting demoralising....

DEBATE: Are GP incentives an appropriate way of cutting referrals?
January 14, 2009... NO Rewarding reductions in referrals is grossly simplistic and inevitably leads to conflicts of interest, counters the GPC's Dr Simon Poole `How sick: GPs paid bonuses to not send patients to hospital.' The headline in the Daily Mail...

PULSECLINICAL: MANAGING HEADACHE - AN EFFECTIVE HEADACHE CONSULTATION.
January 14, 2009... In the first of a five-part series on headache, GPs Dr David Kernick and Dr John Fox look at the key elements of a successful consultation In the UK, 3% of GP consultations are for headache, of which 4% are referred to secondary care....

PULSECLINICAL: SUDDEN NECK SWELLING.
January 14, 2009... This smooth swelling on the neck of this child was worrying his mother. But what was it? Dr Mike Wyndham describes another case The patient This boy was almost four and perfectly fit and healthy. At least, that was what his mother...

PULSECLINICAL: DRUG MISUSE.
January 14, 2009... Drug and alcohol misuse specialist Dr Stefan Janikiewicz answers GP Dr Linden Ruckert's questions on methadone maintenance, benzodiazepine prescribing and managing drug users with alcohol problems 1 Is there a changing pattern to the use of...

LONG-ACTING REVERSIBLE CONTRACEPTION.
January 14, 2009... Sexual health GPSI Dr Meg Thomas offers tips on LARC promotion, use as emergency contraception and bone health 1 Take the chance to promote LARC when a young woman wants to go on the pill as she may be unaware of the option. This includes...

ASK THE EXPERT: UNFAIR COMPETITION.
January 14, 2009... Do these APMS practices have unfair advantage? I think I am the victim of unfair competition from APMS practices. The money available for APMS practices in Hounslow works out at #166.67 per patient year. This is a lot more than GMS...

ASK THE EXPERT: EMPLOYMENT LAW.
January 14, 2009... Can I ask a staff member off sick to come in? A member of staff recently rang into work saying she was ill and unable to come to work. The practice manager rang her at her home and more or less insisted she came in. As the first seven days...

BUSINESS BRIEFING: A FINANCIAL NEW YEAR'S RESOLUTION.
January 14, 2009... After a festive season of goodwill, ring in 2009 with a pledge to sort out your practices taxes, advises accountant Bob Senior At the start of a new year, one resolution that all GP practices should make is to ensure that they do not fall...

PULSESERVICES: Be clever with your investment portfolio.
January 14, 2009... To beat the recession you may need to think carefully when reviewing your investments. Stuart Smith explains how In view of the chaos experienced by financial markets around the world as a result of the so-called credit crunch, anyone who...

Tackling the qualifiers.
January 14, 2009... Phil has to overcome an inner conflict as his love of football clashes with his dislike of exams I don't do exams any more. I used to, in the old days. It seemed at one point that I didn't do anything else. I did my MB BS and then I did my...

GPs frozen out of Darzi plan rollout.
January 28, 2009... SHAs appoint three times as many consultants as GPs to Darzi implementation teams Exclusive By Steve Nowottny GPs are being frozen out of the rollout of Lord Darzi's plans for the NHS and given little say in key decisions that...

Controversial SHA plans.(Strategic Health Authority)(Brief article)
January 28, 2009... Paediatrics: NHS Yorkshire and Humber proposed that community specialists take over responsibility for routine paediatric care from GPs Urgent care centres: Several SHAs are planning urgent care centres, and claim they could take on up to...

MPs criticise rollout of NHS IT programme.
January 28, 2009... A report by the Commons public accounts committee has criticised the implementation of the Government's IT programme. In a damning appraisal of the rollout, MPs said the scheme had failed to meet clinical expectations, was way behind...

Confederation hails private firms' `success'.(Brief article)
January 28, 2009... Private-sector providers have successfully improved patient choice and access, the NHS Confederation has claimed. In its report New Providers, New Solutions, it said private operators had made significant improvements to local services -...

Delays and lack of support in arthritis care.
January 28, 2009... Insufficient GP expertise in diagnosing and managing rheumatoid arthritis as well as a lack of support services is hindering patient care, say health policy experts. A report from The King's Fund, based on surveys of 900 patients and 500...

REFERRALS CRISIS: Minor surgery row fuelled huge leap in referrals.
January 28, 2009... NICE skin cancer guidance driving rise in hospital activity, with figures showing jump in dermatology referrals Exclusive By Nigel Praities NICE's controversial skin cancer guidance appears to be fuelling the sharp rise in...

REFERRALS CRISIS: Early discharge from hospital fails to save NHS money.
January 28, 2009... PCT schemes discharging patients early from hospital fail in their primary aim of saving the NHS money, say researchers from the Cochrane Collaboration. Their review also uncovered some evidence that early discharge schemes might force up...

Profit squeeze forces GPs to review salaried contracts.
January 28, 2009... Practices are being forced to cut staff and renegotiate the contracts of salaried GPs as the credit crunch exacerbates the effect of successive pay freezes, writes Steve Nowottny. A Pulse snapshot survey of more than 100 practices finds GPs...

PBC bursts into life at last with leap in new services.(practice-based commissioning)
January 28, 2009... Rise in services commissioned suggests predictions of scheme's demise are exaggerated Exclusive By Gareth Iacobucci The Government's flagship practice-based commissioning scheme is finally showing signs of creaking into life, a...

PBC RIP?
January 28, 2009... The Government is considering a radical rebranding of PBC, which could include a change of name and might dilute the role of GPs. The DH is said to have discussed changing the strategy's title to `Clinicians in Commissioning', removing the...

One-third of trusts fail in duty on cCBT.(computerised cognitive behaviour therapy)(Brief article)
January 28, 2009... One-third of PCTs are still failing in their legal obligation to provide computerised cognitive behaviour therapy (cCBT), Pulse can reveal. Trusts cited a lack of funding or financial cutbacks for the failure to commission cCBT services,...

Green strategy urges remote consultations.
January 28, 2009... GPs will be encouraged to increase the number of consultations given by telephone and email, as the NHS desperately looks for ways to implement the recommendations of a hard-hitting report on cutting carbon emissions. The NHS carbon...

Alliance takes on GPC over local QOFs.
January 28, 2009... Alliance calls for some QOF points to be worth more in deprived areas By Lilian Anekwe QOF points should be weighted differently from one area to the next to take into account variation in the difficulty of hitting targets, the NHS...

Local QOFs for local needs.(Quality and Outcomes Framework)(Brief article)
January 28, 2009... Hammersmith and Fulham PCT is one trust planning to invest in local incentives `to focus on areas of identified need and provide the best value for the money spent'. A major element of the scheme includes setting `stretch targets' with...

Referrals warning over new CKD test.
January 28, 2009... The introduction of albumin-creatinine testing in patients with chronic kidney disease is proving chaotic and is set to swamp labs with samples, consultants are warning. A Pulse investigation reveals serious concerns that the introduction...

DH ignores NICE and backs 30-second stop-smoking plan.
January 28, 2009... The Department of Health is encouraging GPs to ignore NICE guidance and use a new 30-second intervention to encourage patients to quit smoking. Under the `3As' approach, GPs would ask patients what their smoking status was, advise on the...

OTC orlistat `may harm not help'.
January 28, 2009... Decision to sell drug without prescription prompts warnings that it may medicalise obesity problem By Lilian Anekwe Selling the obesity drug orlistat over the counter may harm rather than help the fight against obesity, public health...

Should orlistat be sold OTC?
January 28, 2009... FOR `The hope is that making it available OTC will attract new people to think about their weight and do something about it. It's like any OTC drug - its use needs to be monitored, but I don't see it being a problem.' Dr David Haslam,...

MEDIA WATCH THIS WEEK'S TOP... Miracle cure.(Brief article)
January 28, 2009... Developing a sunny and relaxed personality in morning surgery will not only make life easier for your patients and colleagues, but will also reduce your risk of dementia in later life, according to Swedish research reported by the Daily Mail...

MEDIA WATCH THIS WEEK'S TOP... Scare story.(Brief article)
January 28, 2009... A staggering five million women are grinning and bearing the monthly pain of `hormone headaches', reports a concerned Daily Mail. A survey found a third of the 50 (yes, 50) women polled said they were too busy juggling work and family to take...

MEDIA WATCH THIS WEEK'S TOP...most pointless research.(Brief article)
January 28, 2009... Diamonds are a girl's best friend and rich men are their extra special friends, according to research from the University of Newcastle. A study concluded wealthy men give their female partners better and more frequent satisfaction in the...

Acupuncture effective as migraine treatment.
January 28, 2009... Gold-standard reviews find `consistent evidence' to support the therapy By Nigel Praities Acupuncture is an effective treatment option for patients with migraine or tension headaches, according to two gold-standard medical reviews....

Ministers to crack down on crank therapists.(Brief article)
January 28, 2009... Acupuncture and herbal medicine may face tougher regulation, after the DH and the health ministers of the devolved administrations agreed a UK- wide consultation on the statutory regulation of complementary therapies. But a top Government...

Low-GI diets benefit diabetes patients.
January 28, 2009... A new analysis has concluded that low-carbohydrate diets can improve glycaemic control and reduce the number of hypoglycaemic events in patients with diabetes, writes Lilian Anekwe. The study, a Cochrane review of 11 randomised trials of...

WAITING-TIME TARGETS: Patients given `dummy' appointments through C&B.(Choose and Book)(Brief article)
January 28, 2009... Hospitals managing Choose and Book referrals are giving patients `dummy appointments' in a bizarre attempt to help meet waiting-time targets, Pulse has learned. South Devon Healthcare NHS Foundation Trust has become the latest trust to...

JOURNAL WATCH: Dual therapy best in PAD.(peripheral arterial disease)(Brief article)
January 28, 2009... Dual therapy combining aspirin with clopidogrel is more beneficial than aspirin alone in patients with peripheral arterial disease, a team of French and American researchers conclude. In the study of 3,096 patients, the rate of MI was 2.3%...

JOURNAL WATCH: Step up for dyspepsia.
January 28, 2009... A step-up strategy is best for the initial management of patients with new-onset dyspepsia in primary care, Dutch researchers suggest. A trial of 664 patients found treatment success after six months was achieved in 72% of patients in the...

JOURNAL WATCH: Renal impairment risk.(Brief article)
January 28, 2009... Reduced renal function in older people is associated with increased risk of adverse cardiovascular outcomes, an analysis of data from a trial of 5,804 patients on pravastatin has indicated. In an elderly population aged between 70 and 82...

SLOT RESTRICTIONS: PCTs take action over C&B misuse.(Choose and Book, primary care trusts)(Brief article)
January 28, 2009... PCTs across the country have begun taking formal action over the misuse of Choose and Book, serving hospital trusts with performance notices to improve their operation of the system and stop them restricting slot availability. Information...

GPs told to look out for 80 signs of child abuse.
January 28, 2009... Experts warn draft NICE guidance will not help detect maltreatment By Nigel Praities NICE guidelines encouraging health workers to blow the whistle on child abuse are impractical and are unlikely to be adopted by GPs, say experts. ...

When should GPs suspect maltreatment?
January 28, 2009... * Physical features such as bruising in the shape of a hand, eye trauma, fractures or linear marks suggesting attempted strangulation * Failure of provision or supervision such as abnormal growth patterns, unsuitable clothing or footwear,...