Pulse articles from July 2004

Pulse archives from July 2004

Enhanced services crunch.
July 5, 2004... GPs' patience with primary care organisations over their continued refusal to agree satisfactory enhanced services deals is about to run out. A Department of Health deadline of June 30 for PCOs to agree deals on `baskets' of services and...

700 new patients - but income has dropped.(Brief Article)
July 5, 2004... GPs at the Chafford Hundred practice are baffled after being told their weighted list has fallen even though they have taken on more than 700 patients this year. In February the Essex practice's actual list was 12,309 and its weighted...

GPs running risk of hepatitis.
July 5, 2004... GPs are putting themselves at risk from a range of infectious diseases because of failures to report needle stick incidents and gaps in their immunisation. Just 56 per cent of blood exposure incidents that occur in practices are formally...

Patient choice may mean conflict in consultations.(Brief Article)
July 5, 2004... Ministers' plans to extend choice in primary care may harm continuity of care and will increasingly put GPs in difficult situations with patients, GPs are warning. In a Government-backed document on the impact of the proposals, GPs also...

Benefits clinic can transform lives, says GP.(Brief Article)
July 5, 2004... Dr David Memel believes a five-minute assessment of patients with arthritis can transform lives - by identifying people who are underclaiming for disability living allowance. With his fellow researchers, Dr Memel, a GP in Bristol, used the...

GPs told to press for PGEA payment.(postgraduate education allowance)(General practitioners)(Brief Article)
July 5, 2004... GPs who were paid postgraduate education allowance in arrears must insist primary care organisations make the final quarterly payments this year, the GPC has said. The instruction came after GPs in some areas complained PCOs had refused to...

Medication errors cost millions in pay-outs.(Brief Article)
July 5, 2004... Medication errors account for up to one in four negligence claims against GPs and cost defence bodies millions of pounds each year, new figures reveal. Failure to monitor long-term medicines like warfarin and steroids correctly,...

Hep C campaign leaves GPs in dark.(Hepatitis C)(general practitioners)(Brief Article)
July 5, 2004... GPs face a new Government action plan on hepatitis C `in the dark' over the disease and unsure how they will be paid for the expected surge in requests for testing. The Government announced a massive public awareness campaign last week to...

Chronic disease focus `to cut workload'.
July 5, 2004... The Government's drive to transform the management of chronic diseases will dramatically reduce GP workload, cut hospital admissions and save PCTs vast sums of money, two new analyses claim. But while the RCGP welcomed the focus on chronic...

Elder abuse plan rejected.(Brief Article)
July 5, 2004... The Government has rejected calls for GPs to perform three-monthly medication reviews in care homes, saying PCTs should commission locally enhanced services for the elderly if they feel the need. In its response to the health select...

GP takes a break on the high seas.(General Practitioner)(Brief Article)
July 5, 2004... Dr David Roche is taking a 10-month break from his practice to compete in the epic round-the-world yacht race, Global Challenge. Dr Roche said he decided to join the 17-man crew of The Firm after becoming demotivated at work and to raise...

No PMA questions on sexuality.(Positive Mental Attitude)(Brief Article)
July 5, 2004... Insurance companies are to be barred from asking GPs to speculate on a patient's sexuality under new guidelines for the industry. The Association of British Insurers said there had been `almost complete agreement' that GPs not be asked to...

Three months in, how's it going: URBAN GP.(Interview)
July 5, 2004... What has changed? We are recruiting a full-time practice nurse and a part-time salaried GP - the funding for that will come out of the aspiration payments and the quality money. We have been addressing the diabetes and coronary heart...

Three months in, how's it going: RURAL GP.(Interview)
July 5, 2004... What has changed? We have put in the GPASS software. It's all right. The biggest change has been about enhanced services. I have taken more blood pressures, I have got good staff who nag me to do that. I have asked patients if they smoke,...

Three months in, how's it going: COMMUTER-BELT GP.(Interview)
July 5, 2004... What has changed? We have got new software. I have been able to send out letters to patients to see what information is missing, for example for diabetic checks. We have also got two health care assistants - we had planned to have them...

Three months in, how's it going: DISPENSING GP.(Interview)
July 5, 2004... What has changed? We've accelerated an existing programme making sure coding was clean and clinical care was properly referred to in record keeping. We've started revisiting every pathway for chronic disease management. We are using...

Three months in, how's it going: SINGLEHANDED GP.(Interview)
July 5, 2004... What has changed? We are using templates to get chronic diseases as well as what patients are attending for, so if anything consultation are a couple of minutes longer. Our surgeries are fully booked and it's quite busy. How are you...

GP confusion over NSAIDs is putting patients at risk.(General Practitioner)(Non-Steroidal Anti-Inflammatory Drug)
July 5, 2004... Inappropriate prescribing of NSAIDs is putting patients at risk of gastrointestinal bleeds and cardiovascular events, a new study concludes. Just 37 per cent of elderly patients with arthritis were treated according to guidelines from the...

GP spots interactions risk in prescribing records.(General Practitioner)(Brief Article)
July 5, 2004... A GP has spotted a previously unrecognised source of prescribing errors that could be placing patients at risk from drug interactions. Dr Pawan Randev, a GP in Amersham, Buckinghamshire, noticed that GPs were often failing to record drugs...

NICE does U-turn on eczema drug.(National Institute for Clinical Excellence)(Brief Article)
July 5, 2004... The National Institute for Clinical Excellence has bowed to pressure from GPs and patients and provided limited endorsement for the use of immunomodulators in atopic eczema. The institute's final draft guidelines recommend pimecrolimus...

NHS's shame on overseas doctors.(National Health Service-services)(Brief Article)
July 5, 2004... BMA chair James Johnson has condemned the NHS's `shameful record' of exploiting doctors from overseas to deliver health care in the UK. In his opening address to the BMA's annual representatives meeting last week, Mr Johnson said...

A&E visits soar as out-of-hours opt-out confuses patients.(accident & emergency)(Brief Article)
July 5, 2004... Accident and emergency attendance has jumped by 10 per cent in the past year because patients believe they cannot see a GP out of hours any more, MPs have been told. Martin Shalley, president of the British Association for Emergency...

GP community hospital deal.(General Practitioner)(Brief Article)
July 5, 2004... The Welsh Assembly has agreed to negotiate national terms and conditions for GPs who work in community hospitals. GPC Wales chair Dr Andrew Dearden said a national framework could be adjusted according to local circumstances in the 60...

GP faces GMC for smacking three-year-old.(General Practitioner)(General Medical Council)(Brief Article)
July 5, 2004... A GP with an unblemished 30-year record is facing a fight to save his career after he smacked a child who kicked him in the groin. Dr Martin Wolfson is being investigated by the GMC and could face misconduct charges over the incident in...

PCOs support postcode lottery.(primary care organisations-services)(Brief Article)
July 5, 2004... Primary care organisations support postcode variations in services, a survey of NHS chief executives in England finds. Some 70 per cent of 100 chief executives of PCOs, hospital trusts and strategic health authorities said variations were...

JOURNAL WATCH: HRT may raise risk of dementia.(Hormone replacement therapy )(Brief Article)(Excerpt)
July 5, 2004... Hormone replacement therapy may increase the risk of dementia, according to new results from the US Women's Health Initiative memory study. In a randomised, double-blind trial, researchers compared oestrogen only and combination HRT with...

JOURNAL WATCH: Grapefruit juice ups blood statins.(Brief Article)(Excerpt)
July 5, 2004... Drinking grapefruit juice may increase the effectiveness of statins, but could also raise the risk of side-effects, a new study suggests. Researchers conducted a randomised crossover study in which 10 healthy volunteers drank 200ml of...

JOURNAL WATCH: Non-atopic wheeze `undertreated'.(Brief Article)
July 5, 2004... Children with non-atopic wheeze less often receive treatment than those with atopic wheeze, even though morbidity differs little between the two groups, a new study finds. Researchers conducted a whole population birth cohort study in...

JOURNAL WATCH: Aspirin risk for heart failure patients.(Brief Article)
July 5, 2004... Patients with heart failure who receive aspirin may be at increased risk of hospitalisation. In a US trial, researchers assigned 279 patients with heart failure to receive either 300mg/day aspirin, warfarin to a target international...

JOURNAL WATCH: Checklist spots development disorder.(children-health)(Brief Article)
July 5, 2004... A motor performance checklist could help to identify children who should be referred to community occupational therapy services, according to new research. The Australian study assessed the effectiveness of the checklist at identifying...

JOURNAL WATCH: Stress ups later risk of hypertension.(Brief Article)
July 5, 2004... Young adults who are prone to stress are at increased risk of hypertension later in life, according to a new study. Researchers began the study in 1985, enrolling 5,115 men and women aged 18 to 30 and subjecting them to a range of...

GPs urge MPs to probe growing role of drug companies in primary care.(General Practitioners)(Master Practitioners)
July 5, 2004... The health committee faces calls to investigate controversial partnerships between drug firms and PCTs - Cato Pedder reports The RCGP will present evidence to the health select committee on the creeping involvement of pharmaceutical...

Study dispels fears as patients manage anticoagulants safely.
July 5, 2004... Patients are capable of managing their own anticoagulation therapy, a new study suggests, brushing aside fears that self-monitoring would not be safe. The RCGP regards monitoring anticoagulants as sufficiently tricky to merit a new...

Controversy on Alzheimer drug.(Brief Article)
July 5, 2004... GPs have been urged to continue to follow the advice of secondary care clinicians on the prescribing of an Alzheimer's drug, despite an NHS study that found it to be a waste of money. The five-year study, which was carried out in...

Benefit of statins depends on genes.(genes influence on anticholesteremic agents)(Brief Article)
July 5, 2004... Some patients will benefit more than others from taking statins because of their genetic makeup, a new study suggests. US research found patients with two common genetic polymorphisms experienced a smaller than normal reduction in...

Letter: Why I still oppose this mad OTC drugs policy.(Letter to the Editor)
July 5, 2004... The Government's ill-advised promotion of over-the-counter sales of powerful drugs, with serious and potentially fatal risks when improperly used, amounts to the release of safe and effective products into an unsafe and ineffective...

EDITORIAL COMMENT: The hole at the heart of the five-year plan.(Brief Article)(Editorial)
July 5, 2004... In its five-year plan for the NHS, the Government appears to want more of everything. More providers of care, more GPs with a special interest and more walk-in centres. More nurses to provide active case management of chronically ill people,...

Letter: Salaried partners and locums as valuable as principals.(Letter to the Editor)
July 5, 2004... Dr John Couch seems to imply that salaried partners and locums are less important to general practice medicine than principals (Features, June 28). General practice is changing and we should be pleased that our new GPRs are getting...

Letter: Stop whinging about locum pay and quit.(Letter to the Editor)
July 5, 2004... In response to Dr John Couch (Features, June 28) I have three points I would like to make: * As a part-time GP locum I consider it most definitely part of my job to do all clinical paperwork and phone calls at the end of every session,...

Letter: Outcry is needed to ensure our survival.(Letter to the Editor)
July 5, 2004... I am not surprised Professor Sir Brian Jarman thinks the Government is out to destroy general practice (News, June 28). I am surprised he has only just recognised it as fact. Ever since the Steel Lady introduced an invoicing system in 1990...

Letter: Don't give up: fight the good fight for patients.(Letter to the Editor)
July 5, 2004... It was disappointing that neither Labour nor the Conservatives felt it appropriate to discuss their plans for the NHS with clinicians (News, June 28). After all, what do we know about treating patients? At the heart of patient care in the...

Letter: It was like a bereavement - but now practice budgets are back.(Letter to the Editor)
July 5, 2004... With the updated NHS Plan containing two paragraphs that reinstate practice budgets in the form of practice-led commissioning, a real opportunity opens up now for general practice. Do not forget some of the proven advantages of practice...

Letter: I question my sanity at putting up with premises problems.(Letter to the Editor)
July 5, 2004... My premises have been cancelled by my PCT just as the developer is to move on to site. I have been in temporary accommodation for nine-and-a- half years. The whole thing stinks. The development is for 20,000 patients (four practices and 10...

Letter: Thankfully I won't be here to see decline in practices.(Letter to the Editor)
July 5, 2004... I read the article on the future of general Practice by Dr John Couch (Feature, June 14) and felt very thankful I am close to the end of my medical career rather than at the beginning. I can well remember that one of my motivations for...

Letter: Getting hereditary angiodema help.(Letter to the Editor)
July 5, 2004... Regarding your Answerback item on hereditary angioedema (May 24), the Primary Immunodeficiency Association website may be a helpful resource (www.pia.org.uk). Patients with hereditary angioedema now form the second biggest group (after...

Letter: How can we raise premises funding?(Letter to the Editor)
July 5, 2004... In 1986 I started my own singlehanded practice from a small residential property. That was the only time I was assisted with PCT funding. Now we are a PMS practice with two doctors. Our premises are very small for two doctors, a practice...

Letter: Double whammy on our pension pockets.(Letter to the Editor)
July 5, 2004... Surprisingly little has been written about employers' superannuation payments under new GMS. Colleagues I have spoken to look bemused when I ask if they are out of pocket. The truth, I believe, is that for any GP earning more under the new...

Letter: Cognitive behaviour therapy pioneers.(Letter to the Editor)
July 5, 2004... I'd like to congratulate Dr Steven Harris who has started cognitive behaviour therapy in his surgery (News, June 14), but I hate to disagree that he is the first to do this. We started this type of therapy in our practice way back in 1986, 18...

Letter: No need for stressed doctors to feel isolated.(Letter to the Editor)
July 5, 2004... I read with sadness the article about lack of support for stressed GPs (News, June 21). Difficulties can arise at any point in a doctor's life when it would be inappropriate for colleagues to provide support. Precisely for this reason,...

Letter: GP expert advisers are needed for complaints procedure.(Letter to the Editor)
July 5, 2004... Regarding your article `Complaints caseload is set to surge' (News, June 14), the emphasis of the NHS complaints procedure remains local resolution. The Healthcare Commission, in designing the new service, used a planning figure of up to...

Letter: How we take ear temperature is in urgent need of a rethink.(Letter to the Editor)
July 5, 2004... I write to congratulate Dr Michael Blackmore (Letters, June 14) for drawing attention to the inaccuracy of infrared ear thermometers. My experience with them is just the same. It is interesting to know that his local hospitals abandoned...

Inhaled steroids for milder asthmatics.
July 5, 2004... Dr Mark Levy discusses new advice and ways to persuade patients that the benefits outweigh the risks It has been estimated that more than half a million extra patients with mild asthma ought to be taking inhaled steroids following changes...

LEARNING FROM ILLNESS: Autism.
July 5, 2004... Dr Sylvia Bond explains how with the right help her autistic son, James, is developing into a happy, affectionate boy Your son is autistic. Not a phrase you expect a parent to welcome, but for some it comes at the end of a long road to...

CLINICAL CASEBOOK: Angry relative of cancer patient.
July 5, 2004... Case history Helen has been diagnosed with stomach cancer. She and her husband are both aware of the prognosis. Helen has a very caring sister, Margaret, but does not want her to know too many details about her illness as Helen feels she...

ANSWER BACK: Preventing bone loss with inhaled steroids.(Brief Article)
July 5, 2004... Q: What should we do to prevent osteoporosis in women on inhaled steroids? A: There is a linear relationship between steroid exposure and bone density so any amount of steroid, even inhaled, causes some reduction. My advice is first to use...

ANSWER BACK: Three-or five-day course for cystitis?(Brief Article)
July 5, 2004... Q: Despite the 1998 SMAC guidance recommending a three-day antibiotic course for uncomplicated cystitis, a local microbiologist insists we should prescribe for five days. Is there any evidence for this view? A: I am unaware of any useful...

GP protest at premises freeze-out.(General Practitioner)(Brief Article)
July 12, 2004... Dr Raghu Lall has approached the Commission for Racial Equality after he says he was frozen out of a deal to share new premises. Dr Lall, a GP in Mitcham, Surrey, said he feels he was discriminated against when his share of a PFI-financed...

`It's too close to call'.(General Practitioners-elections)
July 12, 2004... Joe Lepper and Ian Cameron report The battle to become chair of the GPC is too close to call after committee members said there was little to choose between the two candidates. GPC members said this week's run-off between Dr Laurence...

Reid weighs call for patient MOTs.(Means of Testing)(Brief Article)
July 12, 2004... A Government-funded commission is calling for the introduction of annual or biannual health checks. A report by the Commission for Patient and Public Involvement in Health recommends routine checks as part of a raft of measures to...

Surge in PSA testing as affluent flock to their GPs.(Prostate Specific Antigen)(General Practitioner )
July 12, 2004... The rate of PSA testing has soared by a third since 1999, with GPs in affluent areas bearing the brunt of the surge, the most comprehensive UK study to date reports. The results suggest screening on demand is creating deep divides between...

GP battles elements on tough TV show.(Brief Article)
July 12, 2004... Dr Chris Creber and family carried out a dramatic house fire rescue and battled through a Royal Marine training course in an attempt to prove they are Britain's Toughest Family. Dr Creber's wife Maggie and teenage sons Ross and Hamish...

GPs risk GMC censure for charging drug reps.(General Practitioners)(General Medical Council)(Brief Article)
July 12, 2004... GPs are charging pharmaceutical company representatives for meetings in direct contravention of GMC rules, writes Cato Pedder. The Prescription Medicines Code of Practice Authority has criticised three practices for asking #100 a time for...

Study backs flu vaccine in all elderly.(Brief Article)
July 12, 2004... Flu vaccination cuts deaths and hospitalisations in all elderly patients, particularly those at relatively low risk of influenza, a new study finds. Previous research had been inconclusive - because of suspicions the `worried well' came...

Jobs crisis adds hour to GP's day.
July 12, 2004... GPs in areas where the workforce crisis is biting hardest have to spend more than an hour a day longer seeing patients, new figures show. The RCGP estimated the extra workload after analysing Department of Health figures, which showed...

PCTs cut long-term sick cover.(primary care trusts)(Brief Article)
July 12, 2004... GPs have been left `horrified' after a group of PCTs unveiled plans to restrict discretionary payments for locum cover while GPs are on long- term sick leave. The proposals by six PCTs in Berkshire include paying only half the maximum...

GP premises to get cash boost.(General Practitioners)(Brief Article)
July 12, 2004... Health secretary John Reid is to announce a multi-million pound boost for GP premises this week. PCTs are expected to be given an extra #100 million to spend on all primary care premises, including GP surgeries. The cash will cover revenue...

Colorectal cancer screening beckons.(Brief Article)
July 12, 2004... The UK is on the verge of introducing national faecal occult blood testing to screen for colorectal cancer, after publication of conclusive results from five major pilot studies. Screening successfully and cost-effectively detected cancers...

GP warning on drug storage.(General Practitioners)(Brief Article)
July 12, 2004... Dr Brian Chrichton believes GPs are putting themselves at medicolegal risk by failing to store drugs at the correct temperature. Dr Chrichton, a GP in Solihull, West Midlands, recorded temperatures of up to 40.5 degrees C in sealed surgery...

Stroke targets tougher than Q&O.(prevention-guidelines)(Brief Article)
July 12, 2004... New guidelines from the Royal College of Physicians urge GPs to go further than the quality and outcomes framework in the secondary prevention of stroke. The guidelines set tougher targets than the framework for controlling blood pressure, with...

NHS Direct report delay attacked.(National Health Service)(Brief Article)
July 12, 2004... The National Association of GP Co-operatives has criticised the Government for delaying publication of a national evaluation of NHS Direct. NAGPC chair Dr Mark Reynolds said he was `upset' that an independent study on pilot sites testing...

GMC expects more flak on revalidation.(General Medical Council)(Brief Article)
July 12, 2004... The GMC has admitted it expects the Shipman Inquiry to make further criticisms of its plans for revalidation when it reports later this year. GMC chief executive Finlay Scott said the council was in a `period of uncertainty' until the...

German GPs flown in.(General Practitioners)(Brief Article)
July 12, 2004... German doctors could be flown in to cover out-of-hours shifts in up to 10 PCTs. Trusts in Norfolk and west Hampshire have already used the GPs to fill gaps in night and weekend rotas. Locum agencies bringing the doctors to the UK said...

Concerns over Primecare.(ombudsman-investigations)(Brief Article)
July 12, 2004... The Health Service Ombudsman has reported concerns over commercial deputising service Primecare's quality of care, communication with patients and record-keeping. In her latest report, the Ombudsman Ann Abraham said: `In the last six...

Dispute over opt-out date.(Brief Article)
July 12, 2004... A row has broken out between GPs in adjoining PCTs after one trust allowed its doctors to opt out four months before the other. The dispute has arisen because the trusts share an out-of-hours co-op, North Yorkshire Emergency Doctors (NYED)....

Specialist GPs `cut referrals by 80%'.(General Practitioners-economic status)
July 12, 2004... The Government's GPs with special interests scheme can reduce waiting times and cut referrals to secondary care by up to 80 per cent, two audits suggest. The results contradict earlier claims that specialist GPs would merely generate more...

New alert over herbal remedies.(Brief Article)
July 12, 2004... GPs are being urged to quiz patients on their use of herbal medicines, with two new studies reinforcing the risk of potentially dangerous interactions with prescribed drugs. Daily doses of ginseng can significantly lower the blood...

Hib success leads to data review.(immunization programme)(Brief Article)
July 12, 2004... The Department of Health is considering adding a routine fourth dose of Hib vaccine to the childhood immunisation programme, after new data showed the Hib booster campaign was an overwhelming success. The number of confirmed cases of Hib...

GPs unlikely to get control of budgets.(General Practitioners)(Brief Article)
July 12, 2004... GPs are unlikely to be given control of their own budget to buy services by PCTs until the Government's practice-level commissioning initiative is well established. Giving practices `fully devolved' commissioning budgets was one of the...

Practices to commission care for `hot 100' patients.(Brief Article)
July 12, 2004... GPs in Cheshire West PCT are to take control of some of the primary care budget in a pilot practice-level commissioning scheme. Five or six practices are expected to become involved in the initiative. The move comes after the PCT...

GP persuades trust to raise surgery cap.(General Practitioner )(Brief Article)
July 12, 2004... Dr Neil McNeil believes he will be able to recoup #50,000 he invested in a minor surgery unit after his PCT increased its cap on procedures at his practice. He has now been commissioned for around 100 procedures a year, up from 13. The...

Victory on incapacity checks.(Brief Article)
July 12, 2004... The Scottish Executive is to change regulations that required GPs to issue certificates to prove patients are incapable of making a decision about their treatment. The move comes after GPs mounted a vigorous campaign against the Adults...

Coping with new contract: `Fearing pressures on drugs budget'.(Brief Article)
July 12, 2004... Coventry PCT remains worried about expected increases in the cost of prescribing as a result of the new contract. The PCT is grappling with a near #2 million overspend and believes the quality and outcomes framework will `inevitably' put...

Coping with new contract: `Struggling with GPs over closing lists'.(General Practitioners)(Brief Article)
July 12, 2004... Central Liverpool PCT is facing a struggle with GPs over the issue of when practices should be allowed to close their lists. The PCT is working with the strategic health authority and other trusts to try to resolve the issues but admitted...

Coping with new contract: `Enhanced services disputes rumble on'.(primary health care)(Brief Article)
July 12, 2004... Disputes over enhanced services are rumbling on in Central Manchester PCT despite its claims to have resolved outstanding problems. The PCT has agreed deals for national enhanced services covering intrapartum care, IUCD fittings and drugs...