Pulse articles from July 2006

Pulse archives from July 2006

Ministers miss key deadline for PBC as chaos dogs scheme.(Practice Based Commissioning)
July 6, 2006... Two surveys show more than half of practices are turning their backs on commissioning By Helen Crump Practice-based commissioning is falling way behind schedule, with more than half of GPs shunning the scheme due to a catalogue of...

It's money for old rope.(Compensation and benefits)(Brief article)
July 6, 2006... Dr Mark Wood has got his practice-based commissioning money, but says his local plan is hardly worth the paper it's written on. Dr Wood, a GP in Barnstaple, Devon, said: 'I suspect most practices' probably don't run to more than a couple of...

GPSI halfway house plan revealed.(General practitioners with special interests)(Brief article)
July 6, 2006... The RCGP is developing plans for a 'practitioner with extended knowledge' grade to help more GPs develop a specialism. Under the proposals to be released next month, GPs who gained skills in a certain field during their SHO years could go...

GPs may have to ration flu vaccine in new shambles.(General Practitioners)
July 6, 2006... Delays in manufacture raise prospect of vaccine shortages once again By Danusia Osiowy GPs may have to reserve flu vaccines for their most vulnerable elderly patients this winter after the flu campaign was once again thrown into...

Scottish GPs show their quality.(General Practitioners)(Brief article)
July 6, 2006... GPs in Scotland scored an average of 1,026 points on the quality framework last year. Figures for the second year of the QOF reveal 153 practices scored the maximum 1,050 points. Only 21 of the 1,020 practices in Scotland scored fewer...

How we doubled our QOF points.(Quality of Framework)(Brief article)
July 6, 2006... The Torridon Medical Practice has had a remarkable year, almost doubling its QOF points from 532 to 1,016. Dr Caroline Brown and Dr Helen Stewart took over the practice in the Scottish Highlands two years ago. It had been run by locums for...

Ministers insist on therapy for patients out of work.(access to cognition therapy )(Brief article)
July 6, 2006... Pulse Action on depression GPs are set to get the improved access to talking therapies they have been demanding ' but under a controversial new scheme that makes therapy compulsory for patients who are off work, writes Cato Pedder. ...

CVD screening to be virtual.(cardiovascular disease)(Brief article)
July 6, 2006... The planned national screening programme for cardiovascular disease will use computer record searches to limit the effect on GP workload, Pulse can reveal. The committee is considering a new computer system capable of estimating Framingham...

HPV testing sends recall rate soaring.(Human papillomavirus)(Brief article)(Clinical report)
July 6, 2006... Human papillomavirus testing is feasible for screening but would dramatically increase recalls and referrals for women under 30, a major new study concludes. The ARTISTIC trial ' the largest-ever UK study of HPV testing as a primary...

InBrief: GP training funds needed.(General Practitioners)(Brief article)
July 6, 2006... The ratio of GPs to consultants has plummeted from 2:1 to 1:1 in recent years and will drop even further unless the Government invests more in GP training, MPs heard. Dr David McKinlay, director of postgraduate education at the North West...

InBrief: Drug choice in COPD.(Chronic Obstructive Pulmonary Disease)(Brief article)(Clinical report)
July 6, 2006... Beta-agonists double the risk of respiratory death in patients with COPD, but anti-cholinergics substantially reduce deaths, a new meta- analysis concludes. The researchers, whose study was published online by the Journal of General...

InBrief: STI incidence still rising.(sexually transmitted infections)(Brief article)
July 6, 2006... The rate of diagnosis of sexually transmitted infections continues to rise, new Health Protection Agency figures show. Workload in GUM clinics climbed 9 per cent and number of diagnoses by 3 per cent from 2004 to 2005. The FPA said it had...

InBrief: PBC risk assessment tool.(Practice Based Commissioning)(www.npsa.nhs.uk/site/media/documents/1823'PracticeBasedCommissioning.pdf)(Brief article)
July 6, 2006... The National Patient Safety Agency has developed a patient safety risk assessment process for GPs undertaking practice-based commissioning. Go to: www.npsa.nhs.uk/site/media/documents/1823'PracticeBasedCommissioning.pdf Copyright: CMP...

InBrief: Jaw risk warning.(biphosphonates usage should be carried with dental examination )(Brief article)
July 6, 2006... GPs have been advised by the MHRA that patients with risk factors for osteonecrosis of the jaw ' such as cancer, chemotherapy, steroid use and poor oral hygiene ' should have a dental examination before treatment with bisphosphonates. ...

InBrief: GP super-surgery cash.(General Practitioners)(community hospitals government aid)(Brief article)
July 6, 2006... GP super-surgeries could be built using part of a #750 million Government windfall for a new generation of community hospitals. PCTs must consult patients on whether they want a community hospital refurbished or replaced or whether they believe...

InBrief: Registrar safety training.(General Practitioners)(Brief article)
July 6, 2006... GP registrars will receive specific training in promoting patient safety from summer 2007. Joint guidance from the RCGP and National Patient Safety Agency adds it to the college's curriculum. Copyright: CMP Information Ltd.

InBrief: NICE guidance for NI.(National Institute of Clinical Evidence)(Northern Ireland)(Brief article)
July 6, 2006... NICE guidance is likely to become applicable across Northern Ireland under a new agreement between the institute and the Northern Ireland Executive. Guidelines will be assessed for their applicability. Copyright: CMP Information Ltd.

InBrief: Cigarette-buyer debate.(legal age for purchasing cigarettes)(Brief article)
July 6, 2006... The Government is to consult on raising the legal age for purchasing cigarettes. Three options will be considered for England and Wales: the status quo, raising the age to 17 and raising it to 18. The Government favours option three. ...

'Move to LIFT building or PCTs will use firms'.(Local Improvement Finance Trust)(Primary Care Trusts)
July 6, 2006... London GPs face increasing pressure over premises and surgery hours EXCLUSIVE By Anna Hodgekiss and Helen Crump PCTs in London are being ordered to bring in alternative providers if GPs refuse to move into expensive new NHS...

'Expensive' LIFT faces failure.(Local Improvement Finance Trust)(Brief article)
July 6, 2006... NHS LIFT is in danger of failing because it is more expensive than other methods of developing GP premises, an influential committee of MPs has concluded. A report from the Public Accounts Committee argues that LIFT must guarantee a...

Blair says GPs are worth it.(Tony Blair)(General Practitioners)(Brief article)
July 6, 2006... GPs are not overpaid, Prime Minister Tony Blair has told Pulse. But they must sign up to the Government's reform agenda to prove they are worth their new contract pay rises, he believes. Responding to a question about recent evidence...

Lifting mood at a sad time for patients.(medical practice growth)(Brief article)
July 6, 2006... Pulse Proud of our practice The long waits for bereavement support services being endured by the Bowburn Medical Practice's patients spurred practice manager Wendy Graham to train as a counsellor herself. Backed by the practice, Ms...

MediaWatch: 'X-ray breast cancer risk'.(Brief article)(Clinical report)
July 6, 2006... The Story Chest X-rays in the under-20s may double the risk of breast cancer, report the Times and Daily Mail. The Source Research published by the Journal of Clinical Oncology found women with defective BRCA 1 and 2 genes were 54...

MediaWatch: 'Pomegranate Ca hope'.(prostate cancer progression arrested with pomegranate juice )(Brief article)(Clinical report)
July 6, 2006... The Story A daily glass of pomegranate juice can slow progression of prostate cancer, the Daily Telegraph, BBC News Online and Reuters report. The Source Research published in Clinical Cancer Research shows that in patients who...

MediaWatch: 'Plastic brittle bones fix'.(fracture repair )(Brief article)
July 6, 2006... The Story Scientists have developed a jab to fix brittle bones by injecting them with a plastic solution, the Daily Mail reports. The Source Manufacturer Disc Orthopaedic Technologies claimed the new treatment ' called the Sky...

COPD register errors.(Chronic Obstructive Pulmonary Disease register with errors)
July 6, 2006... A quarter of patients on practice COPD registers do not have the disease By Daniel Cressey COPD registers are riddled with errors with many patients failing to meet criteria for diagnosis under the quality and outcomes framework, a...

Outsource climbdown.(primary care nursing contract)
July 6, 2006... DoH has to backtrack after advert reveals plan to contract out entire PCTs By Ian Cameron The Department of Health has been forced into a partial U-turn after its plans to contract out entire PCTs to the private sector provoked a...

Patients key to premises.(services)(Brief article)
July 6, 2006... Practices must be patient-orientated when bidding for premises and not complain too much about their existing surgeries. That was the advice from Dr Peter Swinyard, former-chair of the GPC premises subcommittee, to more than 120 GPs...

Brush up your musculoskeletal care skills.
July 6, 2006... GPs can update their knowledge on one of the most challenging clinical areas in general practice with the launch of a new Pulse seminar on musculoskeletal medicine. The one-day event is the first of a series of Pulse clinical seminars...

Balancing books harms PCT services.(Primary Care Trusts)(Brief article)
July 6, 2006... Pressure on PCTs to balance the books above all else is damaging efforts to redesign NHS services, GPs have told MPs. Dr James Kingsland, chair of the National Association of Primary Care, said costs may have to rise on occasion in order to...

Diuretics a top admissions cause.(hospital admission prevention)
July 6, 2006... Study shows diuretics are responsible for nearly one in six of preventable admissions from primary care By Danusia Osiowy Diuretics are the second most common cause of preventable, drug-related hospital admissions, ahead of a series of...

New vaccine call.(rotavirus vaccine included in the childhood schedule)(Brief article)
July 6, 2006... The Government's Joint Committee on Vaccination and Immunisation is to consider introducing a rotavirus vaccine into the childhood schedule. The committee decided to add rotavirus vaccination to its work schedule as RotaTeq last week...

Warning on child malaria.(perventive medicine)(Brief article)
July 6, 2006... Children travelling to countries where malaria is endemic are increasingly failing to take prophylactic medication, a new study reveals. Child health specialists urged GPs to set out the benefits of prophylaxis to parents after their...

Euthanasia opposed again.(law assistance for General Practitioners euthanasia service)(Brief article)
July 6, 2006... Nearly a third of GPs would help a patient to die if the law permitted, a survey reveals. Some 30 per cent of 200 GPs surveyed by pressure group Dignity in Dying said they would be willing in principle, if the law permitted, to write a...

Advisers take ministers to task over faulty vaccine IT.(Information Technology)(Brief article)
July 6, 2006... Government advisers on immunisation have protested to the Department of Health at the damaging effects of faulty computer systems for tracking child vaccination. The Joint Committee on Vaccination and Immunisation warned problems in...

GP fury over practice out to tender.(General Practitioners)
July 6, 2006... Salaried GPs have worked hard for two years to turn practice around only for PCT to offer it to outside bidders By Ian Cameron GPs in the North-East are embroiled in a furious row over a PCT's decision to put one of its...

'Cheap GPs' plan alert.(Brief article)
July 6, 2006... GPs are warning that a new breed of emergency care practitioners must not be used as a cheap alternative to doctors. The caution came after the Department of Health opened a consultation on a curriculum and competence framework for the...

GP hours affecting men's health care.(general practitioners)(Brief article)
July 6, 2006... Extending practice opening hours is vital for improving men's mental health, health minister Rosie Winterton has told MPs. Speaking in a parliamentary debate on the issue, secured by Dr Howard Stoate, Dartford MP and a practising GP, the...

MPs hear catalogue of disasters in NHS IT.(Medical Practitioners)(National Health Service)
July 6, 2006... Key projects delayed for up to two years due to failure to consult clinicians By Ian Cameron Connecting for Health's dismal failure to consult clinicians has led to delays of up to two years in key NHS IT projects, doctors have told...

An opt-in to Care Record demanded.(Patient Care Records)(Brief article)
July 6, 2006... The BMA and RCGP are to oppose the 'opt out' patient consent model for the National Care Record proposed by Connecting for Health. The association's annual representative's meeting last week voted that patients should have to give explicit...

'Raise penalties for data breaches'.(Breach data protection rules)(Brief article)
July 6, 2006... Connecting for Health is to lobby the Government for an increase in the penalties for NHS staff who breach data protection rules. Richard Granger, director general of the IT programme, told the Public Accounts Committee that the current...

GMC to set out new policy over medical education.(Brief article)
July 6, 2006... The GMC is to formulate a new policy on its role in regulating undergraduate medical education. It made the decision after the majority of respondents to a consultation on the issue called for reform. The three-month consultation...

Mocked Lord Warner warns GPs 'you are out of touch'.(General Practitioners Practice)
July 6, 2006... Health minister accuses GPs of resisting patient-friendly plans for longer opening hours Lord Warner was heckled and laughed at by GPs at last month's LMC conference, writes Ian Cameron. His comments on the 'statesmanlike' silence the...

GPs braced for BP challenge.(General Practitioners)(Blood Pressure)
July 6, 2006... NICE leaves GPs with dilemmas over Beta-blocker switch and first-line drug choice, Daniel Cressey reports 'Thiazides are excellent in patients who had a stroke and have heart failure, but otherwise I would go more for a C than a D' Dr...

Managing Beta-blockers switch.(Patients with heart failure, angina or previous myocardial infarction can stay on Beta-blockers)(Brief article)
July 6, 2006... * Around 20 per cent of patients with heart failure, angina or previous myocardial infarction can stay on Beta-blockers * The drugs can still be considered for younger patients, particularly women of child-bearing age * No hurry to...

Diuretic or channel blocker?
July 6, 2006... * ALLHAT found that a thiazide-type diuretic was better than a calcium channel blocker or an ACE inhibitor for preventing major forms of cardiovascular disease JAMA 2002;288:2981-97 * A recent sub-study of ALLHAT also found treatment...

JournalWatch: Night BP predicts HF.(Blood Pressure Predicts Heart Failure)(Brief article)
July 6, 2006... A high night-time blood pressure predicts future risk of congestive heart failure, a Swedish study reveals. The prospective study included 951 elderly men free of congestive heart failure who received 24-hour ambulatory blood pressure...

JournalWatch: ARB best for diabetes risk.(Angiotensin receptor blocker)(Brief article)
July 6, 2006... High-risk hypertensive patients have a lower risk of diabetes on a angiotensin receptor blocker than on a calcium channel blocker, the international Value trial reports. The researchers compared use of valsartan and amlodipine with or...

JournalWatch: Metformin safe in mother.(Brief article)
July 6, 2006... Metformin use by nursing mothers does not affect the health or development of the child, say US researchers. Their study compared 61 nursing infants and 50 formula-fed infants born to mothers with polycystic ovary syndrome on 2.55g...

JournalWatch: Methadone heart risk.(Brief article)
July 6, 2006... Methadone use in former intravenous drug users can increase the risk of long-QT syndrome, Swiss and US researchers conclude. The study compared the effect of methadone in 167 users and 80 controls, after analysing data from all active or...

JournalWatch: Paracetamol Ca benefit.(Brief article)
July 6, 2006... Use of paracetamol may reduce the risk of ovarian cancer, a new meta- analysis by Greek researchers concludes. The researchers conducted a comprehensive search for articles published up until 2004, and analysed data from four case-control...

Letter: More pay for less work was the whole point.(Letter to the editor)
July 6, 2006... From Dr Glyn Phillips East Kilbride, Lanarkshire So Professor Sibbald thinks we are being paid more for working less (News, 22 June)? Surely this was the intended outcome of the new contract - to correct the iniquitous under-rewarded and...

Letter: Guidelines are written backwards.(Letter to the editor)
July 6, 2006... From Dr Adrian Midgley Exeter I read with interest the warning of the risk of legal consequences for GPs who don't follow guidelines - in this case the NICE guideline on suspected gynaecological cancer referral (News, 15 June). Not for...

Letter: Training place cuts are catastrophic for patients.(Letter to the editor)
July 6, 2006... From Dr Arun Sharma Joint PEC chair, Barking and Dagenham PCT Open letter to Professor N Jackson, Dean of postgraduate general practice education, London deanery It is with considerable dismay I note the decision by the London deanery...

Letter: Commission supports PBC.(Letter to the editor)
July 6, 2006... From Andy McKeon Managing director, Health Audit Commission Your story 'Watchdog delivers wake-up call over PBC shortcomings' (News, June 15) will have left readers in the dark on a fundamental point about our new publication on...

Letter: Get involved in substance misuse care.(Letter to the editor)
July 6, 2006... From Dr David Lansley Lincolnshire I don't know what the provision of services for methadone maintenance prescribing is like in Sunderland, where Phil Peverley works. Probably poor if the picture he portrays is accurate, with 'another...

SecondOpinion Andy Jones: A win-win situation.
July 6, 2006... There aren't many win-win situations in health care economics at present. But one of them appears to be cognitive behaviour therapy. I recently attended a seminar on CBT. I was told that, unlike counselling, CBT works. I was told it is the...

Q&As: Am I covered out-of-hours?(General Practitioners)(Brief article)
July 6, 2006... Q I am a GP partner and also work for an out-of-hours organisation. Is this work included in my medical defence cover? A This is something you must clarify with your own defence body. We have confirmed that for at least one of the cover...

Q&As: Records after patient death.
July 6, 2006... Q The wife of one of our patients who recently died has asked for copies of her husband's medical records. However, a few months before he died, he wrote to us saying his wife was not to have access to his medical records. May we release them...

Q&As: Names on letterheads.(General Practitioners)(Brief article)
July 6, 2006... Q I am a doctor working at a practice under the flexible career scheme. Our practice manager insists that for 'legal reasons' my name must be removed from the practice letterhead. Is this true? A Your practice manager probably believes you...

Blowing the dust off systems that foil fraud in the practice.
July 6, 2006... Practice fraud is always a threat - so be prepared When we discovered a fraudulent transaction on our practice credit card recently it made us realise that we had not reviewed our financial governance procedures for some time. On paper...

PulseClinical: Need to know Back Pain.(Chiropractic/osteopathy in comparison with physiotherapy )
July 6, 2006... Dawn Carnes and Professor Martin Underwood sift through the evidence on the common problem of back pain, in response to questions from GP Dr Graham Archard 1. How effective is chiropractic/osteopathy in comparison with physiotherapy for...

BITESIZE EVIDENCE: Fish oils don't cut risk of CVC.(Cardiovascular disease)(Brief article)
July 6, 2006... Q Do omega 3 fatty acids decrease mortality, cardiovascular disease or cancer in adults? Synopsis The authors of this review identified 48 randomised controlled trials and 41 cohort studies evaluating the effect of fish oil...

PulseClinical: How not to miss Pulmonary Embolism.
July 6, 2006... Dr Antony Crockett advises on key diagnostic signs and pitfalls Worst outcomes if missed * Death Mortality can be reduced from 30 per cent in untreated cases to below 10 per cent by rapid and effective treatment. * Pulmonary...

Is patient with well-controlled diseases abusing appointments system?
July 6, 2006... CASE HISTORY Mrs Smith suffers from diabetes, hyperlipidaemia and hypertension; these are all well-controlled and monitored regularly by you and the practice nurse. But Mrs Smith consults frequently in addition to her chronic disease...

PulseRegistrar: Tips for passing the video module.
July 6, 2006... The MRCGP exam assesses consulting skills by marking seven video consultations made with real patients in your surgeries, writes Dr Kamila Hawthorne. For candidates with genuine reasons for not being able to submit a videotape, there is...

PulseRegistrar: How much will I earn?
July 6, 2006... With reports of some GPs making #250,000 a year, many registrars are wondering what they can really expect to earn when they first qualify - Dr Jim Sherifi takes a hard look at the figures Summer heralds the time of year when most GP...

PulseComment: An own goal with PBC.(Brief article)
July 6, 2006... The Department of Health is probably rivalled only by the Football Association in its ability to make complete failure sound like progress. But its attempts to spin the fact two GPs in five have 'adopted' practice-based commissioning as the NHS...

PulseComment: Pay up, Mr Blair.(general practice in united kingdom)(Brief article)
July 6, 2006... 'It's very simple,' said the PM. GPs are not overpaid. Indeed, it's good that they're earning more. So it would hardly be fair to deny them their rightful and well-earned pay rise next year. Would it, Mr Blair? Pulse wants to champion your...

Pressure cranks up on CKD as GPs face tougher targets.(chronic kidney disease)
July 13, 2006... BP target of 130/80mmHg and tough anaemia management indicators may be in store Exclusive By Daniel Cressey GPs face even tougher targets for chronic kidney disease in future versions of the quality and outcomes framework. Pulse can...

How the CKD targets could look.
July 13, 2006... * Proportion of people on the CKD register with a blood pressure below 130/80mmHg * Proportion with proteinuria >1g/day whose blood pressure is below 125/85mmHg * Proportion who have had haemoglobin measured in the last 15 months ...

GMC set to probe `complaints bias'.(Brief article)
July 13, 2006... The GMC is to launch a three-pronged investigation into whether its procedures are biased against doctors who qualified outside the UK, writes Helen Crump. The move has been prompted by research showing the council has referred a far...

GPSIs to undergo tough new system of accreditation.(licensing and certification)
July 13, 2006... DoH moves to stop `every Tom, Dick and Harry calling himself a GPSI' Exclusive By Anna Hodgekiss A stringent national accreditation system for GPs with special interests is to be introduced in the autumn, Pulse can reveal. Under...

Storm over new grade of clinicians.(Brief article)
July 13, 2006... Government plans to call a new grade of clinicians `medical care practitioners' have come under fire from organisations across the NHS. Responses to a Department of Health consultation have demanded the US title on which the grade is based...

I'm working longer and harder.(Letter to the editor)
July 13, 2006... Dr Steve Haigh has no truck with research (Pulse, June 22) showing GPs are working four hours a week less under the new contract. He has been doing his own time and motion study since 1997 and it shows he's working just as long as he ever...

A Vision of the next QOF?(Brief article)
July 13, 2006... Indicators recommended last time which may make it next time around Obesity * Weight management advice or referral to a specialist Cancer * Review cancer cases to identify potential improvements in diagnosis Asthma *...

Anger at benefits move.
July 13, 2006... Expert panel recommendations may signal future direction of the QOF Incapacity GPs will be paid according to the number of mentally ill patients they help return to work under Government demands for changes to the quality framework....

Alcohol screening demand.(Brief article)
July 13, 2006... Alcohol The Department of Health appears to be determined to force screening for signs of alcohol misuse into future versions of the QOF. Pulse has learned that ministers submitted proposals to the expert review for the last round of...

Exception report threat.(Brief article)
July 13, 2006... Diabetes Expert advisers on the QOF review have advised that exception reporting should be scrapped for some diabetes indicators to avoid compromising the care of the most vulnerable. Pulse uncovered the recommendations as a study...

InBrief: GMC consults on hearings.(Brief article)
July 13, 2006... The GMC is to launch a consultation at the end of the year on whether to dispense with hearings in some conduct cases. Legislation allowing the GMC to employ `consensual disposal' of certain cases was approved by Parliament last week. ...

InBrief: Postnatal guidance.(Brief article)
July 13, 2006... GPs should routinely ask pregnant women and new mothers about their mental health, draft NICE guidance on pre- and postnatal mental health states. Released for consultation this week, the guidance calls for GPs to offer women with mild to...

InBrief: GPs fight off PCTs' cuts.(Brief article)
July 13, 2006... GPs in Cambridgeshire have won their battle with two PCTs which had threatened to cut up to #30,000 from their PMS practices' budgets. Dr Guy Watkins, chief executive of Cambridgeshire LMC, said plans by Cambridge City and South Cambridgeshire...

InBrief: Learning difficulty check.(Brief article)
July 13, 2006... The RCGP has been commissioned by the Department of Health to examine the potential for GPs to conduct annual health checks in people with learning difficulties. The college's Learning Disability Group will assess various models of care and...

InBrief: Stroke service criticism.(Brief article)
July 13, 2006... Hundreds of stroke patients are dying unnecessarily each year because the Government is not giving stroke due priority, MPs have said. Stroke should be treated as a medical emergency and more patients should be cared for in specialist stroke...