Pulse articles from July 2007

Pulse archives from July 2007

Boycott throws care records into turmoil.
July 5, 2007... Future of IT system rollout under threat as BMA formally adopts policy of non-cooperation COMMON SENSE: ON IT By Steve Nowottny The future of the electronic care record has been thrown into turmoil with thousands of GPs set to...

Meldrum election sets off GPC race.(Hamish Meldrum)(Brief article)
July 5, 2007... Dr Hamish Meldrum's election as the new chair of the BMA has triggered a wide-open battle to replace him at the helm of the GPC. He stepped down as chair of the GPC after being elected as leader of the BMA at last week's annual...

Drug switching row: Government faces legal challenge on drug switching.
July 5, 2007... Pharmaceutical industry wins judicial review over bribes for GPs EXCLUSIVE By Cato Pedder The pharmaceutical industry is to take the Government to court in an attempt to halt the proliferation of drug switching schemes, Pulse has...

PCTs widen switching drive.(primary care trusts)(Brief article)
July 5, 2007... GPs are facing a swathe of fresh prescribing controls after NHS managers agreed targets for low-cost versions of a series of drugs on top of statins. Strategic health authorities have been discussing new prescribing controls since the turn...

GPC chair contenders set out stall.
July 5, 2007... Candidates to replace Dr Hamish Meldrum step up as GPs debate whether their new leader should be tougher By Tony Lithgow and Christian Duffin The election of a new GPC chair looks set to turn into a debate about whether the...

Minister plans surgery mergers.(Brief article)
July 5, 2007... Plans to merge GP practices in London into a series of so-called polyclinics may be extended beyond the capital, after the surgeon behind the plans was given a top job in Gordon Brown's new health team. Professor Sir Ara Darzi, appointed...

InBrief: Pulse breaks 80% barrier.
July 5, 2007... Latest official figures show 81% of GPs now read Pulse every week - our best-ever figures. The latest JICMARS readership survey strengthens Pulse's position as the best-read magazine in primary care. Thank you, once again, for your...

InBrief: BMA votes against APMS.(alternative provider medical services)(Brief article)
July 5, 2007... The BMA is to oppose the spread of alternative provider medical services. Doctors at the BMA annual representatives' meeting last week defied their leaders' caution to vote two to one against APMS. The vote to support a call by Berkshire GP...

InBrief: ECGs miss atrial fibrillation.(electrocardiography)(Brief article)
July 5, 2007... GPs are often unable to detect atrial fibrillation using electrocardiography, researchers have claimed. Their study, published in the BMJ, concluded electrocardiograms must be read by properly trained people to ensure correct diagnosis of...

InBrief: NHS Direct early warning.(Brief article)
July 5, 2007... The call volume at NHS Direct could be a useful early warning system for the spread of respiratory infections, according to new research. The Health Protection Agency study, published in the Journal of Infection, found at least half the...

InBrief: GPs battle flood chaos.(Brief article)
July 5, 2007... GPs were forced to abandon surgeries last week and some had to wade into work as torrential rain turned towns and cities in northern England into vast lakes. Other health centres were left without electricity for three days as floodwater...

InBrief: Folates treat depression.(Brief article)
July 5, 2007... Folate supplements could be used as a first-line treatment for depression, researchers have suggested. A meta-analysis of 11 studies, published in the Journal of Epidemiology and Community Health, found a clear link between depression and...

InBrief: Negotiator's leap of faith.(Brief article)
July 5, 2007... GPC negotiator Dr Stewart Drage likened the terror of a parachute jump to thrashing out a pay deal for GPs. Dr Drage, joint chief executive of Londonwide LMCs, did the jump last month for charities Help the Aged and The Brain Research...

InBrief: Doctor terrorists shock.(Brief article)
July 5, 2007... The profession has reacted with shock to news that several of the terrorist suspects being held by police after the attack on Glasgow airport and attempted bombings in London are NHS doctors. The men were reported to be foreign nationals...

England and Scotland in CVD risk mismatch.
July 5, 2007... Draft NICE guidance fuels fears over diverging healthcare systems By Daniel Cressey GPs in England and Wales will be taking decisions on statin use based on dramatically different risk evaluations from those in Scotland, a Pulse...

MPs back GPs on ephedrine scripts.(Brief article)
July 5, 2007... MPs have attacked the drug regulator's plans to make medicines containing ephedrine prescription-only, following warnings over the impact of the move on GP workload. The all-party parliamentary groups on primary care and public health...

Short sharp shock best for antibiotics.(Brief article)
July 5, 2007... GPs should consider a `short sharp shock' approach to antibiotic use as the most effective way of preventing resistant infections, researchers report. Their study found antibiotic exposure was a `strong risk factor' for resistant E. coli...

Johnson's arrival a ray of hope.(Alan Johnson )
July 5, 2007... Replacement of unpopular Patricia Hewitt as health secretary comes amid major departmental shake-up By Tony Lithgow GP leaders hope the appointment of former education secretary Alan Johnson as health secretary signals the end of the...

MediaWatch: `Stone Age diabetes diet'.(Brief article)
July 5, 2007... The story People at risk of diabetes should consider a `Stone Age diet', devoid of modern foods such as bread and dairy, to escape the disease, says the Daily Mail. The source Swedish scientists from Lund University studied the Kitava...

MediaWatch: `Obesity-dementia link'.(Brief article)
July 5, 2007... The story Britain's obesity explosion could trigger an epidemic of dementia, according to the Independent. The source At the launch of the Alzheimer's Society's `Be Headstrong' campaign, leading researchers in heart disease, stroke and...

Bone drugs for all ages.
July 5, 2007... NICE scraps controversial age limits for osteoporosis primary prevention By Jennifer Rigby NICE has scrapped its controversial age limits on osteoporosis treatment in last-minute changes to its primary prevention guidance. The...

BMA conference special: BMA plans major voting shake-up.
July 5, 2007... Radical revamp of voting procedure on the cards but new BMA chair escapes early re-election threat By Steve Nowotttny The BMA is to propose a radical shake-up of its voting procedures to allow rank and file members to elect its next...

Regulation changes will be profession's next big battle.(Brief article)
July 5, 2007... Proposed changes to professional regulation will be the BMA's `next big battle', the conference was warned. In a heated debate, representatives passed a series of motions opposing the plans outlined in the white paper, including proposals...

GPs keep quiet on violence.
July 5, 2007... Alarming attacks on GPs by their patients are repeatedly going unreported, Pulse can reveal. Concern over the scale of the problem will lead to a new drive by the NHS security management service to persuade GPs to adopt a zero- tolerance...

Call for easier early abortions.(Brief article)
July 5, 2007... Abortion legislation should be amended to give women easier access to early abortions, the BMA decided last week. Delegates voted to make first trimester abortion available on the same basis of informed consent as other treatment, removing...

Referral rules queried for postcoital bleeding.
July 5, 2007... Researchers warn younger women are left at risk by referral age limits By Jennifer Rigby Younger women are being left at risk by age limits on referral for postcoital bleeding, an analysis concludes. Researchers called for GPs to...

Breathing training helps ease asthma.(Brief article)
July 5, 2007... A breathing technique developed in the 1960s can reduce asthma symptoms by a third, a trial has finally proved. But GP experts warned patients could miss out as there was no funding. In the first-ever controlled trial of the Papworth...

JournalWatch: Glitazone cancer link.(Brief article)
July 5, 2007... Glitazones have been linked to cancer by a new US study. A diagnosis of cancer was significantly associated with use of the drugs even after correcting for potential confounders in the study of 1,003 patients with diabetes analysed by...

JournalWatch: SSRIs no birth-defect risk.(selective serotonin reuptake inhibitors)(Brief article)
July 5, 2007... SSRIs do not pose a major birth defect risk, according to a large-scale new study. Researchers in Boston found SSRI use did not increase the risk of previously linked conditions such as craniosynostosis, omphalocele or heart defects. They...

JournalWatch: Diabetes add-on benefits.(Brief article)
July 5, 2007... Addition of low-dose rosiglitazone to insulin therapy is an effective treatment for poorly controlled patients with type 2 diabetes, according to US researchers. Their 24-week, double-blind study of 630 patients with diabetes who were...

JournalWatch: Backing for etanercept.(Brief article)
July 5, 2007... Long-term exposure to etanercept does not cause more infections or adverse events than placebo, according to US researchers. A randomised trial of 618 patients with moderate to severe psoriasis using either placebo or 50mg of etanercept...

JournalWatch: HPV vaccine benefits.(Brief article)
July 5, 2007... The HPV vaccine has shown prophylactic efficacy and can be used for cervical cancer prevention, according to an international research group. In total, 18,644 women aged 15-24 received either the HPV16/18 vaccine or a hepatitis A vaccine....

Call for routine GP HIV tests.(Brief article)
July 5, 2007... Public health experts have called for routine HIV testing in GP surgeries to help identify thousands of undiagnosed individuals, writes Cato Pedder. With a third of HIV-positive people in the UK unaware they have the virus, leading doctors...

Analysis: NICE lipid guide takes middle path.
July 5, 2007... Institute's long-awaited guidance takes very different approaches to primary and secondary prevention By Lilian Anekwe It's finally here. The hotly anticipated, suitably controversial NICE guidance on lipid modification has arrived -...

Letter: Online health checks are just scaremongering.(Letter to the editor)
July 5, 2007... From Dr Lewis Miller, Belfast I was sufficiently intrigued by your article on the Government's new online health checks (News, 21 June) to try them out for myself. I found the site without difficulty, but things went downhill after that....

Letter: Statins are no universal panacea.(Letter to the editor)
July 5, 2007... From Dr Malcolm Kendrick, Cheshire, author of The Great Cholesterol Con It is time for a major rethink of statin prescribing (News, 14 June). Somehow these drugs have reached the status of universal panacea. Not only are they hailed as...

Letter: Pesticides do not cause Parkinson's.(Letter to the editor)
July 5, 2007... From Dr Anne Buckenham, director of policy, Crop Protection Association Your article on the Aberdeen University Study into Parkinson's (Media Watch, 7 June) may have caused readers undue concern about exposure to pesticides. The...

Letter: Skin cancer criticism insulting to GPs.(Letter to the editor)
July 5, 2007... From Dr John Tisdale, Truro, Cornwall I am responding to your article about researchers accusing GPs of ignoring NICE skin cancer guidelines (News, 14 June). First, guidelines are precisely that. They are not legislation and therefore...

Letter: I'd resign over out-of-hours demands.(Letter to the editor)
July 5, 2007... From Dr Paul J Searle, St Neots, Cambridgeshire Having worked on call from home for 17 years then in an out-of-hours co- op for nine, I cannot agree with Dr Krishna Korlipara (Letters, 7 June) that such arrangements are viable. When he...

Letter: Phil's insulted Bob's memory.(Phil Peverley, Bob Monkhouse)(Letter to the editor)
July 5, 2007... From Mr Mark Emberton FRCS, trustee of Prostate Cancer Research Foundation and consultant urologist, University College Hospital NHS Foundation Trust I felt compelled to reply to the article written by Phil Peverley (Columnists, 21 June)...

Dinah'sDiary: Dinah Roy.
July 5, 2007... Dinah considers breaking the hosepipe ban over smokers and suitors Monday Stop at services for cappuccinos for self and PM on way to surgery. Smoking ban enforced - hooray! However, forced to run gauntlet of wet smokers puffing away...

Opinion: Patients deserve so much more than to be treated as customers.
July 5, 2007... Dr Tim Heywood vents his fury over the idea GP surgeries should operate like 24-hour Tescos I am blue-in-the-face angry as I write this. On the Today programme this morning (in the business news of all places) I heard a `health consultant'...

PulseFinance: HOW TO BOOST INCOME FROM GMS AND PMS.
July 5, 2007... Maximising all forms of income is important for any business and is imperative for GPs since there will be no pay award this year - Dr James Gillgrass offers some practical advice Following the announcement in March that the Review Body had...

PulseFinance: CHECK YOUR SUPERANNUATION AND PLAN AHEAD.
July 5, 2007... Superannuation calculations are complex and in the present climate GPs would be well advised to keep an eye on developments and in particular on cash flow, says Dr John Couch If I have learnt anything about practice finance over the years...

PulseFinance - IT Q&A: TURNING ON MY COMPUTER AUTOMATICALLY.(question and answer)(Brief article)
July 5, 2007... Is your computer working rather more slowly than before? Dr Mark Smith shows how to kick-start it Q My surgery computer is very slow to start up in the mornings and I wish I could programme it to turn itself on in advance. Is this...

PulseClinical - WHERE ARE WE NOW?: PSA TESTING.(prostate specific antigen)
July 5, 2007... In the first of two articles this week focusing on prostate cancer, GP expert Dr Graham Easton examines the pros and cons of testing for prostate specific antigen and explores the fallout from this clinical controversy for GPs Many men...

PulseClinical: HOW SHOULD WE MANAGE PROSTATE CANCER?
July 5, 2007... Useful websites * www.cancerbackup.org.uk/Cancertype/ Prostate * www.prostate-research.org.uk * www.cancer.gov/cancertopics/pdq/ treatment/prostate/healthprofessional/ * info.cancerresearchuk.org/cancerstats/...

PulseClinical: ARE OATS SAFE FOR PATIENTS WITH COELIAC DISEASE?(Brief article)
July 5, 2007... Q Can people with coeliac disease safely include oats in their diet? Synopsis Many patients with coeliac disease are still advised to avoid oats. This recommendation is largely based on early uncontrolled studies, anecdotal evidence,...

PulseClinical: CHRONIC KIDNEY DISEASE.
July 5, 2007... References 1 Royal College of Physicians (Edinburgh). UK Consensus Conference on Early Chronic Kidney Disease. 2007 2 Keith DS. Arch Intern Med 2004;164:659:63 GP Dr Kathryn Griffith shares her expertise on managing CKD in primary...

PulseClinical: PROGESTOGEN-ONLY EMERGENCY CONTRACEPTION.
July 5, 2007... The Faculty of Family Planning and Reproductive Health Care shares answers it has given to questions from experienced family planning clinicians For women who attend more than 72 hours after unprotected sexual intercourse, can a...

PulseClinical - NEED TO KNOW: METABOLIC BONE DISEASE.
July 5, 2007... In this second and final article on bone conditions, Professor Juliet Compston answers questions from GP Dr Madhu Valuri Take-home points * Day case parathyroidectomy can be performed on even quite frail patients with hypercalcaemia....

PulseClinical - POSTOPERATIVE CARE: KNEE ARTHROSCOPY.
July 5, 2007... Mr Steffen Breusch and Dr Carlo Alonzi highlight the key considerations for GPs in managing patients who have undergone simple knee arthroscopy 1 POST-OP CARE Recommended activities * Gradually increase levels of activity *...

SHOULD YOU CANCEL SURGERY BECAUSE COMPUTER HAS GONE DOWN?
July 5, 2007... Three GPs share their approach to a practice problem CASE HISTORY The computer has gone down at the beginning of a busy surgery. You are a paperless practice and all the records are on the computer, including medication, allergies and...

PulseRegistrar: HOW TO READ PRACTICE ACCOUNTS.
July 5, 2007... If you're looking to join a new practice as a partner, you will need to look at its accounts before coming to a final decision. Dr Stefan Cembrowicz offers advice on what to look for Double entry bookkeeping - still the basis of today's...

PulseServices: Octopus launch will spread its tentacles.
July 5, 2007... One of the big investment firm success stories of recent years is to diversify - here's your chance to take advantage One of the success stories in the investment world over the last few years has been the rise of Octopus Asset Management,...

PulseCareers: TIME OUT: VOLUNTEERING AS A DOCTOR IN REMOTEST PERU.
July 5, 2007... Dr Jasmine Salih put her clinical skills to use in a completely different setting when she volunteered for a novel and lifesaving healthcare project in Peru The city of Iquitos in Peru is so remote it cannot be accessed by road. Earlier...

PulseCareers - CareerCoach: Avoiding burnout.
July 5, 2007... Prevention is better than cure. Dr Mike Wyndham advises how to avoid burnout, a condition not uncommon in GPs Defining burnout * Burnout is present when an individual who normally aspires to high achievement finds they lose the passion...

PulseComment: BMA must learn lesson.(British Medical Association)(Brief article)
July 5, 2007... COMMON SENSE: ON IT Amid dramatic scenes last week, delegates at the BMA's annual representatives' meeting ignored the pleadings of their leaders, and voted to have nothing to do with the Government's care record plans. The move, which...

LAST WORD.
July 5, 2007... Dr Andrew Mimnagh... on being the baddest thing on the street The best thing about my practice is the friendliness of my colleagues and staff. And the worst is the mezzanine floors and no lift for patients. My greatest fear is not...

Practices hit by QOF gaming accusations.(Quality and Outcomes Framework)
July 6, 2007... GPs `manipulate' prevalence data to boost pay * 11% of exception reports `inappropriate' EXCLUSIVE By Jennifer Rigby GPs have been hit with fresh accusations that they have `gamed' the quality framework, with a major new report...

`That's rich, coming from politicians'.(Brief article)
July 6, 2007... Dr Rob Barnett, secretary of Liverpool LMC, angrily rejected the accusations - insisting GPs would never risk their livelihood for `an extra pound'. Dr Barnett said: `There's no evidence in my area of any record manipulation. You'll get a...

How conclusions were reached.(Brief article)
July 6, 2007... * Hypothesis: practices use first-year QOF performance to inform reporting the following year * Analysis of prevalence reporting across eight disease domains, and exception reports in 41 indicators * Found prevalence increased in...

Choose & Book delays urgent cases.(booking service)(Brief article)
July 6, 2007... COMMON SENSE - ON IT A report is calling for a revamp of Choose and Book's software after finding some patients are failing to receive urgent appointments, writes Laura Doherty. Poorly trained staff left to make bookings were...

GPs in care record pilot split in row on patient consent.(general practitioners)
July 6, 2007... Group of GPs refuse to take part, with even LMC split over implied consent CAMPAIGN: COMMON SENSE - ON IT By Steve Nowottny A row has broken out between GPs in the pilot area for the rollout of Connecting for Health's...

`Lives at risk' from GP maternity cuts.(Brief article)
July 6, 2007... Mothers and babies are being put at `considerable risk' because of reductions in funding for GP maternity care, the RCGP has warned. The college claimed GPs were being `systematically excluded' from antenatal care, in its submission to a...

Row in store over BMA chair vote.
July 6, 2007... BMA members are to vote on a major shake-up of the organisation's leadership after GPs branded its election procedures unrepresentative. Pulse can reveal the annual representative meeting later this month will debate a call for voting for...

Council faces stormy waters at annual reps' meeting.(Brief article)
July 6, 2007... * BMA council members have told Pulse they expect the annual representative meeting, which runs from 25 to 28 June in Torquay, to be one of the stormiest in its history * Among issues to be discussed is a possible breakaway from doctors'...

Legal challenge to proof standard.(Brief article)
July 6, 2007... A medical defence body is threatening to take the GMC to a judicial review over its plans to bring in a civil standard of proof to determine whether a doctor is fit to practise. The GMC decided at its last council meeting to press ahead...

Civil standard will increase GP cases.(Brief article)
July 6, 2007... A former GMC case examiner predicts the number of doctors hauled before fitness-to-practise panels will increase by half when new civil standards of proof are brought in. Dr Krishna Korlipara, a GP in Bolton and veteran GMC member, claimed...

InBrief: Call for NHS independence.(Brief article)
July 6, 2007... Political meddling is damaging the NHS and it should become independent of Government, according toa thinktank. A report from the Nuffield Trust called for responsibility for primary care and hospitals to be passed to an independent NHS...

InBrief: Blow for obesity drug.(Brief article)
July 6, 2007... Obesity drug rimonabant is not a significant advancein the treatment of overweight patients, a review has concluded. The Drug and Therapeutics Bulletin concluded orlistat was a better choice for obese patients who had not lost weight...

InBrief: Renal units draft in help.(specialist nurses in Welsh renal unit)(Brief article)
July 6, 2007... Specialist nurses will be parachuted in to renal unitsin Wales struggling to cope with a surge in demand following inclusion of chronic kidney disease in the quality and outcomes framework. The Welsh renal national service framework says...

InBrief: NHS morale at all-time low.
July 6, 2007... Doctors have lost confidence in the Government and morale is at an all time low, the BMA's consultants conference was told this week. Dr John Fielden, chair of the BMA's consultants' committee, urged incoming Prime Minister Gordon Brown to...

InBrief: Clopidogrel counterfeiting.(Brief article)
July 6, 2007... Clopidogrel has become the latest drug to be hit by warnings of counterfeiting. The Medicines and Healthcare Products Regulatory Agency is requesting boxes of 75mg tablets, with batch numbers 3103/1 to 3103/20 inclusive, be returned to...

InBrief: #20 evening surgery fee.(Brief article)
July 6, 2007... A demand to make patients pay #20 to see their GP out of hours will be heard at the LMC conference next week. Dr Andrew Green, a GP in Hedon, East Yorkshire, has proposed the motion, claiming most people wanting to see GPs in the evening...

InBrief: SearchMedica's drug info.(Brief article)
July 6, 2007... GP search engine SearchMedica has launched a service to provide GPs with swift access to authoritative UK information on medicines and prescribing. The feature gives GPs direct access to the contents of a dozen leading medicines websites,...

GPs ignore NHS policy and chase JBS2 targets.
July 6, 2007... UK doctors also among first in the world to move away from diuretic use By Lilian Anekwe A majority of GPs are chasing aggressive cholesterol targets for secondary prevention against explicit Department of Health advice not to go...

`I ignore Government CVD advice'.(Brief article)
July 6, 2007... Dr Kathryn Griffiths refuses to be bound by Department of Health directions on how to treat patients with cardiovascular disease. Dr Griffiths, a GP in York and secretary of the Primary Care Cardiovascular Society, insisted: `For secondary...

Funding formula penalises GPs in Scotland and Wales.(Brief article)
July 6, 2007... GPs in Scotland and Wales are losing out in payments through the quality framework because of the way the funding formula is calculated. Funding for diabetes and heart disease fails to properly account for the extra workload in areas of...

QOF an `abysmal failure' in managing GP workload.(quality and outcomes framework )(Brief article)
July 6, 2007... The quality framework has failed to address key patient concerns or improve GP morale, a detailed analysis concludes. The study found the QOF had not improved access to care, and had `failed abysmally' to help GPs manage their workload. ...

Stop-smoking drug set to save #590m.
July 6, 2007... Varenicline given NICE approval and GPs prepared for `surge of interest' By Cato Pedder A stop-smoking drug newly approved by NICE has the potential to save hundreds of millions of pounds of NHS cash, data considered by the institute...

NICE recommendations.(National Institute for Clinical Excellence)(Brief article)
July 6, 2007... * Evidence from direct trials and systematic reviews carried out by the manufacturer and expert review group demonstrated varenicline was superior to NRT and bupropion in achieving continuous abstinence * Varenicline is recommended in its...

BMA's hard line on drink in pregnancy.(British Medical Association)(Brief article)
July 6, 2007... The BMA has called for a complete ban on drinking in pregnancy after criticising new Government advice for not going far enough. But some GPs were highly critical of the association's stance, saying it was patronising and unrealistic. ...

30% of oxygen orders go wrong.(Brief article)
July 6, 2007... The changeover of home oxygen provision is continuing to create havoc in primary care, with an error rate of 30% on order forms to private companies, Pulse has learned. The problem with home oxygen order forms is the latest addition to the...