Pulse articles from June 2003

Pulse archives from June 2003

GPs urged to take leap of faith.(general practitioners and June 2, 2003 contract vote)
June 2, 2003... GPs will finally get their chance to vote on the new contract from June 2 after the GPC voted overwhelmingly to take a high-risk gamble on a Yes vote. The decision came after GP negotiators won some of the concessions demanded by GPs in a...

Prescribing cash rewards focus on cost not quality.(Brief Article)
June 2, 2003... Cash-strapped primary care trusts are hampering GPs' efforts to improve the quality of their prescribing with unfair incentive schemes, Government-funded researchers are warning, writes Brian Kelly. In 52 per cent of PCTs, any practice that...

BMA polling reveals ballot result rests on knife-edge.(British Medical Association)(Brief Article)
June 2, 2003... The outcome of the contract ballot is too close to call, according to private polling by the BMA. But the proportion of GPs intending to vote in favour of the contract has risen sharply in recent weeks, boosting negotiators' hopes of a Yes...

Carr-Hill delay plan `too late'.(general practitioners' income guarantee)(Brief Article)
June 2, 2003... A last-ditch proposal from GPC members Dr Fay Wilson and Dr Gillian Braunold to delay moving to the Carr-Hill formula until 2005 was rejected as too late by negotiators. The plan, which mirrored an earlier proposal by the NHS Alliance, was...

GPs `fail' learning disability patients.(general practitioners)(Brief Article)
June 2, 2003... GPs `can't be bothered' to treat patients with learning disabilities and fundamentally misunderstand their condition, the chair of a Government taskforce has claimed. Michelle Chinery, co-chair of the learning disability taskforce, said...

Worst summer ever for finding locums.(substitute physicians need to spell general practitioners)
June 2, 2003... The prolonged contract delays are contributing to the worst summer ever for locum availability and leaving GPs facing costs of up to #2,000 a week if they can find cover. GPs around the UK say already acute locum shortages have been...

GP calls for a pneumococcal vaccine.(general practitioners)(Brief Article)
June 2, 2003... Dr Ian Kerss wants pneumococcal disease targeted as a national priority after his 11-year-old son almost died from the condition earlier this year. Dr Kerss, a GP in Carlisle, Cumbria, said the illness was difficult to diagnose in children...

CSM inquiry on HRT-dementia link.(hormone replacement therapy)(Brief Article)
June 2, 2003... The Government's drug safety watchdog is to scrutinise new research that suggests HRT doubles the risk of dementia in elderly women. New data from the US Women's Health Initiative study on the risks and benefits of long-term HRT use...

GP develops an altitude sickness aid.(general practitioners)(Brief Article)
June 2, 2003... Keen climber Dr Nigel Hart is developing a method of spotting the early symptoms of altitude sickness. The device uses angina spray GTN to predict whether climbers are more prone to suffering a cerebral oedema as they ascend to greater...

GPs' quality workload is linked to poverty.(general practitioners)(Brief Article)
June 2, 2003... The importance of weighting quality payments against practice disease prevalence has been hammered home after Government statistics showed a clear link between deprivation and several quality markers. Data released last week by the Office...

Co-ops are hit by helpline crashes.(general practitioners)(Brief Article)
June 2, 2003... GP co-operatives testing links with NHS 24 are being put under huge pressure as a result of repeated computer crashes at the nurse-led helpline. Ayrshire Doctors On Call, which linked up with the Scottish version of NHS Direct at the end...

GPs have `unhealthy' relationship with reps.(general practitioners)(Brief Article)
June 2, 2003... The BMJ has criticised GPs for relying too heavily on the pharmaceutical industry for information and education about drugs. The GPC reacted by strongly defending the relationship between GPs and drug representatives and claimed...

Outcry as negotiators agree a pay deal for salaried GPs.(general practitioners)
June 2, 2003... Non-principals condemned GPC negotiators for favouring GP partners as research offered a boost to salaried GPs - by Susan McNulty and Rob Gough Non-principals have blasted GP negotiators for recommending `woefully low' pay rates for...

Patients more satisfied with care given by salaried GPs.(general practitioners)
June 2, 2003... Salaried GPs are more productive and their clinical care is at least as good as their GMS counterparts, Government-funded research reveals. The study, which compared clinical care and workload at 10 salaried PMS and 10 GMS practices in the...

Poor pay will scupper new GP minor surgery target.(general practitioners)
June 2, 2003... GPs have denounced a new Government target for practices to carry out up to 285,000 more operations in the next three years. GPC members said continuing acute GP shortages and derisory funding for minor surgery as an enhanced service meant...

GPs are warned over Parvovirus upsurge.(general practitioners)(Brief Article)
June 2, 2003... Government scientists have warned GPs to be alert to cases of Parvovirus B19 infection amid a steep rise in cases in Scotland. A report from the Scottish Centre for Infection and Environmental Health shows there have been 261 reported cases...

Hanged GP `under pressure at work'.(general practitioner commits suicide)(Brief Article)
June 2, 2003... A GP who committed suicide last November was under tremendous pressure at work, an inquest has heard. Dr Nicholas Fenner, 47, a GP in Flintshire, was found hanged at his home in Gwernymynydd, near Mold. Dr Fenner's wife, Elizabeth,...

Government way off mark on appraisal workload.(general practitioners)(Brief Article)
June 2, 2003... The Government has grossly underestimated the time GPs will have to spend on appraisals, new research suggests. The analysis of a pilot appraisal scheme in Wales found GPs undergoing appraisal spent up to 15 hours on interviews, meetings...

Overseas GPs `lack tact to strike deals'.(general practitioners and primary care organizations)(Brief Article)
June 2, 2003... Dr Shiv Pande believes overseas GPs do not have the `expertise, experience or tact' to negotiate deals with primary care organisations on local enhanced services. The chair of the British International Doctors Association - formerly the...

GPC denies province has enough GPs.(general practitioners)(Brief Article)
June 2, 2003... The GPC in Northern Ireland has rejected claims by the Department of Health, Social Services and Public Safety that GP numbers in the province are `more than adequate'. It argues an extra 300 GPs are needed to cope with workload and even...

Major flaws in letters GPs get from A&E.(general practitioners, emergency departments)(Brief Article)
June 2, 2003... Computer-generated letters sent to GPs by A&E departments after they have treated patients often lack crucial information and give wrong diagnoses, research has found. Inaccuracies or wrong diagnoses were found in 46 per cent of 300...

GP hits out at #1m out-of-hours deal.(general practitioners)(Brief Article)
June 2, 2003... Dr Eric Rose has condemned a PCT for awarding an out-of-hours contract to a commercial deputising service which forces GPs to either work shifts or lose their out-of-hours development money. He accused Herefordshire PCT of acting...

GPs risk litigation for ignoring Government advice on NSAIDs.(general practitioners, non-steroidal anti-inflammatory drugs)
June 2, 2003... GPs have been warned they risk litigation if they continue to prescribe standard non-steroidal anti-inflammatory drugs to high-risk patients. The Primary Care Rheumatology Society claimed a considerable number of GPs continued to prescribe...

Meningitis cases on the decline.(Brief Article)
June 2, 2003... The Government has reported an overall reduction in the number of cases of meningococcal disease in the UK. Official data from the Health Protection Agency showed the number of cases of meningitis C fell 46 per cent from 52 in the first...

OTC labelling a danger to drivers.(over-the-counter medicines)(Brief Article)
June 2, 2003... The labelling of some over-the- counter medicines is inconsistent, inaccurate and could be a danger to drivers, according to Government research. The Department for Transport study into the impairment effects of drugs and driving called...

Consultants accuse GPs of conniving in NHS tourism.(general practitioners, National Health Service)
June 2, 2003... Consultants have accused GPs of promoting NHS tourism by `conniving with patients' from overseas who are flocking to the UK for free care. In a report published last week, unnamed consultants also branded GPs `less than honest' for...

Reckoner boosts Scots pay hopes.(general practitioners)(Brief Article)
June 2, 2003... GPs in Scotland have reported significant increases in their income under the new contract after they finally got to test the `tartanised' ready-reckoner. The rises of between 20 and 30 per cent on average come as a boost to negotiators'...

Patients are slow to report hearing loss.(Brief Article)
June 2, 2003... A third of patients with hearing loss take more than two years to approach their GP about the problem, putting them at risk of long-term hearing damage, according to a survey. The 846-patient survey, conducted by the charity Defeating...

Rights and duties of a GP will be set out.(general practitioners)(Brief Article)
June 2, 2003... GPs' roles, rights and responsibilities are to be defined in a new agreement being drawn up by Chief Medical Officer Sir Liam Donaldson. The `compact', announced at a recent GMC dinner by Health Secretary Alan Milburn, will also identify...

Telephone triage cuts costs but does not satisfy patients.
June 2, 2003... GPs face widespread patient dissatisfaction with telephone triage-based out-of-hours care - and there is a `stark' lack of evidence to prove it is safe or cuts in-hours GP workload, research has concluded. Up to 28 per cent of patients are...

Flu vaccination reduces deaths in over-65s by more than a quarter.
June 2, 2003... The national flu vaccination campaign could slash death rates among the over-65s by over a quarter, according to new research by an expert adviser to the European drug regulatory body. GPs welcomed the findings but called for Government...

Safety fears over ulcer drugs plan.(Brief Article)
June 2, 2003... A Government plan to widen availability of proton pump inhibitors has been sharply criticised by a former member of its own medicines watchdog. The Medicines and Healthcare Products Regulatory Agency, formerly the Medicines Control Agency,...

New inquiry launched into SSRI withdrawal.(selective serotonin reuptake inhibitors)(Brief Article)
June 2, 2003... The Government has reconvened its inquiry into the safety of selective serotonin reuptake inhibitors after the committee originally set up to look at potential withdrawal reactions was dissolved. The inquiry was halted in March after it...

TALKING POINTS.(interview with Dr. Ruth Livingstone)(Interview)
June 2, 2003... Dr Ruth Livingstone practises in Stamford, Lincolnshire. She has been a GP for 20 years. Jo Carlowe spoke to her about the hot topics in her practice. New contract Should the ballot be delayed? Yes. This is a fantastic opportunity...

Letter: `Outsiders' have a hidden agenda with our contract.(Letter to the Editor)
June 2, 2003... Most GPs are focusing on the new contract's financial implications, but there are other issues I suspect many are unaware of. I recently attended a workshop in East Anglia looking at the implications of the contract and it appeared to be...

Damage is done to reputation of GP leadership.(general practitioners)(Brief Article)
June 2, 2003... Other agencies view new contract as an opportunity to influence the way GPs work The damage has been done to the BMA and the GPC, whatever the ultimate fate of the contract. The reputation of both has been heavily compromised. The BMA...

Letter: How new contract betrays GPs toiling in the inner cities.(Letter to the Editor)
June 2, 2003... Nowhere in the new contract is there a policy statement or strategy addressing the issue of inner-city deprivation, or which recognises the need for additional resources to provide basic-level care to vulnerable groups. The argument that...

Letter: It's GPs with clean lists who lose out.(Letter to the Editor)
June 2, 2003... Your front-page story last week said that if registered lists were to be used to work out global sums, resulting in a reduced capitation payment because of national list inflation, then practices with many ghost patients would suffer most. ...

Letter: Dear Minister, PMS worries us - Dear Doctor PMS is here to stay.(Letter to the Editor)
June 2, 2003... A clear commitment to PMS practices is made by Health Minister John Hutton, and I would be grateful if you would publish these letters to help the huge numbers of PMS GPs who are being asked to vote to understand the implications. Dr Ed...

Letter: Do not sit in your ivory tower telling us what to do.(Letter to the Editor)
June 2, 2003... You featured last week both the plight of Dr Michael Silver before the GMC and the ongoing debacle of our outclassed negotiators fumbling around for a solution to the new contract. Dr Silver should in any fair system be paid considerable...

Letter: How advanced access has eased our working day.(Letter to the Editor)
June 2, 2003... Dr Stephen Banham wrote about the demands of patients on primary care (Letter, May 19) and how advanced access will stoke demand. I am a partner in a practice that has worked with advanced access for more than two years, and insatiable demand...

Letter: How does it work doing a house call on your bike?(Letter to the Editor)
June 2, 2003... Dr John Green wrote about cycling to work (May 19). I am a GP registrar and I have always cycled to my hospital jobs, but since starting my GP year I have had to drive as I have to do house calls. Could Dr Green tell us how he goes about house...

Letter: When push comes to shove our cash ends up in secondary care.(Letter to the Editor)
June 2, 2003... I refer to your news report that enhanced services cash `has already been spent' (May 19). This could either make or break the contract, primary care and maybe the NHS - or am I being melodramatic? Circular HSC2002/012 told health...

Letter: Yes Ma'am, and it was my care that got her to 100!(Letter to the Editor)
June 2, 2003... One of my patients received a telegram from the Queen on her 100th birthday. This made me think perhaps a thank-you telegram/letter to the GP and staff congratulating them on the hard work that made this possible would have been nice. We...

Letter: Woeful sign of times: private care for GP staff.(Letter to the Editor)
June 2, 2003... I was disturbed to find in my mail this morning two letters, one from Norwich Union, trying to suggest that since the health service was in such a poor state it would be worthwhile for me to insure all my staff for private medicine. The...

Working among the misery of refugees and asylum seekers.
June 2, 2003... Dr Peter Lefeuvre describes the pain and joy of working with asylum seekers who in his experience are very far from the scroungers so often portrayed in the popular press The young Iraqi man looked anxious as he sat down in my consulting...

Will `cuckoo in nest' poach our patients?(group medical practice management)
June 2, 2003... The problem As a three-partner training practice we applied to take over the small list of a singlehanded GP who was retiring. But the PCO appointed a new singlehanded GP to the practice and gave him a lot of development funding and an...

GP appraisal is a real professional plus.(general practitioners)
June 2, 2003... Dr Melanie Wynne-Jones overcame her initial unease to feel extremely positive about GP appraisal My first reaction when I heard about compulsory appraisal and revalidation was similar to many GPs' - more hoops to jump through, an...

When a doctor asks you to bend sicknote rules.
June 2, 2003... Case history June has been off work for four months, ostensibly with frozen shoulder but really because of an acrimonious dispute with her employers about the allegedly unbearable stress of her work. She has rather grudgingly been seeing...

Q&As: What should I look out for in a new job interview?
June 2, 2003... Q I have an interview at a new practice - what advice can you give me, and what should I look out for? A Despite the crisis in general practice, individual practices are still choosy when taking on partners or salaried doctors, and will...

Challenging fears of vaccine side-effects.
June 2, 2003... Dr David Baxter dispels the confusion - highlighted by his recent research - over what advice to give about adverse reactions to vaccines MMR vaccine: you're discussing MMR vaccination and the parents ask about the usual side-effects. What...

Test yourself on: Diabetic ulceration.(Brief Article)
June 2, 2003... Use our quick quiz to check your clinical knowledge Questions 1 Name the two main conditions which predispose patients with diabetes to ulceration. 2 Which areas are most at risk of diabetic ulceration? 3 Approximately what...

Tackling treatment- resistant depression.
June 2, 2003... Highlights * How to deal with the problem * Key points for the consultation * Essential drug information * Practical guide to stopping antidepressants * `Why me? Why now?' Dr Stefan Cembrowicz discusses what GPs can do for...

Timely tips for treating injuries in budding gardeners.
June 2, 2003... As gardening jobs get into full swing, Dr Geoff Davies gives basic advice on how to avoid the hazards, and outlines how to treat injuries that occur Gardening can be extremely therapeutic and a good form of exercise for many people if...

10 TOP TIPS: Acne.
June 2, 2003... Show an interest: patients sometimes feel their GP does not take their acne seriously. Acne affects people at a sensitive time in their lives and can make it more difficult for them to form relationships and find employment. It is worth...

Clinical casebook: Advising a poor sleeper on melatonin.
June 2, 2003... Case history At Mr Smith's BP check his wife suggests that she buys melatonin because he is sleeping badly. She asks if it mixes with his medication. Dr Melanie Wynne-Jones advises. What is normal sleep? By 50, many people get...

Practice meeting.(physicians' interpersonal skills)
June 2, 2003... Practice meetings are a great opportunity to observe your partners' interpersonal skills - Dr Tanvir Jamil explains As a registrar you may feel your hands are already full seeing patients and sorting out their ailments. As a partner, the...

Pulse-PDP virtual tour.(professional development online service)
June 2, 2003... Our online professional development learning environment is now up and running - if you want to see how it will work for you, why not take a virtual tour around the concept www.pulse-pdp.co.uk Pulse-PDP is the new tutor-supported,...

Back answer: How risky is stopping epilepsy drugs?(Brief Article)
June 2, 2003... Q A patient who has been fit-free for five years has asked if he can stop his anti-epilepsy drug. How should I advise him? A About 1 per cent of the population have epilepsy, but about 70 per cent become seizure-free on medication....

Back answer: How do you manage a missed abortion?(Brief Article)
June 2, 2003... Q What is the best management of missed abortion? Are there any significant risks attached to awaiting events? A Miscarriage ends up to 25 per cent of pregnancies. Missed miscarriage is the term used to describe a failed intrauterine...

Hutton warns contract is `all or nothing'.(Health Minister John Hutton and general practitioners)(Brief Article)
June 9, 2003... The Government has issued a stark warning that the new contract is `not a pick-and-mix menu' and GPs will sacrifice the chance to drop out-of- hours care if they vote No. But Health Minister John Hutton has given a strong hint to PMS GPs...

GP moved by hunger strike protest.(general practitioner and asylum seeker)(Brief Article)
June 9, 2003... Dr Chris Udenze says he was `moved by the conviction' of an asylum seeker under his care who risked death by stitching his mouth, eyes and ears and going on hunger strike for 12 days. Abas Amini, an Iranian Kurd, protested after the Home...

Fears over death audits.(Brief Article)
June 9, 2003... GPs are concerned Home Office plans to overhaul the death certification process will add to their workload. Under the proposals announced last week, certificates for burials and cremations will be investigated by an independent doctor, who...

Patients help to choose new GPs.(general practitioners)(Brief Article)
June 9, 2003... Dr Cliff Bishop joined forces with patients to bring greater democracy to his PCT's GP recruitment drive. Dr Bishop, a GP in Harlow, Essex, was part of a recruitment scheme commended by the Commission for Health Improvement in its recent...

New quality pay deal to allay fears on cash-flow.(general practitioners and labor relations)
June 9, 2003... Contract negotiators have thrashed out a new deal to double the money paid up front for the quality framework in a bid to allay GPs' fears of cash-flow problems. Practices that achieve their quality points target in year one will get an...

Primecare accused over long waits.(Brief Article)
June 9, 2003... EXCLUSIVE BY SUSAN MCNULTY A row has broken out between GPs and Primecare amid accusations the deputising service has left patients waiting up to 16 hours for an out- of-hours home visit. GPs in Manchester have claimed waiting times...

CHI concern over adverse incidents.(Commission for Health Improvement )(Brief Article)
June 9, 2003... Commission for Health Improvement reports into four primary care trusts have criticised systems to enable GPs to report adverse incidents. In its review of Airedale PCT in Yorkshire, CHI found GPs preferred to use their own system and were...

HRT products now to warn on stroke risk.(hormone replacement therapy)(Brief Article)
June 9, 2003... The Government's medicines watchdog is ordering manufacturers to update all product information for hormone replacement therapies to include warnings about the increased risk of stroke. The increased risk, already set out in the BNF, is...

GPs' drug costs to soar in battle for quality points.(general practitioners)(Brief Article)
June 9, 2003... GPs' prescribing costs will surge as they grapple to meet targets set out in the quality framework, the Government's lead negotiator on quality has warned. His comments came as it emerged that GPs involved in a Government-funded prototype of...

Rebels go their separate ways over contract.(general practitioners)(Brief Article)
June 9, 2003... A split has emerged between the two GPC members who won support from grassroots GPs to send the negotiators back to the drawing board. Birmingham GP Dr Fay Wilson has revealed she will be voting No in the contract ballot - but her erstwhile...

LMCs to pressure negotiators further.(general practitioners and labor relations)(Brief Article)
June 9, 2003... GP negotiators will face further criticism of their handling of the GMS contract at this week's annual LMCs conference. In an agenda dominated by the contract, motions call for negotiators to take responsibility for the `shambolic'...

Buckman declares interest over notes.(negotiator Dr Laurence Buckman, general practitioner)(Brief Article)
June 9, 2003... The GPC register of declared interests reveals that GP negotiator Dr Laurence Buckman's wife has the potential to generate business from summarising patient notes. Dr Buckman, whose wife is managing director of London-based Superlative...

Over-75s should boost income.(general practitioners and costs of treating elderly patients)(Brief Article)
June 9, 2003... Dr David Reade believes his practice income will get a boost following the pledge to use registered lists and practice disease prevalence data. His urban practice in Liverpool has a high proportion of patients over 75 and is expecting to...

GPs left in the dark on pay as voting begins.(general practitioners)
June 9, 2003... GPs will have to cast their vote in the contract ballot without any real idea of what they will earn under the new deal - a situation condemned as `crazy' by medical accountants. Without a new ready reckoner that takes into account the...

Labour admits failing over violence to GPs.(general practitioners)(Brief Article)
June 9, 2003... Labour Party policymakers have admitted the Government has not done enough to tackle violence against GPs. A policy paper on health published last week says that while significant progress has been made on the zero tolerance drive against...

Two in three patients don't take diabetes or CHD drugs.(coronary heart disease)(Brief Article)
June 9, 2003... Labour's plans for a GP-patient contract are revealed as a Government- commissioned report exposes alarming patient non-compliance with statins and diabetes drugs - Brian Kelly and Susan McNulty report A Government-commissioned report has...

GPC vows to fight obesity and smoking contracts.(general practitioners)(Brief Article)
June 9, 2003... The GPC has vowed to resist any moves by the Government to force obese patients or heavy smokers to sign contracts promising to change their lifestyle in exchange for NHS GP care. Apart from `irretrievably' destroying the doctor-patient...

Study highlights women missing out on DEXA scans.(dual X-ray absorptiometry)(Brief Article)
June 9, 2003... GPs have been urged to respond to a huge unmet need for dual X-ray absorptiometry (DEXA) scans in general practice. Researchers at the Primary Care Sciences Research Centre at Keele University estimated 180 women at high risk of...

Postal patient survey forms trigger more GP criticism.(general practitioners)
June 9, 2003... GPs will face less criticism from patients if they conduct satisfaction surveys under the new contract in the surgery rather than by mail, Government-commissioned research shows. The response rate is also likely to be up to 30 per cent...

NHS Direct #4 dearer than GP consultation.(National Health Service call service costs versus general practitioner visit costs)(Brief Article)
June 9, 2003... The cost of an average call to NHS Direct is still rising, despite the massive increase in the number of calls taken by the helpline, Government-commissioned research shows. Calls now cost #17 each, up from #15.85 in 2001 and well above the...

Right of appeal on seniority pay aims to mollify low-earning GPs.(general practitioners)
June 9, 2003... GPs will be able to appeal to the board of their primary care organisation and their LMC if they think their seniority pay is too low under plans to make the scheme more fair. Precise details of how the appeals process will work are yet to...

Rise in practice nurses boosts smear uptake.(cervical screening)(Brief Article)
June 9, 2003... Slowing list inflation and a rise in the number of practice nurses have boosted cervical screening coverage over the last decade, a study has shown. Uptake was consistently higher in more affluent areas - ranging from 84 per cent in 1991...

LMC with rejection Plan B urges Yes vote.(Brief Article)
June 9, 2003... An LMC that developed a `Plan B' for GPs to resign from the NHS if the contract was rejected is now urging its members to vote for the deal. Cornwall and Scilly Isles LMC planned to release its contingency plan to GPs if they did not like...

Soaring resistance prompts new advice on gonorrhoea.(Brief Article)
June 9, 2003... GPs have been warned they may need to consider changing the treatment of patients with gonorrhoea following marked increases in resistance to ciprofloxacin, the first-line drug treatment. Figures released by the Health Protection Agency...