Pulse articles from June 2005

Pulse archives from June 2005

New face of general practice.
June 4, 2005... Latest GP census reveals the extent and speed with which general practice is changing * Women make up 80 per cent of net increase in GPs since last year * 60 per cent of GP registrars are now women * One GP in four now works...

Modern practice is plain sailing.(Brief Article)
June 4, 2005... Dr Claire Bailey says the flexibility of modern general practice has allowed her to plan a family - and spend six months yachting round the world. Dr Bailey, a GP in Yelverton, Devon, is one of a growing number of doctors who have chosen a...

First picture emerges of GP quality achievement.
June 4, 2005... The first detailed, official picture of GPs' quality achievement in the first year of the GMS contract emerged this week, with publication of Scotland's quality scores. The results confirm GPs have made a spectacular success of their first...

Buddy scheme lands `the full monty' of 1,050 points.(practice of Stephen Dunn )(Brief Article)
June 4, 2005... Dr Stephen Dunn used teamwork and a buddy scheme with a neighbouring practice to achieve `the full monty' of 1,050 points in the quality framework. Dr Dunn, a GP in Dumbarton, Argyle and Clyde, held special clinics for diabetes, asthma and...

GPs vow to fight for their future at LMC conference.
June 4, 2005... Grassroots GPs are set to launch a blistering attack on Government policies that they say threaten the destruction of general practice, writes Rob Finch. This month's annual LMC conference will also seek to block Choose and Book plans,...

How I bombarded GMC to beat off frivolous complaint.(General medical council)
June 4, 2005... A GP has claimed a victory in the battle against frivolous complaints after he `bombarded' the GMC with letters protesting his innocence. Dr Andrew Bargery, a GP in Barnstaple, north Devon, said the GMC backed down from pursuing a...

NEWS IN BRIEF: Review on shingles vaccine.(Brief Article)
June 4, 2005... The Joint Committee on Vaccination and Immunisation is to review US evidence suggesting herpes zoster vaccination can cut cases of shingles in the elderly. A study of more than 38,000 people aged over 60 found the VZV vaccine could reduce...

NEWS IN BRIEF: Wales jobs crisis worsening.(Brief Article)
June 4, 2005... The GP workforce crisis in Wales has worsened, with new statistics revealing a significant drop in full-time workers and an ageing GP population. The number of full-time GPs as a proportion of the total fell to 79 per cent from 88 per cent...

NEWS IN BRIEF: New move over fluoxetine.
June 4, 2005... European drug regulators could overrule the decision of the UK's Committee on Safety of Medicines to allow use of fluoxetine in children. The European Medicines Agency has initiated an arbitration review on fluoxetine's safety after...

NEWS IN BRIEF: ACE inhibitors diabetes doubt.(Angiotensin converting enzyme inhibitors)(Brief Article)
June 4, 2005... ACE inhibitors and angiotensin-II receptor antagonists may not be the best first-line option for treating hypertension in type 2 diabetes. The influential Drug and Therapeutics Bulletin found it was unclear if the drugs were beneficial in...

NEWS IN BRIEF: #1,050 fee to become a GP.(Brief Article)
June 4, 2005... The introduction of a new fee scale for GP certification could discourage doctors from becoming GPs, the GPC has warned. GPs could be charged up to #1,050 for the consideration of a certificate of completion of training as the Postgraduate...

NEWS IN BRIEF: NHS 24 `gone badly wrong'.(Brief Article)
June 4, 2005... Things have gone `badly wrong' with NHS 24 and senior management are to blame, a Scottish Executive review has found. The review of the controversial Scottish health helpline and triage service came after a series of high-profile incidents...

New measles warning as child susceptibility soars.
June 4, 2005... Susceptibility to measles is soaring among nursery-age children, Health Protection Scotland researchers report. Their study found an eight-fold increase in the number of areas with over 20 per cent susceptibility, prompting new warnings on...

GPs back our Great Patient Survey.
June 4, 2005... Dr Vellupillai Kunasingam says the Great Pulse Patient Survey strengthens the doctor-patient relationship as it proves practices are listening. Dr Kunasingam, a GP in Chatham, Kent, was the first GP to return his patients' responses,...

GPs to face worried parents on powerline leukaemia risk.(Brief Article)
June 4, 2005... GPs will be braced for a new wave of worried parents after researchers found children born close to overhead powerlines could be at increased risk of leukaemia. A study of 29,081 children with cancer, published in this week's BMJ, found...

Practices with high prevalence enjoy better quality scores.(Brief Article)
June 4, 2005... Practices with high disease prevalence may do particularly well out of the GMS contract, new data suggests. The analysis of 540 practices found a positive correlation between a practice's prevalence in areas such as stroke, mental health,...

Ministers adapt NHS Lift to entice private providers.
June 4, 2005... The Government is wasting no time clearing the way for private providers to move into primary care. By Ian Cameron The Government intends to modify the NHS Lift premises improvement scheme so it can lure private firms into providing health...

Department gave firms green light on GP services.(Brief Article)
June 4, 2005... The Department of Health held a meeting with scores of private firms last month to assure them the door to providing GP services was wide open. Senior officials told representatives of companies including AstraZeneca, Nuffield Hospitals...

COMING YOUR WAY: `Pill ruins women's libido'.(Brief Article)
June 4, 2005... THE STORY The contraceptive pill may permanently damage a woman's libido, according to The Guardian and The Daily Mail. THE SOURCE New Scientist magazine reported on a study examining levels of sex hormone binding globulin in...

Access target is `hitting quality of diabetes care'.(Brief Article)
June 4, 2005... The Government's 48-hour access target is distorting clinical priorities and preventing diabetes patients getting the advance appointments they need for review, experts claim. Diabetes UK, in conjunction with GP members of the Primary Care...

COMING YOUR WAY: `Pesticide link to Parkinson's'.(Brief Article)
June 4, 2005... THE STORY Parkinson's disease may be triggered by exposure to garden pesticides, the Daily Mail claims. THE SOURCE A study which appeared in New Scientist of 767 people with Parkinson's disease found those exposed to high levels...

COMING YOUR WAY: `Viagra makes you go blind'.(Brief Article)
June 4, 2005... THE STORY Viagra could be responsible for cases of blindness, The Times, The Guardian, and Daily Telegraph report. THE SOURCE The Food and Drug Administration in the US is investigating 42 reports of nonarteritic ischaemic optic...

COMING YOUR WAY: `Ibuprofen causes breast Ca'.
June 4, 2005... THE STORY Women who take ibuprofen regularly could be raising their risk of breast cancer, claim the Daily Mail and Sun. THE SOURCE A study due to be published in the Journal of the National Cancer Institute found women who took...

Tougher prescribing alerts on GP computer systems.
June 4, 2005... Prescribing alerts on practice computer systems will be toughened to stop GPs over-riding them so easily. The move, devised to cut adverse incidents, comes after two pieces of GP-led research highlighted weaknesses in practice software and...

NHS `spine' records will be summaries.(Brief Article)
June 4, 2005... The new NHS Care Record `spine' will contain only summary information from patients' records - at least in its early stages. Professor Mike Pringle, one of two GP clinical leads attached to Connecting for Health, said a `less rich' record...

Orkney GPs will finally get their contracts.(Brief Article)
June 4, 2005... A group of GPs who have been working without a new contract for more than a year are finally about to strike a deal with their local health board. Orkney LMC chair Dr Paul Kettle, a GP on Hoy, said several GPs had been operating on `fresh...

New approach to hypertension in south Asians.(Brief Article)
June 4, 2005... GPs should consider treating patients of south Asian origin who have hypertension with an alpha-1 adrenergic blocker rather than a thiazide diuretic, a new study suggests. The study of 160 patients, published in the British Journal of...

Exception reporting rates vary dramatically between practices.
June 4, 2005... Rates of exception reporting under the GMS contract vary dramatically from practice to practice, new PCT data reveals. A survey of 134 practices from nine PCTs found rates varied from 0 to 100 per cent in some clinical areas. The team...

GPs too wary over methadone doses.(Brief Article)
June 4, 2005... GPs are becoming more willing to take on methadone maintenance but remain far too cautious over drug dosages, a new study concludes. Researchers found three times as many GPs were treating opiate misusers as in the mid-1980s, but uncovered...

GP's hep C enhanced service.
June 4, 2005... Dr Michael Varnam has set up an enhanced service to treat drug misusers for hepatitis C infection, in response to their low hospital attendance rates. Dr Varnam, a GP in Nottingham, audited local drug misusers and found 47 per cent were...

Quick savings for commissioning GPs.
June 4, 2005... GPs taking on practice-based commissioning can make `quick-win' savings by tidying up coding for hospital activity. Immediate savings could be made by querying activity data that is `riddled with errors' and then investing the money in...

Franchise practice squashed by PCT.(Primary care trust)(Brief Article)
June 4, 2005... Two PCTs have pulled the plug on a ground-breaking scheme which saw one practice `franchise' another in a neighbouring PCT to solve a recruitment crisis. Dr James Kingsland's practice in Wallasey, Wirral, took over the running of the Great...

Ministers warned on Choose and Book.(Brief Article)
June 4, 2005... Getting the support of doctors for Choose and Book was identified by the Department of Health nearly two years ago as the `single most important element'. The business case for the electronic booking scheme, released under the Freedom of...

Deprived practices struggle over flu vaccine uptake.
June 4, 2005... Researchers uncover inequalities in flu vaccine uptake as MMR is put back under the media spotlight - Emma Wilkinson reports Practices in deprived areas need more resources to address inequalities in uptake of the flu vaccine, researchers...

GPs to get unlicensed MMR stocks from US.(Measles-mumps-rubella vaccines)(Brief Article)
June 4, 2005... GPs are to receive further stocks of unlicensed MMR vaccine, this time from the US. As with the German vaccine distributed to practices over the past few weeks for catch-up campaigns, it is not covered by patient group direction. GPs...

BBC strikes delicate balance over MMR.(Brief Article)
June 4, 2005... On Sunday evening, BBC's Horizon revisited the MMR debate, examining how Andrew Wakefield's claims have stood the test of time. Dr Rod Manton, a GP in Woodley, Cheshire, gives his verdict on the programme. With clips of both the harrowing...

JOURNAL WATCH: SSRIs increase risk of nocturia.(Selective serotonin reuptake inhibitors)(Brief Article)
June 4, 2005... Use of SSRIs appears to increase the risk of nocturia, Swedish researchers report. Their study assessed 1,375 people by questionnaire on somatic and mental health, sleep, sleepiness and the need to urinate at night. Of patients taking...

JOURNAL WATCH: Fibric acid reduces MI risk.
June 4, 2005... Treatment with a fibric acid derivative can reduce the risk of myocardial infarction in patients with the metabolic syndrome, Israeli researchers report. Their study compared daily 400mg bezafibrate with placebo in 1,470 patients with at...

JOURNAL WATCH: Hair dye has little effect on Ca risk.(cancer)(Brief Article)
June 4, 2005... Use of hair dyes has little, if any, effect on cancer risk, according to a US study. The meta-analysis collated data from 79 studies conducted from 1966 to 2005, mainly examining risk of breast, bladder or haemopoietic cancers. Hair...

JOURNAL WATCH: Melatonin eases IBS symptoms.(Brief Article)
June 4, 2005... Melatonin treatment can alleviate bowel symptoms and sleep disturbance in patients with irritable bowel syndrome, researchers from Singapore conclude. Their study randomised 40 patients with irritable bowel syndrome, all of whom were...

JOURNAL WATCH: Mass NRT distribution ups quit rates.(Nicotine Replacement Therapy )(Brief Article)
June 4, 2005... Large-scale distribution of nicotine patches can substantially increase quit rates, a US study shows. A New York initiative distributed 34,098 courses of nicotine replacement therapy to callers to a free quitline. Researchers evaluated...

Alert issued over meningitis after judge criticises GP.(Brief Article)
June 4, 2005... Medical defence bodies have urged GPs to employ a `low threshold' of suspicion for diagnosing meningitis after a judge criticised a GP for being `too dismissive and insufficiently investigative'. The Medical Defence Union and the Medical...

Why out-of-hours is a mess.
June 4, 2005... Six months after the last GPs opted out, out-of-hours services across the UK are in crisis - Rob Finch reports The right to drop out-of-hours was the single biggest factor that led GPs to vote in favour of the new GMS contract. GPs saw...

GPs are braced for swathe of new quality indicators.
June 4, 2005... Nerys Hairon reports on the clamour for new quality targets as deadline day arrived for the framework review GPs are braced for tough new targets and indicators on a swathe of new disease areas in the review of the quality framework, as the...

Letter: Be aware of flaws in antiplatelet advice.
June 4, 2005... After two years of review and consultation, NICE has just published guidance on the use of antiplatelet agents for prevention of occlusive vascular events in high-risk patients. As physicians with expertise in the management of these patients,...

EDITORIAL COMMENT: GPC must resist calls for new quality indicators.(General Practitioners Council)(Brief Article)
June 4, 2005... Every specialist group imaginable has been clamouring for its very own quality indicators this week, as the deadline arrived for submissions to the framework review group. Not only that, but there is a move to make existing indicators a whole...

Letter: Most GPs have the write stuff.(Letter to the Editor)
June 4, 2005... Dr Tina Ambury's article about being a medical writer (Careers, May 14) was motivating, succinct and fun to read, but I would disagree that the money is small. Freelance medical writers, once established, can earn good money in their spare...

Letter: Setting the record straight on dispensing GPs.
June 4, 2005... David Roberts's appraisal of the new pharmaceutical services regulations (Soapbox, May 14) is to say the least disingenuous and inaccurate. Prior to the reformation of the Dispensing Doctors Association (DDA) the omens for the future of...

Letter: Giving references for dreadful staff.(Letter to the Editor)
June 4, 2005... I was appalled at the content of the recent 3 GPs article `Must we give our dreadful receptionist a reference?' (Features, April 16). The only reply to this question is to pass the call to the practice manager. The only comments...

Letter: Why I will carry on prescribing co-proxamol.(Letter to the Editor)
June 4, 2005... Dr Winter's view on co-proxamol (Letters, May 28) is, I am sure, widely held. There must be a reason for this allegedly useless drug's popularity with patients and prescribers alike in the face of the BNF's decades-long oppobrium. I...

ANDY JONES: Market reform.
June 4, 2005... Dr Andy Jones is a GP in Stamford, Lincolnshire After eight years, and considerable expense to the public purse, New Labour has learnt that cash alone will not fix the NHS. It has consumed huge wads of cash since Labour came to power, which...

PHIL PEVERLEY: A social worker.
June 4, 2005... Dr Phil Peverley is a GP in Sunderland Sociable feelings are not usually aroused when a social worker calls the surgery Tuesday is a bad day. Tuesday is my day on-call in our practice. It always starts badly; the Monday rush makes sure...

Avoid losing income in vaccine rules change.
June 4, 2005... A recent rule change in immunisation payments has threatened GPs' earnings - Dr Stephen Gardiner and Rachel Stark explain what has changed, who will be affected and what GPs should do about the situation Income for childhood immunisations...

Dealing with difficult patients - a skill well worth learning.
June 4, 2005... Learning how to deal with difficult patients is well worth it in terms of time saved and energy conserved, say Roy Lilley and Dr Paul Lambden In the vast majority of cases patients' behaviour and attitudes pose no problems, but every...

Make cash-flow forecasting work.
June 4, 2005... The hours taken to set up cash-flow forecasting will pay financial dividends, says Dr John Couch The new contract has tempted, cajoled or forced practices to become more efficient or suffer a catastrophic fall in profits. This revolution...

The lost art of reassurance.
June 4, 2005... Clinical expertise and medicolegal requirements are not the be all and end all of doctoring, argues Dr Jane Bowskill - sick, frightened patients also need kindness and reassurance To relieve sometimes, to cure if possible, to comfort always...

PracticeQ&As: Can I charge for travel advice?(Brief Article)
June 4, 2005... Q: I have been told GPs are not allowed to charge for travel advice. I don't think this is correct as such advice would not fall under the definition of essential or additional services, nor is it contracted separately as an enhanced service. I...

PracticeQ&As: Is there a fee for a coroner's report?(Brief Article)
June 4, 2005... Q: I have been asked to provide a written report for the coroner. May I charge a fee? A: Yes. The BMA suggests a fee of #48 for a full written clinical report without examination, which is provided at the request of the coroner, and a fee...

Patients' health at risk from partner's affair.
June 4, 2005... Case history It's an open secret that one of your male partners is having a relationship with the practice secretary. Neither are patients of the practice and the secretary is registered with a neighbouring practice. Both are single but...

What's new in: Gynaecology for menopausal women.
June 4, 2005... Miss Joan Pitkin outlines the latest developments in her field 1 New results from largest-ever study of female health In April this year, the Committee on Safety of Medicines said its advice that the short-term benefits of HRT for...

IN MY OPINION: Evidence-based medicine is a hierarchy of uncertainty.
June 4, 2005... Dr Des Spence of `No free lunch' makes the case that evidence-based medicine leaves a lot to be debunked As a junior doctor knowledge was the preserve of the consultant with treatment decisions changing with the weather. The medical tablets...

ANSWER BACK: Use of NSAIDs/cox-2s with aspirin.(Nonsteroidal anti-inflammatory agents)
June 4, 2005... Q: I've heard that not all NSAIDs/cox-2s negate the antiplatlet effect of aspirin. Is this true? A: Because of their mode of action, many pharmacologists predicted cox- 2s would be more likely to promote platelet aggregation, and hence...

ANSWER BACK: Cranberry alert in warfarin.(Brief Article)
June 4, 2005... Q: Is there an interaction between cranberry juice and warfarin and if so how should I advise patients of the risks? A: Cranberry juice is a drink rich in antioxidants that has sometimes been used for the prevention of cystitis. ...

We decided to make our baby wear a helmet 23 hours a day.
June 4, 2005... Dr Harriet Fraser tells how she came to the difficult decision to undergo expensive non-NHS treatment to correct her son's plagiocephaly Our son William was born a normal healthy delivery on May 14, 2004. At about two months of age we...

TROPICAL DISEASE CLINIC: Fleeting rashes in the returning traveller.
June 4, 2005... In the last of our series on tropical diseases, Dr Mike Jones advises on how to deal with a potentially fatal rash in a returning traveller Case study A 22-year-old woman has returned from a one-year period of voluntary work in...

The role of the podiatric surgeon.
June 4, 2005... A recent survey found 95 per cent of the public and 84 per cent of health professionals thought podiatric surgeons were trained doctors - Jason Hargrave clarifies what they do and how they are trained The last 15 years has seen an...

YOUR FIRST: Request for some friendly advice.
June 4, 2005... Offering advice informally or to people who are not our patients can be a problem, says Dr Melanie Wynne-Jones As medical students and hospital doctors we get used to being asked for advice by friends, family and neighbours. As GPs the...

CLINICAL CASEBOOK: Caring for the singer's voice.
June 4, 2005... Case history Julia is a successful professional singer and actor. In four weeks she is about to take the lead in a West End musical. She had a sore throat a month ago and this seemed to have resolved itself after a few days. Now for about...

How to keep your career fresh and interesting.
June 4, 2005... Professor Ruth Chambers advises on how to get the most out of your career As a GP you know that you never stop developing. So it's likely that you'll want a colourful career where you diversify as you proceed through your 30s, 40s and 50s...

US-style rallies to shape future of general practice.
June 11, 2005... Ministers are planning a major series of US-style mass focus groups aimed at shaping the future of general practice - amid fears they may be used to rubber-stamp controversial policies. From next month the Washington-based America-Speaks...

GMC drops pledge to patients.(Brief Article)
June 11, 2005... The GMC has dropped its pledge to protect patients. The organisation's slogan is now `Regulating doctors, Ensuring good medical practice', replacing `Protecting patients, guiding doctors'. It insisted the new slogan was a clearer...

GPs and managers join row over NICE guidance lottery.
June 11, 2005... Pressure is mounting on the Department of Health to review the role of NICE guidance after a row erupted over `postcode prescribing' of arthritis drugs. NHS managers have joined GPs in calling for reform of the system that leaves PCTs...

GP on mission to promote NRT.(nicotine replacement therapy)(Brief Article)
June 11, 2005... Dr Alex Bobak is on a mission to explain the benefits of nicotine replacement therapy after finding GPs were shying away from prescribing it because of safety fears. Dr Bobak, a GP in Wandsworth, south London, surveyed 205 GPs and found...

GPC to tackle frivolous complaints.(General practitioners council)(Brief Article)
June 11, 2005... The GPC has vowed to tackle the growing numbers of doctors facing `frivolous' complaints on non-therapeutic matters. The pledge follows the case of Dr Andrew Bargery, reported in Pulse last week, who faced a GMC investigation after a...

Racism crackdown to monitor GP decisions.
June 11, 2005... GP decisions made under practice-based commissioning are to be monitored to ensure racial health inequalities are not exacerbated. The move comes as part of a Government crackdown on what it calls `racism without intent' in the NHS - to...

514 submissions for QOF changes.(Quality and Outcomes Framework )
June 11, 2005... The quality framework review team has received a staggering 514 submissions calling for changes and additions. According to NHS Employers and the BMA, which are leading the review, the top four existing clinical areas of concern are...

LMCs urge GPs to help in Pulse Patient Survey.
June 11, 2005... LMCs across the country are recommending GPs use the Great Pulse Patient Survey to secure a ringing public endorsement of the traditional values of general practice. As hundreds of completed patient survey forms poured in to the Pulse...

GP hypertension services `will fail'.
June 11, 2005... Many primary care hypertension services will `fail' because of the increased workload and financial pressures associated with expanding treatment under new guidelines, a new study suggests. Researchers from the University of Newcastle...

NEWS IN BRIEF: MHRA claims under fire.(Medicines and Healthcare Products Regulatory Agency)(Brief Article)
June 11, 2005... The Medicines and Healthcare Products Regulatory Agency has come under fire over false claims that two-thirds of the public supported the sale of statins over the counter. The MHRA has admitted an `administrative error' led to the reports...

NEWS IN BRIEF: Deal to root out fake doctors.(Brief Article)
June 11, 2005... Fraudulent and fake doctors will be easier to `root out' following an agreement this week between the GMC and the NHS counterfraud service. Finlay Scott, chief executive of the GMC said the moves would ensure stronger safeguards and...

NEWS IN BRIEF: Affluent have more PSA tests.
June 11, 2005... Men in affluent areas are more likely than those in deprived parts of the country to have a PSA test, to be diagnosed with prostate cancer or receive radical surgery, according to new research. A study found 3.4 per cent of men in affluent...

NEWS IN BRIEF: Chloramphenicol drops OTC.(over the counter drugs)(Brief Article)
June 11, 2005... Chloramphenicol eye drops for acute conjunctivitis are to be sold over the counter. The move, announced by the Medicines and Healthcare Products Regulatory Agency, follows approval by the Committee on Safety of Medicines, reported by Pulse...

NEWS IN BRIEF: Heart attack risk and cox-2s.
June 11, 2005... Some conventional NSAIDs carry a similar cardiovascular risk to cox-2 inhibitors, a study published in the BMJ this week reports. The nested case-control study of 9,218 patients found the risk of first- time myocardial infarction increased...

NEWS IN BRIEF: RCGP warns over matrons.(Royal college of general practitioners)(Brief Article)
June 11, 2005... The RCGP and LMCs have warned about the dangers of fragmentation of care and lack of communication in the Government's plans for community matrons. In its response to the Skills for Health consultation on long-term conditions, the RCGP...