Pulse articles from June 2006

Pulse archives from June 2006

New deprivation adjusted risk score ousts Framingham.
June 1, 2006... Expert committee develops new risk score - and advises 4mmol/l cholesterol target ExcLusive By Daniel Cressey The Framingham risk charts are to be consigned to history and replaced by a new cardiovascular risk score that adjusts for...

Levelling the playing field.(risk assessment tool)(Brief article)
June 1, 2006... Dr Peter Brindle, whose work underpins the new risk tool, believes it will `level the playing field' for deprived groups. Dr Brindle, head of research strategy at Bristol PCT and a GP in the city, told Pulse: `It will make the Framingham...

Ban on sale of goodwill could end.(ban on practice based care )(Brief article)
June 1, 2006... ExcLusive The Government is considering scrapping the ban on the sale of goodwill on essential GP services, writes Ian Cameron. Leading health care consultants said the ban would go by the end of the year as part of the drive to...

Starting gun fired on competition as firm wins contract.(Care UK general practitioner service contract)
June 1, 2006... Care UK wins #5 million APMS contract - but local GPs are defiant By Anna Hodgekiss The first of a wave of Government-brokered contracts for private firms to run GP services has been awarded to care homes provider Care UK. In the...

Medical reporting reprieve.(General Practitioners medical reporting to insurance agencies)(Brief article)
June 1, 2006... The High Court has overturned a judgment that had threatened to wipe out a large chunk of GPs' medical reporting work. The Court of Appeal last week ruled that medical reporting agencies can charge administration fees for supplying medical...

Child vaccine delayed by six months.(pneumococcal vaccination schedule)(Brief article)
June 1, 2006... Pneumococcal vaccination will not be introduced into the childhood schedule until the end of the year at the earliest, GP negotiators have warned. It is the first confirmation that the vaccine will be delayed from its original proposed...

GP on top of the world.(General Practitioner climbs mount Everest)(Brief article)
June 1, 2006... Dr Alistair Sutcliffe has overcome the highest hurdle in his quest to scale the world's major peaks after successfully climbing Mount Everest. Dr Sutcliffe, a GP in Whitby, North Yorkshire, is aiming to join a select band of around 100...

Choose and Book setback.(general practitioners referral fee)
June 1, 2006... Most practices are certain to miss the June target to make a quarter of their referrals via Choose and Book, writes Ian Cameron. The failure means thousands of practices that have signed up to the Choose and Book directed enhanced...

GP's alcohol screening snubbed.(General Practitioners)(Brief article)
June 1, 2006... Dr Nigel Robinson has been frustrated in his attempts to screen for alcohol problems at his practice - after finding only a tiny minority of patients were willing to accept help. Screening identified excess drinking in 400 patients at Dr...

GP views harden over assisted dying.(General Practitioners)(Survey)(Brief article)
June 1, 2006... GP attitudes have hardened against physician-assisted suicide, with only a quarter now supporting a change in the law to allow it. The findings represent a significant shift post-Shipman, after a 1994 study published in the BMJ found half...

Care Record delayed by two years.(electronic care record software introduction delayed)(Brief article)
June 1, 2006... The roll-out of the national electronic patient record will be delayed by up to two-and-a-half years, the Government has admitted. Lord Warner, health minister, said delays by suppliers to the National Programme for IT in delivering the...

Three-year pension rise to hit 48%.(general practitioners pension earnings rise)(Brief article)
June 1, 2006... GPs' pensionable earnings for the first three years of the contract will be uplifted by around 48 per cent, the BMA has estimated. Dr Andrew Dearden, chair of the BMA's pensions committee, told a Surrey and Sussex LMCs conference that the...

NICE is to restrict drugs for dementia.(National Institute for Clinical Evidence)(Brief article)
June 1, 2006... NICE has stuck by its guns and released a second draft of its appraisal on Alzheimer's disease drugs which continues to heavily restrict their use. The appraisal committee said donepezil, rivastigmine and galantamine should only be used...

InBrief: `Fee was not inducement'.(medical referral payment for general practitioners approved by health minister)(Brief article)
June 1, 2006... Health minister Lord Warner has approved a PCT's #30 per patient payment to GPs for referring to an independent sector treatment centre (Pulse, 18 May). In a letter to the Guardian, Lord Warner said Ashton Leigh and Wigan PCT's payment to...

InBrief: Flu pandemic advice.(practice guidelines for General Practitioners )(Brief article)
June 1, 2006... GPs should review consultation times and access arrangements in the event of a flu pandemic, new guidance from the GPC and RCGP advises. Practices should rethink surgery layout to minimise congestion, and staff may even have to ask patients...

InBrief: Boost for Welsh GPSIs.(General practitioners with special interests )(Brief article)
June 1, 2006... The Welsh Assembly has issued guidance to NHS managers to help boost numbers of GPs with a special interest. It aims to define the role of GPSIs, outlines potential benefits and risks and provides a framework for establishing GPSI positions....

InBrief: NICE not too restrictive.(National Institute for Clinical Evidence guidelines)(Brief article)
June 1, 2006... NICE is not overly restrictive when assessing whether drugs should be made available on the NHS. An analysis of 86 sets of NICE guidance, published in the BMJ, found NICE had only said No in 19 per cent of cases, Yes in 23 per cent and Yes...

InBrief: `Road map' for GPs.(General Practitioners)(Brief article)
June 1, 2006... The RCGP is consulting GPs in order to draw up a `road map' identifying the future of the NHS and the role of general practice within it. Dr Mayur Lakhani, RCGP chair, has written to all RCGP faculties and college groups for views on how...

InBrief: Flu jab call for mentally ill.(influenza vaccination)(Brief article)
June 1, 2006... Patients with severe mental illness should be added to the at-risk groups for influenza vaccination, say MPs. An early day motion said vaccination was necessary because mentally ill patients had a raised risk of respiratory and...

InBrief: Cheaper scripts for Welsh.(English General Practitioners get higher pay)(Brief article)
June 1, 2006... Welsh citizens registered with English GPs are to get an entitlement card qualifying them for cheaper scripts. It will end the anomaly which saw them paying the #6.65 English fee rather than the #3 set in Wales. Copyright: CMP...

InBrief: Asthma drug delivery.(drug delivery system for asthma drugs)(Clinical report)
June 1, 2006... Using a metered-dose inhaler plus a spacer is at least as effective as a nebuliser for children with acute asthma, a Cochrane review has concluded. The updated review, which examined four new clinical trials, found the method of delivery...

Blood pressure fails to predict CVD risk.(Cardiovascular Disease)(Clinical report)
June 1, 2006... Study calls for wider use of antihypertensives irrespective of BP readings By Daniel Cressey Blood pressure measurements are almost useless for predicting a patient's future risk of heart disease or stroke, a start-ling new NHS study...

GPs quit LIFT move in fear of `horrific bills'.(General Practitioners)(local improvement finance programme )(Brief article)
June 1, 2006... Dr Stewart Manning's practice has pulled out of a move into NHS LIFT- financed premises because of concerns over `horrific' bills at the new site. Questions over the terms of the lease, use of spare space and security issues also led the...

Scripts soar but cases stay static.(antidepressants prescription rate increases)(Brief article)
June 1, 2006... Pulse Action on depression Antidepressant prescribing has soared over a period when the incidence of depression has not increased, a new study concludes. The research, published in June's British Journal of General Practice, challenges...

Rise in women GPs to spark workforce crisis.(General Practitioners)(Report)
June 1, 2006... Warning after study finds women GPs work fewer hours than men By Anna Hodgekiss General practice is heading for a crisis within the next decade because of the increasing influx of women GPs, GP-led research has concluded. The...

Care problems for discharged children.(children discharged from hospitals have problems in getting medicines)(Brief article)
June 1, 2006... Children with life-threatening conditions are struggling to get the medicines they need in primary care after being discharged from hospital, a study has found. A third of parents had problems getting hold of unlicensed or off-label...

PCT's U-turn on #1m cuts.(Primary Care Trusts budget cuts )(Brief article)
June 1, 2006... A PCT which had threatened to cut up to #250,000 from its PMS practices' budgets in a desperate bid to save cash appears to be backing down. Cambridge City and South Cambridgeshire PCT claimed the measure, clearly stated in a letter to GPs...

MediaWatch: `Prostate surgery harmful'.(curative treatment for prostate cancer)(Brief article)(Clinical report)
June 1, 2006... The story Surgery for low-grade prostate cancer does more harm than good, according to the Daily Mail, the Guardian and BBC. The source Research in the British Journal of Cancer found most men aged 55 to 59 at diagnosis with...

MediaWatch: `Booze is good for you'.(drinking cuts heart disease risks)(Brief article)(Clinical report)
June 1, 2006... The story Drinking every day cuts the risk of heart disease in men, the Daily Express, Daily Mail, Guardian, Independent and BBC News online report. The source A study of 50,000 individuals published in the BMJ found men who drank...

MediaWatch: `BP drugs halve Ca risk'.(Blood pressure)(cancer)(Brief article)(Clinical report)
June 1, 2006... The story Blood pressure drugs slash the risk of cancer, according to the Daily Mail. The source Data on nearly 500,000 individuals presented to the Digestive Disorders Week conference in the UK appears to show that ACE inhibitors...

Study refutes flu vaccine slur.(immunization statistics)(Report)(Brief article)
June 1, 2006... A new study has vigorously debunked Department of Health claims that GPs frittered away last winter's flu vaccine supplies on the worried well, writes Christian Duffin. An analysis of records from 51,000 patients who received the flu...

Our first quarterly winners.(Middle Chare Surgery winner of Pulse's Proud of Our Practice campaign)(Brief article)
June 1, 2006... The Middle Chare Surgery in Chester-le-Street, County Durham, has been chosen as the first quarterly winner of Pulse's Proud of Our Practice campaign. The practice has received the accolade for its successful mood management clinic, which...

Setback for chlamydia screening.(Clinical report)
June 1, 2006... Study finds chlamydia infection less serious than feared, questioning need for screening programme By Daniel Cressey The consequences of chlamydia infection are far less serious than had been feared, with the rate of complications less...

Asthma care varies.(general practitioners asthma care)(Brief article)
June 1, 2006... The level of asthma care offered by practices varies `vastly' with some far better than others at achieving good control of patients' symptoms, a new study reports. The researchers said the study at last offered hope of tying down exactly...

JournalWatch: BNP rules out heart failure.(Brain Natriuretic Peptide testing )(Clinical report)
June 1, 2006... BNP testing can effectively rule out a diagnosis of heart failure in a primary care setting, a new study by UK and Swiss researchers concludes. The meta-analysis combined data from 19 studies describing 22 patient populations, nine of whom...

JournalWatch: High statins in diabetes.(statin therapy benefits diabetes and coronary heart disease)(Brief article)(Clinical report)
June 1, 2006... Intensive statin therapy brings significant benefits for patients with diabetes or coronary heart disease, a sub-study of the international Treating to New Targets trial reveals. The researchers randomised a group of 1,501 patients with...

JournalWatch: High-dose flu vaccine safe.(Brief article)(Clinical report)
June 1, 2006... High doses of the influenza vaccine are safe in elderly patients and give increased protection against the disease, a US study reveals. Researchers randomised 202 ambulatory participants aged 65 or older to a single intramuscular injection...

JournalWatch: Commercial diets effective.(commercial weight reducing diets comparative report)(Brief article)(Clinical report)
June 1, 2006... Commercial diets are effective for helping people lose weight but there are no major differences between them, a UK study reports. The trial randomised 293 patients to the Atkins' diet, Slim-Fast plan, Weight Watchers pure points programme,...

JournalWatch: Hawthorn can lower BP.(Blood Pressure)(Brief article)(Clinical report)
June 1, 2006... Hawthorn extract can lower blood pressure in patients with diabetes who are already taking antihypertensive medication, a UK study shows. The general practice-based trial randomised 79 patients with type 2 diabetes to 1,200mg hawthorn...

Pin PCTs down over commissioning money.(Primary Care Trusts)(practice based commissioning agreements)
June 1, 2006... Legal warning for GPs at Pulse's practice-based commissioning seminar By Helen Crump GPs must get their PCT to sign binding legal agreements detailing their obligations before they agree to take on practice-based commissioning, a...

Start small and gain momentum.(primary care trust management )(Brief article)
June 1, 2006... Dr Tom Debenham's practice saved #400,000 in a year by shifting management of some chronic conditions from secondary to primary care. Dr Debenham told the Pulse seminar that he and his GP colleagues benefited from an `invest to save'...

Incentives not good enough.(general practitioners incentives )(Brief article)
June 1, 2006... Incentives for practice-based commissioning are still not strong enough to encourage many practices to take part, GPs and health care experts told the Pulse seminar. Dr Mark Hunt, a GP in Frome, Somerset, and former senior policy adviser...

You've got to feel comfortable.(practice based commissioning for general practitioners)(Brief article)
June 1, 2006... Dr Safiy Karim stressed to GPs the importance of only joining a commissioning cluster they feel comfortable in. Dr Karim, a GP in Nottingham, said he got involved early on with the practice-based commissioning agenda. But a major...

Can GPSIs get up to scratch?(General Practitioners with Specialist Interest)
June 1, 2006... How can PCTs improve GPSI services - and should they fund complementary therapies? By Daniel Cressey GPs with special interests have been on the ropes lately, with a series of reports branding the services they provide as expensive,...

Should complementary medicine be provided on the NHS?(National Health Service)(Brief article)
June 1, 2006... A group of hospital doctors and researchers sparked a furious debate over use of complementary therapies last week, claiming they were a waste of money and shouldn't be provided by the NHS. We asked a panel of GPs where they stood. `It's...

LETTER: The real problem with inhaled insulin lies in the cost.(Letter to the editor)
June 1, 2006... From Dr David Taylor Birmingham I feel Professor Kirby is being a little disingenuous when he argues that inhaled insulin's `ground-breaking technology' should be available for patients to choose (Letters, 18 May). It seems it is...

LETTER: Why I'll keep taking SSRIs no matter what.(Letter to the editor)
June 1, 2006... From Dr Chris Manning Teddington, Middlesex I wonder how many more researchers need to get their names into lights for reiterating what has now been so frequently stated, before people start to become complacent in the other direction? ...

LETTER: Where do their health loyalties lie?(Letter to the editor)
June 1, 2006... From Dr Kailash Chand Ashton-under-Lyne Lancashire The authors of the letter in the Times criticising the role of complementary medicine are behaving like old-fashioned guardians of mainstream medicine, more concerned with the health of the...

LETTER: CBT should become first-line.(Letter to the editor)
June 1, 2006... From Dr C Goldsmith Norwich I applaud your access to psychological therapies campaign. Sadly, once again Patsy Hewitt and the short-termism of today's Government has let down not only the 2.9 million people with depression in the UK,...

LETTER: System is against us.(Letter to the editor)
June 1, 2006... Name and address supplied We are about to build new premises and have taken four years wading through red tape at PCT and strategic health authority level and with planning issues. I can assure you that `one of the barriers to building...

LETTER: Speak up for overseas doctors.(Letter to the editor)
June 1, 2006... From Dr Kamalpreet Sidhu Newcastle upon Tyne After the recent changes in immigration rules for overseas doctors, they have been left in complete confusion and chaos. BMA efforts to get a grace period for doctors in training don't seem...

LETTER: Better GP premises? Once bitten.(Letter to the editor)
June 1, 2006... From Dr Anita Sharma Oldham Despite Department of Health claims to have improved the quality of GP premises via the LIFT scheme, the problem is getting worse. Three years ago I noticed insects in my surgery. Most of our rooms were...

LETTER: Play fair with nurse clinicians.(Letter to the editor)
June 1, 2006... Name and address withheld We are a practice that uses nurse clinicians extensively with the encouragement and support of our PCT. However, the same PCT has denied us payment for the access targets in the quality and outcomes framework...

Counselling counterblast.(health counseling)(Column)
June 1, 2006... Why do we all have counsellors when we know it's wasteful self- indulgence - at NHSexpense We need to talk about counselling. We've all, as GPs, got counsellors in our surgeries by now. We all use them, gratefully. After about five minutes...

SecondOpinion Andy Jones: No cause for Swede bashing.
June 1, 2006... The Swedes have a saying: `The third time is always the best.' This suggested some parallels to me as the NHS undergoes yet more reconfiguration, taking us from PCGs and PCTs back to good old health authorities. I was recently invited to...

PulseFinancial: Does your accountant measure up?
June 1, 2006... In the new business environment of general practice top-class accountants are a must - Dr John Couch explains how to monitor their performance and make changes if necessary No successful practice should be without a great accountant. But...

PulseFinancial: Widen your skills and prosper.
June 1, 2006... Add another professional string to your bow, not only to keep up to date but also to boost your career prospects, says Dr Melanie Wynne Jones General practice is changing rapidly and is under threat from private providers. GPs who wish to...

PulseClinical: How not to miss...Myeloma.
June 1, 2006... In the second part of this series highlighting rarer conditions which require rapid diagnosis, Dr Melanie Wynne-Jones outlines the tell-tale signs of myeloma Worst outcomes if missed * Acute hypercalcaemia - up to 30 per cent of...

PulseClinical: Do compression stockings prevent DVT on airlines?
June 1, 2006... Many patients buy flight socks believing they prevent deep vein thrombosis - a recent Cochrane review looks at whether this is money well spent In the last few years, there has been increasing interest in whether compression stockings...

PulseClinical: Recent papers on cardiovascular medicine.
June 1, 2006... Dr Rubin Minhas gives a personal take on recent cardiovascular papers that have caught his eye 5 questions answered 1 Is BMI or waist circumference the better MI predictor? 2 Does `metabolic syndrome' aid cardiovascular risk...

PulseClinical: Need to know STIs.(sexually transmitted infections )
June 1, 2006... Take-home points * Chlamydia testing should be considered opportunistically in those under 25, those with a change of partner in the last three months and those with more than one partner in the last year. * In a low-prevalence group...

PulseRegister: Passnotes how to excel in the oral.(oral exam passing tips for general practitioners)
June 1, 2006... Col Robin Simpson gives tips for impressing the examiners when you take the MRCGP oral The oral module of the MRCGP is best taken towards the end of general practice training or perhaps as the last module. This gives candidates a chance to...

PulseRegister: HASLAM'S HINTS.(receptionists management tips)(Brief article)
June 1, 2006... 10 tips for working well with the reception team 1 Do make the effort to remember the names of everyone in the team 2 Give praise when praise is due - too many doctors only give negative feedback 3 Be clear and precise when asking...

PulseCareers: Why not become an RCGP examiner?(Royal College of General Practitioner)
June 1, 2006... With the GP assessment system being overhauled there has never been a more exciting time to become an RCGP examiner, Dr Karen O'Reilly reveals Ever thought of being an examiner for the RCGP? I hadn't either. It doesn't figure highly on...

PulseComment: Do we really want a pill for every ill?(Brief article)
June 1, 2006... First it was statins, now it is antihypertensives. A new week, a new class of drugs GPs may soon be offering to everyone reaching their 50s. On top of it all, just a few weeks ago we learned that 10 per cent of the entire population will...

PCTs rush to bring in private providers to run GP services.(Primary Care Trusts)(General Practitioners)
June 8, 2006... One in three PCTs will strike a deal with a private company to run GP services by the end of this year, a major Pulse survey reveals. The survey of 104 trusts shows the rush towards privately-run NHS GP surgeries is surging ahead at a far...

GPs fight off APMS threat.(General Practitioners)(Alternative Provider Medical Services)(Brief article)
June 8, 2006... GPs are grouping together and launching their own limited companies in a desperate rearguard action against private providers. Dozens of GPs plan to target emergent APMS contracts and collectively compete against even the biggest...

GPs turn the tables to win.(General Practitioners)(Brief article)
June 8, 2006... Dr Martin Whiting has won the contract to run a neighbouring practice after tendering with a corporate-style business plan. He and his seven partners in north Manchester beat off competition from several private companies to win the...

Euro battle over denying mercury sphygmos to GPs.(General Practitioners)(sphygmomanometers)
June 8, 2006... As Europe phases out mercury devices, UKseeks medical equipment opt- out By Daniel Cressey The UK drug regulator is fighting European proposals that may jeopardise accurate measurement of blood pressure by denying GPs the use of...

New drug hope for child asthma.(leukotriene receptor antagonist for asthma treatment)(Clinical report)
June 8, 2006... A leukotriene receptor antagonist is substantially better than inhaled steroids for controlling symptoms in children with mild asthma, a study of UK general practice concludes. The GP researchers said they expected a `dramatic' increase in...

GP's lateral thinking saves a life.(General Practitioners)(Brief article)
June 8, 2006... Dr Helen Pelendrides saved a patient's life and says she could not have done it without access to the national NHS data `spine'. She was working for an out-of-hours organisation on a Friday night when a pathology lab called to warn about a...

Smartcard security concerns.
June 8, 2006... Connecting for Health is investigating widespread lapses in security stemming from misuse of smartcards used to access Choose and Book and other IT systems, writes Ian Cameron. The organisation in charge of NHS IT reforms admitted the...

Row over surgeries star-rating plans.(general practitioners rating scheme)(Brief article)
June 8, 2006... The BMA is at loggerheads with the RCGP over plans for a Michelin- style star rating scheme for practices. The college is in talks with the Government over a mandatory three-star at-a-glance guide grading quality of services delivered. It...

BNP advised for all in heart failure.(Brain Natriuretic Peptide in heart failure diagnosis )(Brief article)
June 8, 2006... Testing for brain natriuretic peptides is better than an ECG and should be used in all patients with suspected heart failure before beginning treatment, new draft guidance recommends. The guidance, from the Scottish Intercollegiate...

Choose and Book problems with consultants' expertise.(medical referral details)(Brief article)
June 8, 2006... Patients are being referred to consultants unfamiliar with how to treat their conditions through Choose and Book. Pulse has learned of orthopaedic surgeons being forced to leave their own patients anaesthetised on the operating table while...

InBrief: New venlafaxine advice.(prescribing regulations)(Brief article)
June 8, 2006... The UK drug regulator has eased prescribing regulations on venlafaxine, allowing GPs to initiate use of the antidepressant without specialist supervision. Supervision is only needed for severely depressed or hospitalised patients on 300mg...

InBrief: New Scottish GPC leader.(Dr Dean Marshall General Practitioners Committee)(Brief article)
June 8, 2006... Dr Dean Marshall has been elected to lead the Scottish GPC from 31 August. A GP in Midlothian and secretary of the Lothian LMC, he has served as deputy-chair since 2004. He succeeds Dr Mary Church and Dr David Love, joint-chairs from 2001,...

InBrief: Name and number drive.(General Practitioners to display their registered name)(Brief article)
June 8, 2006... The GMC is recommending GPs display their GMC registered name and number on stationery or practice leaflets, on letters, reports, entries in medical records, on practice plaques, consulting room doors or name badges, on prescriptions and...

InBrief: Methotrexate warning.(oral methotrexate dosage warning for general practitioners)(Brief article)
June 8, 2006... GPs are being warned to check patients are taking oral methotrexate at the right dose and with appropriate monitoring. The National Patient Safety Agency has reissued a safety warning on the drug after 151 reported incidents since the original...

InBrief: Prozac licence for children.(Brief article)
June 8, 2006... The European Medicines Agency is expanding indications for fluoxetine (Prozac) to include children of eight or older with moderate to severe depression who do not respond to psychological therapy. Copyright: CMP Information Ltd.

InBrief: Commissioning tool.(general practitioners practice based tool available)(http://pbc.drfoster.co.uk)(Brief article)
June 8, 2006... A practice-based commissioning tool is being made available to GPs on a free one-month trial basis. The software, released by Dr Foster Intelligence, allows GP practices to access their own hospital referrals data, including who has been...

InBrief: Attacks on health workers.(workplace harassment at Scotland)(Brief article)
June 8, 2006... Almost 18,000 attacks on Scottish health workers were reported last year, 80 per cent of which occurred in community primary care settings and GP surgeries. Separately, the BMA in Wales renewed its call for a policy of `zero tolerance' on...

InBrief: Rofecoxib statistics error.(Merck report on safety of Vioxx )(Drug overview)(Brief article)
June 8, 2006... Merck has admitted a `statistical error' was made in one of the key papers on the safety of rofecoxib (Vioxx). The correction changed the p- value for one analytical method used in the trial from 0.01 to 0.07 in a paper concluding...

QOF failing to ensure optimal heart care.(Quality of Framework)
June 8, 2006... Researchers find high QOF points are masking `unmet' health care needs By Helen Crump The quality and outcomes framework in its existing form will not achieve optimal care for cardiovascular disease and needs significant tightening...