Pulse articles from June 2007

Pulse archives from June 2007

Plans put 14 million in line for statins.
June 14, 2007... GPs say CVD drive is `fanatical' as screening is set to put half of over-40s on statins By Cato Pedder Plans to assess everyone from the age of 40 for cardiovascular risk will herald a new era of mass medicalisation, with almost half...

IT campaign in Commons debate.(Brief article)
June 14, 2007... Common sense on IT Pulse's IT campaign found itself at the heart of a House of Commons debate as MPs called for a `full and independent review' of the NHS IT programme, writes Steve Nowottny. The Government came in for fierce criticism...

10% of patients fail to book clinic under Choose and Book.
June 14, 2007... Reduced DNA rate does not compensate for patients who slip through net Campaign Common sense on IT By Steve Nowottny Patients are more likely to miss out on outpatient appointments if they are left to book themselves in under...

Next stage for care records rollout.(Brief article)
June 14, 2007... Campaign Common sense on IT Connecting for Health has launched the next stage in the rollout of its patient electronic care records, with Bury becoming the second area to introduce the project. The move has created more division...

BMA members want a vote for all.(British Medical Association)
June 14, 2007... A Pulse survey this week reveals 70% of BMA members believe its leadership election procedure should be ripped up to allow one member one vote. With the 34-strong BMA council set to vote on a new chair in two weeks' time, a further 56% say...

New candidate at the eleventh hour.(Brief article)
June 14, 2007... Dr Tony Calland this week became a last-minute contender in the battle to be the next BMA chair. The deadline for nominations ran out on Tuesday and with just hours to go, the retired GP made the competition a three-horse race. Dr...

`Ammunition' for Brown in survey.(Gordon Brown)(Brief article)
June 14, 2007... GPs fear a sting in the tail from the Government after receiving results from the Department of Health's controversial survey on access to surgeries. Although many received outstanding scores in the survey, they fear the Government will...

InBrief: Premises claim denied.(Brief article)
June 14, 2007... A Government report boasting of a #29bn facelift of NHS estate over the past 10 years has been criticised as misleading by doctors. The report says 2,848 GP premises have been refurbished or replaced and 674 one-stop primary care centres...

InBrief: Hep B vaccine call.(Brief article)
June 14, 2007... Universal vaccination against hepatitis B should be introduced in the UK and other European countries, concludes a review in The Lancet. Researchers insisted universal vaccination rather than the current strategy of vaccinating at-risk...

InBrief: Alert on forced marriages.(Brief article)
June 14, 2007... GPs are being asked to look out for signs of forced marriages in new Government guidelines. They say GPs should look out for evidence of depression, self-harming, anorexia or substance abuse as well as unwanted pregnancy, as many women are...

InBrief: Arthritis drugs review.(Brief article)
June 14, 2007... NICE is to re-evaluate its guidance on use of three drugs used to treat rheumatoid arthritis. The institute has agreed to review its ruling that if a patient does not respond to one of the anti-TNF^ treatments adalimumab, etanercept and...

InBrief: Clear steps on eczema.(Brief article)
June 14, 2007... GPs should use a stepped approach to the treatment of atopic eczema in children, according to draft guidance from NICE. At each consultation, GPs should assess the severity of eczema symptoms into one of four categories- clear, mild,...

InBrief: Choose & Book champion.(Clive Pickles)(Brief article)
June 14, 2007... Dr Clive Pickles, a consultant gynaecologist at Sherwood Forest Hospitals NHS Trust, has become secondary care clinical lead for Choose and Book. He will promote the use of Choose and Book among hospital consultants and ensure they have...

InBrief: Ranibizumab approval.(Brief article)
June 14, 2007... The Scottish Medicines Consortium has accepted ranibizumab (Lucentis) for use in the treatment of neovascular (wet) age-related macular degeneration. Guidelines state it should be used when visual acuity falls persistently below 6/60. NICE...

Mortality fears spark statin switch rethink.
June 14, 2007... Trusts review shift to simvastatin after signs it may put lives in danger By Jennifer Rigby Two PCTs are reviewing their implementation of Government policy on statin switching after a local audit suggested it was putting lives at...

Chlamydia screening stalls.(Brief article)
June 14, 2007... The National Chlamydia Screening Programme is struggling to build uptake to the levels required to combat infection rates and has been criticised for continuing to rely on the goodwill of GPs. Health Protection Agency figures obtained by...

CBT `no benefit' in severe depression.(cognitive behavioral therapy)(Brief article)(Clinical report)
June 14, 2007... New research has questioned NICE guidance after finding adolescents with moderate or severe depression do not gain added benefit from cognitive behavioural therapy. Both the institute and the Department of Health have pushed the benefits...

Patients being sent to GPs for post-op checks.(general practitioners)
June 14, 2007... Hospitals implement GP checks amid concerns over rushed discharge By Cato Pedder Hospitals are beginning to shift responsibility for postoperative checks to GPs following recommendations from the primary care tsar earlier this year....

Cases missed out of hours.(Brief article)
June 14, 2007... Delays in diagnosis or failure to diagnose at all are the main reasons for complaints and negligence claims against out-of-hours GPs. Medical Defence Union figures showed that these featured in 15 of 18 negligence claims in 2006 and 61 of...

#9m paid out for missed Cancer diagnoses.(Report)(Brief article)
June 14, 2007... New figures show that the Medical Defence Union has paid out #9m in the past five years to compensate patients for missed or delayed diagnoses of cancer. These now account for a quarter of all successful legal claims against GPs. A...

Fears over Boots APMS ambitions.(alternative provider medical services)
June 14, 2007... Plans by chemist chain to host GP surgeries across the country have fuelled suspicions about its long-term aims By Joanna Clarke-Jones Plans by high street giant Boots to roll out GP surgeries in its stores across the country have...

Why we're choosing books.(Brief article)
June 14, 2007... A practice in Liverpool has employed the services of a reader in residence to run weekly reading groups with patients. GPs can refer patients to the groups at the Vauxhall surgery and an outreach group in sheltered accommodation. Patients...

PBC to get `flying squad'.(Brief article)
June 14, 2007... The NHS Alliance has announced it is forming a practice-based commissioning `flying squad' to help areas struggling with the issue. The move, in partnership with international healthcare business AstraZeneca, will see a team set up to...

Who will have access to records for research?(Brief article)
June 14, 2007... Connecting for Health has yet to confirm exactly who will have access to electronic care records. In its submission to the Health Select Committee electronic care record inquiry, technology provider BT suggested selling data to drugs...

Academics to access records.
June 14, 2007... Ministers back report concluding access to care records for studies is `integral' to public health By Steve Nowottny The Government is to press ahead with controversial plans to open up electronic patient records to researchers, after...

GPs fear dangers outweigh benefits.(general practitioners)(Report)(Brief article)
June 14, 2007... The benefits of opening electronic care records to researchers will be outweighed by the harm to patients' health if they begin holding back information from their GPs, the Government has been warned. Dr Paul Thornton, a GP in Kingsbury in...

GP skin care targets labelled `unworkable'.(general practitioner)(Report)
June 14, 2007... Ministers `not living in real world' over care closer to home drive By Jennifer Rigby Government demands to shift even more dermatology work into the community were criticised last week as out of touch and unworkable. The authors...

GPs' fury over NICE skin cancer `farce'.(general practitioners)(Brief article)
June 14, 2007... GPs have angrily hit back at a report accusing them of putting patients at risk by ignoring NICE skin cancer guidelines. Researchers have claimed GPs disregarded NICE guidance on the management of skin cancer by continuing to surgically...

MediaWatch: `Stem cells could end AMD'.(age-related macular degeneration)(Brief article)(Clinical report)
June 14, 2007... The story British scientists are working on a pioneering technique that could restore the sight of millions of people blinded by age-related macular degeneration (AMD). The story appeared in the Times, Daily Mail, Daily Telegraph and...

MediaWatch: `Low testosterone danger'.(Report)(Brief article)
June 14, 2007... The story Men with low levels of testosterone are `more likely to die young', according to the Daily Mail. The source A study conducted by US researchers presented at the Endocrine Society conference in Toronto followed 800 men aged 50 to...

MediaWatch: `Cures for seven diseases'.(Brief article)(Clinical report)
June 14, 2007... The story A genetic breakthrough has paved the way for potential new treatments for seven diseases that could help more than 20 million people, say the Daily Telegraph, Daily Mail, Times and Daily Express. The source A two-year study...

Statins safe in muscle pain.(Brief article)(Clinical report)
June 14, 2007... GPs should not routinely stop statin treatment in patients who develop muscle pain, a new review suggests. Statins have been linked to muscle problems and many GPs automatically stop treatment in patients with muscle pain while they...

Rosiglitazone risks questioned.(Clinical report)
June 14, 2007... Confusion over diabetes drug continues with new study suggesting it may not increase cardiovascular risk By Cato Pedder Early findings from a major international trial suggest rosiglitazone may not increase cardiovascular risk...

GPs waiting to hear if procurement bids are successful.(general practitioners)(Brief article)
June 14, 2007... GPs are waiting to hear if their bids have been successful in a national procurement process aimed at attracting more GPs to under- doctored areas. Bids closed last week on the first stage of the Department of Health's Fairness in Primary...

Beta-blocker row reignites.
June 14, 2007... Hypertension therapy under spotlight at British Cardiovascular Society conference By Daniel Cressey Experts are demanding Beta-blockers be reinstated as a first-line treatment for hypertension, in a move that has split the cardiology...

Warfarin and echo underused in AF.(atrial fibrillation)(Report)(Brief article)
June 14, 2007... NICE guidelines on atrial fibrillation could be leading to underuse of warfarin in primary care, GPs are being warned. A new audit found only half of high-risk patients were on warfarin, and also uncovered serious underuse of...

Pacemaker lottery sees rates vary 350% between trusts.(Report)(Brief article)
June 14, 2007... Provision of pacemakers has been found to vary massively across the UK, with differences in implantation rates of up to 350% between PCTs. Many clinics are falling short of national guideline standards, with GPs' patients in some cases...

GPs face cuts despite underspend.(general practitioners)
June 14, 2007... Government report identifies #700m of potential `productivity' savings - and confirms #510m NHS surplus By Joanna Clarke-Jones GPs are facing major cutbacks in prescribing budgets and enhanced services payments, despite a #500m NHS...

GPs fight phone mast on surgery.(general practitioners)
June 14, 2007... GPs in the Isle of Man have become the latest to take on the might of mobile phone companies over the siting of controversial telephone masts. The first that three GPs at a surgery in Orchan knew of the plans to erect two new masts on...

JournalWatch: Rheumatoid IHD risk.(ischemic heart disease)(Brief article)(Clinical report)
June 14, 2007... Rheumatoid factor is an independent risk factor for ischaemic heart disease, a new UK study suggests. The presence of the factor was investigated in 567 men and 589 women. It was associated with a 3.1-fold increase in risk of ischaemic...

JournalWatch: Antidepressants in cancer.(Brief article)(Clinical report)
June 14, 2007... Antidepressant treatment does not improve symptoms, wellbeing or survival in patients with advanced cancer who do not have major depression, according to a new paper. In the study of 189 patients randomised to either sertraline or placebo...

JournalWatch: Three factors in CVD risk.(cardiovascular diseases)(Brief article)(Clinical report)
June 14, 2007... Anaemia, eGFR and microalbuminuria are all independently associated with CVD, according to a major new US study. Haemoglobin of 12.8g/dL or less was associated with a 45% increased risk of CVD. Microalbuminuria greater than 30mg/L was...

JournalWatch: Obesity-prostate link.(Brief article)(Clinical report)
June 14, 2007... Obesity and height are independently associated with prostate volume, which may interfere with cancer detection, according to a new study. US researchers studied the association between PSA, obesity and prostate volume among 753 men...

JournalWatch: No ACE or ARB benefit.(Brief article)(Clinical report)
June 14, 2007... No significant benefit for ACE inhibitor or ARB use in atrial fibrillation patients has been found in a new study. Previous evidence has shown that ACEis and ARBs have a role in preventing new onset atrial fibrillation and also in...

A postcode and specialty lottery.(Report)(Brief article)
June 14, 2007... Government figures show the huge disparity in waiting times across the UK. Figures showed 98% of Leicester City PCT patients fell within the Government's 18-week target. Yet only 25% of Mid Essex PCT's patients were treated within 18 weeks. ...

18-week target hit by cuts.(Report)(Brief article)
June 14, 2007... The scale of the Government's task in meeting its 18-week referral-to- treatment target has been revealed, with orthopaedics identified as the biggest area of concern. Health minister Andy Burnham said the specialty remained `the biggest...

PulseInterview - Professor Mike Richards: The tsar who rebranded cancer.(Interview)
June 14, 2007... The Government's national cancer director on the shift in emphasis on the disease and the vital role of GPs By Lilian Anekwe It's an important time for the Government's cancer tsar, Professor Mike Richards. With the looming...

LETTER: Divided views on Choose & Book.(Letter to the editor)
June 14, 2007... Campaign Common sense on IT From Dr Milton Barron, Manchester I have now completely stopped using Choose and Book. It is pointless and offers my patients no advantage. On the contrary, I find that by using it I have less time to...

LETTER: Unfair to criticise GPs' infertility care.(Letter to the editor)
June 14, 2007... From Dr Declan Fox, Newtownstewart, County Tyrone Critical comments on GP management of infertility (News, 3 May) cannot be allowed to go unchallenged. I speak as one who has often prescribed clomiphene with good results and I remember...

LETTER: Telling patient the truth need not be a cosmetic exercise.(Letter to the editor)
June 14, 2007... From Dr John Wotherspoon, St Helens, Lancashire Phil Peverley asks how to explain to the patient that you have decided to deny her request for cosmetic procedures (Peverley, 31 May)? My advice, Phil, is to tell the truth. You can't...

LETTER: `No security flaw' on patient care records.(Letter to the editor)
June 14, 2007... From Robert Navarro, managing director, Sapior I am writing to correct what I believe to be a misleading account of my views given in your article `Confidentiality of millions at risk as IT chief exposes security flaws' (News, 24 May),...

LETTER: GP training opportunity.(Letter to the editor)
June 14, 2007... From Dr Roger Burns, chair, Welsh Area Course Organisers The demise of MTAS and the disgraceful behaviour of the Government towards junior doctors provide us with a training opportunity. GP training is normally three years. Surely now...

FOR THE RECORD: Dr Mark Davies.(Correction notice)
June 14, 2007... Last week we reported that Dr Mark Davies, primary care medical director for Choose and Book, said most appointments were generated by GPs. The quote should have read: `Only 9% of appointments are booked by GPs. Most appointment requests are...

LETTER: Don't take on the task of rationing, Phil.(Letter to the editor)
June 14, 2007... From Dr Simon Walsh, Newcastle-under-Lyme, Staffordshire Phil Peverley's dilemma clearly demonstrates the main problem of fundholding under the last lot and PBC under this lot (Peverley, 31 May). Phil, you are being asked to do the `R' word...

OPINION: `We've tackled care record fears'.
June 14, 2007... The Pulse Common Sense on IT campaign has highlighted fears over the confidentiality of care records. But Dr Gillian Braunold insists a series of safeguards puts patients firmly in control After all the discussions over the consent model...

In a spin over screening.
June 14, 2007... Phil's reeling from trying to ease his patients' fears prompted by Government `health fascism' I have a number of patients who I think of as spinning plates; people who find life only just this side of bearable. They are crippled by...

Dinah'sDiary: 14.06.07.
June 14, 2007... Dinah's being driven crazy by speed cameras and secret smokers Monday Damn. I hate speed cameras. Rushing to work, minding my own business and sailing down the motorway, I glance up to see an evil looking black lens glaring down from a...

PulseFinance: Starting your career on the right foot.
June 14, 2007... Young doctors keen to enter general practice should start planning and advancing their career from day one, says Dr John Couch The past four years have brought dramatic changes to the GP jobs market. My generation of GPs usually became...

How to...Prepare for an appraisal.
June 14, 2007... To describe anything as `an opportunity not a threat' has become a cliche. But it is the right way to approach your appraisal. Here are some tips: 1 Most GPs will exceed the standard expected. You might surprise yourself when you start to...

PulseFinance: How to wow them at the practice bid interview.
June 14, 2007... Your plan to take over another practice, as discussed last week, has proved a good one and you have been invited to an interview. What strategies should you adopt? Dr Clare Gerada offers some suggestions So the new world of general practice...

PulseFinance: Eight ways to maximise profit.
June 14, 2007... In the last of his series, Dr Sohail Butt offers suggestions on how to maximise your profit and keep care standards high over the next 12 months How can you keep your workload manageable, your staff happy and yet maintain high profits and...

PulseClinical: Calculating cardiovascular disease risk.(Report)
June 14, 2007... Recommendations on cardiovascular risk assessment are under review. Dr Anthony Wierzbicki, Professor Tim Reynolds and Dr Rubin Minhas consider the implications for GPs Which patients should be treated because they are at high risk of...

PulseClinical: Postoperative care inguinal hernia repair.(Report)
June 14, 2007... Professor Andrew Kingsnorth describes the possible complications that can follow the health service's most common surgical operation Inguinal hernia repair is the most commonly performed general surgical operation, with approximately...

PulseClinical: Dilemmas in family planning advice on Missed pills.
June 14, 2007... In this occasional series, the Faculty of Family Planning and Reproductive Health Care answers GPs' questions What should women who miss combined oral contraceptives containing 30- 35ug or less of ethinylestradiol do? Missed ONE or TWO...

PulseClinical: The pill and St John's Wort.(Brief article)(Clinical report)
June 14, 2007... For women who start using the Pill immediately after stopping St John's wort (Hypericum perforatum), is contraceptive efficacy reduced? Liver enzyme-inducers increase the metabolism of ethinylestradiol and progestogen. Ethinylestradiol and...

PulseClinical: Length of intrauterine system use.(Brief article)(Clinical report)
June 14, 2007... For women using the levonorgestrel containing intrauterine system (LNG- IUS), is the device safe and effective for use fore longer than five years? Randomised trials have shown that the LNG-IUS has contraceptive efficacy for up to seven...

PulseClinical: Condoms and spermicide.(Report)(Brief article)
June 14, 2007... Which are more effective at preventing pregnancy: condoms lubricated with nonoxynol-9 or non-spermicidally lubricated condoms ? The World Health Organization reviewed the safety and effectiveness of nonoxynol-9 in the family planning...

PulseClinical: Mental health chronic fatigue syndrome.(Disease/Disorder overview)
June 14, 2007... The non-specific symptoms of CFS pose a problem for GPs. In the second part of our mental health series, consultant psychiatrist Dr Jeanette Downie offers a guide to diagnosis and treatment Chronic fatigue syndrome (CFS) is a collection of...

PulseClinical: Long-term PPI use increases hip fracture risk.(proton pump inhibitors)(Clinical report)
June 14, 2007... Q Does the long-term use of proton pump inhibitors increase the risk of hip fracture? Synopsis Significant hypochlorhydria as a result of proton pump inhibitor therapy may cause calcium malabsorption, resulting in a higher risk of...

PulseClinical: Gynaecological cancers.
June 14, 2007... Gynaecological cancers endometrial cancer, ovarian lesions and HPV vaccination Consultant gynaecologist Mr Martin Lamb and associate colposcopy specialist Dr Beth Devonald answer questions from GP Dr Pam Brown 1 Is human papilloma...

PulseRegistrar: Painful red eye.
June 14, 2007... Dr Tanvir Jamil discusses a common problem Case history Christine presents on Monday morning and complains of a painful red eye for the last two days. The eye is very watery, slightly painful and feels like there is something stuck...

NMRCGP HOT TOPICS: Domestic violence.
June 14, 2007... Dr Priya Joshi gives a round-up of the latest thinking on another key nMRCGP subject Domestic violence, though common, is chronically under-reported. About one-quarter of women experience it in their lifetime. It has more repeat victims...

PulseRegistrar: Fear and loathing on the home visit.
June 14, 2007... The home visit provides a real insight into patients' lives - and makes for a great anecdote or two Geoff tipper's registrar diary The home visit has been a unique part of my registrar training, and I imagine this goes for a lot of us....

PulseCareers: On the job working with asylum seekers and refugees.
June 14, 2007... Dr Sarah Montgomery explains how she came to work with this group of patients and what she gets out of it Her English was good enough to respond to the question I always ask at the beginning of my consultations: `How can I help you?' ...

PulseComment: The great statin debate.(Brief article)
June 14, 2007... Statins are one of the most talked about classes of drug in medical history and there's no sign of the debate quietening down any time soon. It's not that there's real doubt over the drugs' effectiveness - it's precisely because they can work...

Last word: Dr Rob Barnett.
June 14, 2007... Dr Rob Barnett... on penguins, being perfect and shooting politicians The best thing about my practice is the new premises that we moved into about three years ago - just fantastic. I'm very happy with it. My greatest fear is...

GPC ready to talk on extended hours.
June 21, 2007... Negotiators forced onto back foot over access after ministers spin patient survey results By Ingrid Torjesen GP leaders are prepared to open talks with the Government over extending surgery opening hours, while rejecting its negative...

`Survey figures are unreliable'.(United Kingdom government patient survey)(Brief article)
June 21, 2007... Dr Peter Wilczynski of Northamptonshire LMC told the LMCs conference the Government's patient survey was not only based on leading questions but also unreliable figures. He said two rival computer systems used for the survey led to massive...

Patients to rate practices online.(rating general practitioners)(Brief article)
June 21, 2007... GPs face seeing their practices rated online by patients just as restaurants and pubs are now, under plans for an NHS website to encourage patient choice. Patients will soon be able to post comments about their GP consultation online for...

Online life checks set to swamp GPs.(NHS Choices health screening website)
June 21, 2007... CVD screening to kick off via website rating top five disease risks By Lilian Anekwe A controversial system of online health checks will be used to invite patients into general practice for cardiovascular screening from the autumn,...

HPV vaccine likely for girls.(Brief article)
June 21, 2007... Government advisers are on the verge of recommending that a routine HPV immunisation programme for 12-year-old girls be introduced next year, media reports suggest. The programme looks set to commence in September 2008 - the beginning of...

GPs have no confidence in ministers.(general practitioners)(Brief article)
June 21, 2007... GPs passed a resounding vote of no confidence in the Government and health secretary Patricia Hewitt at a fiery LMCs conference. Last year the conference backed off from a similar motion for fear of harming negotiations with ministers. ...

Hospitals abusing Choose and Book to bend rules.(Survey)
June 21, 2007... Common sense on IT PCTs and hospital trusts are manipulating Choose and Book to manage referrals and hit waiting list targets, a Pulse survey has found. One in five GPs is being forced by trusts to make all referrals through Choose and...

Warning on records workload for GPs.(general practitioners)(Brief article)
June 21, 2007... GPs face being swamped with a huge workload to explain new electronic records to patients, the House of Commons health select committee was warned. On the final day of oral evidence to its inquiry on the records, Dr Howard Stoate, a Labour...