Pulse articles from June 2008

Pulse archives from June 2008

Drug budget cash shifts to pharmacy.
June 4, 2008... DH proposals outline major shift in funding for minor ailment and chronic disease work By Nigel Praities GPs will lose hundreds of millions of pounds from their prescribing budgets under Government plans to dramatically expand the...

Impact of Government's plans for pharmacistsin numbers.(Brief article)
June 4, 2008... 57 Million number of GP consultations per year involving a minor ailment 50 per cent predicted proportion of consultations for minor ailments taken over by pharmacists, within three years 1 Hour estimated time GPswill save per week...

Lords reject responsible officers pilot.(Brief article)
June 4, 2008... Medical defence bodies have expressed dismay after a plan to trial the idea of a new army of GMC regulators at PCT level was rejected in favour of an immediate national rollout. The House of Lords voted against a call for the system of...

GP choice key to rollout of polyclinics.
June 4, 2008... The Family Doctor Association has warned against coercion of practices into new buildings, after returning from a fact-finding trip to a polyclinic in Berlin, hailed by NHS chiefs as a model for the UK rollout. Members of the FDA, who...

NHS commercial boss quits after less than a year.
June 4, 2008... The head of the Department of Health's commercial directorate, Channing Wheeler, has quit less than a year into his contract. The former boss of Uniprise, a division of US healthcare giant UnitedHealth, said he was resigning for `family...

LMCs call for PR drive against care records.
June 4, 2008... LMCs are calling on the BMA to launch a publicity campaign highlighting the threat to patient confidentiality posed by electronic care records. The proposal came as 29 separate care records motions were submitted to next week's LMCs...

Row as trial casts doubt over quality of GP minor surgery.
June 4, 2008... GPC disputes findings of NHS research, warning GPs are not sufficiently skilled to operate safely EXCLUSIVE By Rob Finch GP minor surgery has been branded `unsafe' by researchers on a key NHS- funded trial. The Health...

PCTs rush to implement GP `scorecards'.
June 4, 2008... PCTs are already rushing to implement a controversial `school report' system for rating GP performance, ahead of Government moves to persuade managers to use it across the country. An exclusive Pulse survey shows many trusts are developing...

NICE analysis casts doubt on CVD screening plans.
June 4, 2008... The Government's planned cardiovascular screening programme will be far less cost-effective than an opportunistic approach based on GP records, according to detailed economic modelling released by NICE. The analysis found using existing...

PATIENT BACKLASH: Anti-polyclinic outcry shocks GP trailblazer.
June 4, 2008... Scale of opposition to Government plans emerges as patients express anger over travel and loss of continuity By Steve Nowottny A leading GP proponent of plans to relocate practices into polyclinics this week admitted he had been...

MP VISIT: Patients line up behind GP's polyclinic campaign.
June 4, 2008... More than 600 patients have signed one Surrey GP's petition against polyclinics. Dr Rohit Goel, a GP in Carshalton Beeches, this week met his Liberal Democrat MP, Tom Brake, as part of Pulse's Save Our Surgeries campaign. Dr Goel told...

GPs face pressure on chlamydia screening.
June 4, 2008... GPs are set to face intense pressure from PCTs to participate in chlamydia screening after the Department of Health demanded NHS managers step up efforts to raise testing rates. The department wrote in a letter to SHAs that many more...

Matrons fail to cut high-risk admissions.
June 4, 2008... Nurse-led case management schemes - including the Government's flagship community matrons programme - are failing to reduce hospital admissions in high-risk patients, an evaluation reveals. Researchers examined the effect of case management...

Conference: Alert over steroid dose in children.(Conference news)
June 4, 2008... Research on inhaled steroids, COPD and leukotrienes was presented at international respiratory conference By Nigel Praities GPs are being warned to urgently review their prescribing of inhaled steroids in children after research...

Conference: COPD guidelines `flawed'.(Conference news)
June 4, 2008... Guidelines on COPD are flawed and could lead to many patients being wrongly labelled with the disease, researchers warn. Overall, COPD is greatly underdiagnosed, but a new study finds the spirometry thresholds for diagnosis set by NICE...

Conference: `Update leukotriene role'.(Conference news)
June 4, 2008... Researchers are insisting asthma guidelines `need rewriting' after a study showed leukotriene antagonists were just as good as long-acting Beta-agonists when added to inhaled steroids. BTS guidance recommends long-acting Beta-agonists as...

Conflict over NICE lipid targets.
June 4, 2008... Institute's tough new targets on cholesterol will only be feasible if GPs ignore branded drug limits, says study By Nigel Praities Tough new NICE cholesterol targets will be impossible to hit unless GPs ignore a new benchmark requiring...

IN BRIEF: Cremation legal threat.(Brief article)
June 4, 2008... GPs face prosecution if they fail to follow cremation regulations, a medical defence body has warned. Under new Crown Prosecution Service legal guidance, GPs who breach death and cremation certification rules will be dealt with by criminal...

IN BRIEF: CV screening consultation.(cardiovascular)
June 4, 2008... The Department of Health has announced it will hold a series of stakeholder events to consult on its proposed cardiovascular screening programme. Professor Roger Boyle, national director for heart disease, and Professor Donal O'Donoghue,...

IN BRIEF: Alert over tick disease.(Brief article)
June 4, 2008... GPs may be overlooking symptoms of a potentially fatal tick disease, a public health expert is warning. Professor Michael Kunze, chair of the international scientific working group on tick-borne encephalitis, said: `My assumption is you do...

Darzi review to `reinvigorate' PBC.
June 4, 2008... Health minister set to advise stronger incentives as report claims `radical expansion' is required By Gareth Iacobucci Lord Darzi's much-anticipated review of the NHS will `reinvigorate' practice-based commissioning by focusing on...

PBC plus.(Brief article)
June 4, 2008... * Epsom Downs Integrated Care Service in Surrey PCT piloting new advanced form of PBC * Groups of practices to take on a `full, capitated provider contract rather than a notional ("soft") practice commissioning budget' * Budgets...

New blow as care record IT deal fails.
June 4, 2008... The ill-fated Summary Care Record system is facing fresh questions and perhaps even more delays after negotiations broke down with a key supplier. Connecting for Health failed to reach agreement with IT specialist Fujitsu, which had had a...

DH `set for U-turn' over 0844 ban.
June 4, 2008... Report on use of controversial high-rate telephone numbers `highly unlikely' to ban them, claims supplier By Steve Nowottny The Department of Health is set to back down from banning the use of 0844 numbers in GP practices, the...

0844 numbers.(Brief article)
June 4, 2008... * Lobbyists estimate about 800 practices in England use 0844 numbers, but insiders believe it could be as many as 2,000 * BMA supports letting practices use the numbers but says they must mention it in leaflets * Practices cannot make...

Media Watch: This week's top... Miracle cure.(Brief article)
June 4, 2008... The Daily Mail bears welcome news for those who struggle to keep a trim waistline, reporting on a once-a-day wonder-pill credited with helping women to drop two dress sizes in six months. The paper says the drug, called tesofensine, could...

Media Watch: This week's top... Scare story.(Brief article)
June 4, 2008... There doesn't seem much chance of it at the moment, but the Daily Mail, Sun and Daily Telegraph are all warning of the dangers of excessive sun- worshipping. Sun-lovers may be putting themselves at extra risk because the actual level of...

Media Watch: This week's top... and most pointless research.(Brief article)
June 4, 2008... Researchers at the University of California have nailed the problem with trying to give up smoking. It's all to do with peer pressure, apparently. They found it was easier to give up if others were doing so at the same time. If close family or...

JournalWatch: Aspirin cost-effective.
June 4, 2008... Low-dose aspirin is cost-effective for prevention of cardiovascular disease in men and women, although at different levels of risk, a Dutch analysis reports. Researchers compared two strategies - aspirin and no aspirin - in patients at age...

JournalWatch: Gout increases CV disease.
June 4, 2008... Gout is independently associated with a raised risk of cardiovascular disease in middle-aged men, a US study reports. A University of Pittsburgh team studied 9,105 men, aged from 41 to 63, who remained alive and free of cardiovascular disease...

JournalWatch: Stress raises stillbirth risk.
June 4, 2008... Psychological stress during pregnancy appears to raise the risk of stillbirth, say Danish researchers. Their study examined data on 19,282 singleton births from 1989 to 1998, using information on stress levels measured with the 12-item...

Echo waits `appalling'.
June 4, 2008... Study shows access to test in the UK lags behind most of Europe By Nigel Praities Waiting times for echocardiography are `appalling' in the UK compared with most of Europe, a new large-scale study shows. The research, published...

Warning on dementia referral cost.
June 4, 2008... GPs need training to distinguish early signs of dementia from normal old-age memory loss, to avoid swamping specialist services as the population ages, a new report concludes. The report, by health think-tank the King's Fund, warned cases...

Focus on... The rise of pharmacy.
June 4, 2008... Pharmacists are to be thrust into competition with GPs under Government plans - we look at the implications By Nigel Praities Your friendly local pharmacist is feeling rather cheerful. While GPs scan the horizon for threats from the...

Government plans for pharmacists.
June 4, 2008... Case management Supplementary or independent prescribing as part of a multidisciplinary team Long-term conditions management Medicines management - with routine patient monitoring and possibly supplementary prescribing and referral - and...

Debate: Do patients really want extended hours?
June 4, 2008... Access to GPs is getting worse and is frustrating patients, warns Dr Michael Dixon - GPs must make themselves available for longer to win back respect and secure their future YES Our own complacency is the single biggest threat to the...

LETTER: Nurses will always depend on GPs' advice.(Letter to the editor)
June 4, 2008... From Dr Rupen Kulkarni Redditch, West Midlands So Professor Bonnie Sibbald believes the nurses of tomorrow will look like the GPs of today (`Can nurses do a GP's job?', pulsetoday.co.uk/ debates). I'd agree that specialist nurses have...

LETTER: We're not culling, just reorganising.(Letter to the editor)
June 4, 2008... From Richard Sumray (chair), Dr Mayur Gor (PEC chair) and Tracey Baldwin (chief executive), Haringey PCT Delivering high-quality, accessible care to all our residents is the single most important element of our vision for improving health...

LETTER: Hours affair shows us GPs are as spineless as our leaders.(Letter to the editor)
June 4, 2008... From Dr Thomas Bloch Broadway, Worcestershire I always thought the GPC were a spineless lot who couldn't stand up to the Government and Department of Health. I now have to take it all back. It is their constituency - that is my colleagues,...

What you're saying online in support of our SOS campaign.(Save Our Surgeries)(Brief article)
June 4, 2008... PULSE: SOS - Save Our Surgeries Dr Peter Harborow, Horam, East Sussex The setting up of polyclinics assumes that all medical problems can be sorted out by medical or surgical intervention. This detracts from the doctor-patient...

60-second interview: Dr Kailash Chand.
June 4, 2008... Dr Kailash Chand is a GP in Ashton-under-Lyne, Lancashire, a GPC member and BMA council member. Dr Chand is calling on GPs to support the Pulse and BMA campaigns against Government primary care policy. * Is it time for GPs to be more...

Editorial: Polyclinic: a dirty word.(Editorial)(Brief article)
June 4, 2008... PULSE: SOS - Save Our Surgeries It is 11 months since the Healthcare for London report first laid down proposals for polyclinics, and in some ways we are still no clearer about what they will mean for GPs and patients. Indeed, leading...

PulseClinical: OSTEOPOROSIS.
June 4, 2008... Take-home points * Although individuals with osteoporosis are at great risk of a fracture, most fractures occur in the osteopaenic population * Current data up to 10 years suggests no adverse skeletal effects from bisphosphonates ...

PulseClinical: OSTEOARTHRITIS.
June 4, 2008... Professor of complementary medicine Edzard Ernst and colleagues assess the evidence to give you the bottom line on what works, what doesn't and what might cause harm among complementary OA therapies OA is a degenerative disease of the...

PulseClinicall: COW'S MILK ALLERGY.(Disease/Disorder overview)
June 4, 2008... Clinical presentation * Cow's milk allergy can lead to persisting dermatitis, diarrhoea and/or growth failure in an infant. * Diagnosis is established by clinical elimination and challenge tests. * Adequate nutrition and normal...

PulseClinical: SWOLLEN CALF.(Disease/Disorder overview)
June 4, 2008... GPs Dr Keith Hopcroft and Dr Vincent Forte continue their series on how to make sense of common presentations The GP overview Such has been the publicity about `economy class syndrome' that this presentation - and the closely related...

PulseClinical: PAINFUL NECK SWELLING ON AN INFANT.(Case study)(Brief article)
June 4, 2008... Dr Mike Wyndham describes how he got to the root of another puzzling presentation The patient This 18-month-old boy had only previously visited our surgery for his routine immunisations. His mother explained that he had not been well...

PulseClinical: IMPLANTABLE CARDIAC DEVICES.
June 4, 2008... League tables suggest the UK could make more use of heart rhythm devices. Cardiologists Dr Richard Charles and Dr Chris Plummer offer hints on spotting who could benefit and on the care of people who already have one 1 Cardiac device...

PulseWorking Life: THE IMPORTANCE OF MINIMISING TAX.
June 4, 2008... Practice finance In the third in our series on boosting practice profit, Paul Samrah stresses the crucial importance for a practice of minimising tax It is a truism to say that one way of maximising income is minimising loss....

NonPrincipal'sDiary: Dr Ruth Chapman.
June 4, 2008... At last I am reading articles written by partners who are prepared to stick their heads above the parapet and warn against the diminishing numbers of partnerships. Dr Clare Gerada, RCGP vice chair and a GP partner in south London, wrote of...

LEGAL LESSONS: LIABILITY ISSUES OF PRACTICE FUN DAY.
June 4, 2008... Barristers Michael Salter and Chris Bryden advise on a topical and worrying problem The Situation My surgery has always held a summer fun day in a local park for staff and their families. As a number of children attend, we have...

PulseWorking Life: DR HUW THOMAS.
June 4, 2008... Useful websites www.patient.co.uk www.mentor-online.com CV Dr Huw Thomas is a half-time GP principal in Minehead, Somerset, and deputy head of decision support for EMIS Knowledge Based Services, where he is clinical editor...

PulseServices: Cover if you become too ill to practise.
June 4, 2008... More GPs find they are glad they took out critical illness cover, says Stuart Smith from Pulse Independent Critical illness insurance has always had a fairly high profile in the medical profession, perhaps because the day-to-day contact...

Sorry, I don't do teeth.(Column)
June 4, 2008... Dental problems are naff-all to do with Phil, as everyone knows - except those with toothache Teeth hold a strange fascination for me. I'm attracted to the subject because it is the one, tiny, area of the human body over which I hold no...

DH to set out plans to abolish MPIG.(Department of Health)(Minimum Practice Income Guarantee)
June 11, 2008... Ministers hope consultation will avert legal challenge to scrapping of income guarantee EXCLUSIVE By Steve Nowottny Ministers are set to announce plans within the next few weeks to abolish the MPIG, Pulse can reveal. A new...

NHS Direct referring one in five to GPs.
June 11, 2008... More than a fifth of calls made to NHS Direct are referred to a GP, according to figures obtained by Pulse. Of nearly 34 million calls made between January 2003 and May 2008, an average of 22.5% were referred to a GP, with 6.1% referred to...

Polyclinics `will treble patient journeys to GPs'.
June 11, 2008... Introducing polyclinics could treble the distance people need to travel to see their GP, the Conservatives claimed this week. The average journey will rise by up to four miles in many areas of the country, according to figures compiled by...

New funding to tackle health inequalities.(Brief article)
June 11, 2008... The Government has announced #34m of new funding in 2008/9 to tackle health inequalities. In a speech to the Institute for Public Policy Research, health secretary Alan Johnson said the programme, entitled Health Inequalities: Progress and...

GPs beat firms to first Darzi centre contract.
June 11, 2008... A team of GPs has beaten a string of private firms to become preferred bidder for the first GP-led health centre contract awarded under Lord Darzi's nationwide tender process. Bedfordshire PCT chose GPs at King Street Surgery in Kempston to...

Save Our Surgeries: 4,000 GPs set for polyclinics.
June 11, 2008... As practices across the country join Pulse's Week of Protest, London PCTs meet to rubber-stamp polyclinic plans PULSE: SOS - Week of Protest By Steve Nowottny PCT bosses are this week set to rubber-stamp plans that would see up to...

Save Our Surgeries: SOS protest kicks off.
June 11, 2008... GPs and practice staff across the country are this week taking part in a week of protest to campaign against the Government's imposition of polyclinics. As a key element of Pulse's Save Our Surgeries campaign, GPs have been wearing...

Save Our Surgeries: PCT may reconsider surgery closures.
June 11, 2008... The first signs have emerged that the imposition of polyclinics may crumble in the face of opposition as a trailblazing PCT said it might shelve its plans. Haringey PCT has told councillors it may scrap proposals to close 37 surgeries...

QOF expert panel: Panel advises CVD screening pay.
June 11, 2008... Expert panel advises targets for primary prevention as part of its vision for the future of the QOF By Nigel Praities GPs could be paid for primary prevention of cardiovascular disease for the first time under proposals for new QOF...

QOF expert panel: Proposed QOF indicators.
June 11, 2008... The panel proposes indicators for the proportion of people with: * hypertension who have a baseline record of total and HDL cholesterol * hypercholesterolaemia who have total cholesterol of 5mmol/l or less and baseline record of HDL...

QOF expert panel: CKD targets may get tougher.
June 11, 2008... GPs should be given stricter blood pressure targets for patients with chronic kidney disease and incentivised for measuring proteinuria, says the QOF expert panel. Current QOF blood pressure targets for CKD are set at 140/85mmHg, but the...

QOF expert panel: Diabetes sliding scale push.
June 11, 2008... GPs should have a sliding scale of QOF targets for blood pressure in patients with diabetes to encourage stricter control, says a top Government adviser. The comments come after the QOF expert panel recommended a split indicator for blood...

QOF expert panel: How the QOF may evolve.
June 11, 2008... * New indicators for proteinuria and protein/creatinine ratio and stricter blood pressure targets for patients with CKD * Raising payment thresholds and splitting blood pressure indicator for patients with diabetes * Tightening up...

FRACTURES.(Brief article)(Clinical report)
June 11, 2008... Strong evidence exists for a raft of QOF indicators to improve osteoporosis care, says an expert report into the disease. A Government evaluation branded osteoporosis care a `national disgrace' last year, and the new report recommends five...

Peer support will be vital for revalidation.
June 11, 2008... GMC to investigate GPs who struggle to get colleagues to vouch for them By Gareth Iacobucci GPs who fail to come up with enough colleagues to vouch for their performance face investigation by the GMC, under the regulators'...

How revalidation will work.
June 11, 2008... * The colleague survey will play a key role in revalidation, set to be rolled out in 2010. * Revalidation will be required every five years to demonstrate fitness to practise. Its two key elements are specialist recertification (a sign...

Risk tool beats CVD screening.
June 11, 2008... A simple risk score based on information in patient records is effective at picking out those at high risk of developing diabetes, say UK researchers. The tool may be more feasible for population-wide screening than glucose tolerance...

Doubt cast on NICE glucose advice.
June 11, 2008... Key trial reports benefits for intensive glucose lowering, just weeks after NICE guidance cautions against it By Lilian Anekwe A major trial of intensive glucose lowering has thrown doubt on the recent recommendation by NICE that GPs...

Media Watch: This week's top... Miracle cure.
June 11, 2008... Something you might want to consider for that tardy member of practice staff: a genetic test for laziness. A swab taken from inside your cheek can pick up certain genes that make you more likely to wake up early or get up late, according to the...

Media Watch: This week's top... Scare story.
June 11, 2008... The Guardian lit up the cannabis debate this week, reporting on research that suggests smoking the drug for long periods of time may shrink parts of the brain. Scientists in Australia found that, despite several generations of musicians...

Media Watch: This week's top... most pointless research.
June 11, 2008... Road traffic accidents in China have soared by nearly 100% since 1985, say researchers. Shocking until you consider the number of cars on the road increased ninefold and other vehicles, principally motorcycles, jumped by a factor of 54. Talk...

JournalWatch: Post-stroke benefits.(Brief article)
June 11, 2008... Dipyridamole plus aspirin is significantly more effective than aspirin alone at preventing cerebrovascular events following a transient ischaemic attack or a stroke, a meta-analysis shows. An international team analysed data from five...

JournalWatch: Antipsychotics in utero.
June 11, 2008... Exposure to atypical antipsychotics in the womb increases the risk a baby will be born at larger than average weight, a UK study shows. Researchers compared 25 infants exposed to atypical antipsychotics in utero, 45 exposed to typical...

JournalWatch: Lipid tests miss FH.(Brief article)
June 11, 2008... Genetic testing is better than measuring cholesterol levels for detecting familial hypercholesterolaemia in children, say UK researchers. A study of 115 children - 69 with proven familial hypercholesterolaemia and unaffected siblings -...

JournalWatch: Alcohol cuts arthritis risk.
June 11, 2008... Alcohol consumption substantially reduces the risk of developing rheumatoid arthritis, Scandinavian researchers report. They analysed two separate studies, including 2,750 people with rheumatoid arthritis and case-matched controls. The...

JournalWatch: Pioglitazone lipid benefits.
June 11, 2008... Adding in pioglitazone to conventional therapy improves lipid profiles in patients with type 2 diabetes, an Italian study shows. The study of 196 patients compared the efficacy of pioglitazone in combination with metformin or a...

IN BRIEF: PCTs cutting to hit targets.(Brief article)
June 11, 2008... PCTs have been forced to restrict the healthcare they fund to help the NHS achieve its #515m surplus in 2006/7, an MPs' committee claimed this week. The Public Accounts Committee said the Department of Health's turnaround of NHS finances,...

IN BRIEF: NHS reforms `damaging'.
June 11, 2008... The Government's NHS reforms are damaging patient care, a group of academics has claimed. Writing in the BMJ, Professor John Howie, professor of general practice at the University of Edinburgh, argued that `tinkering' reforms will destroy...

IN BRIEF: Diabetes on the increase.
June 11, 2008... New figures reveal that by 2025 there will be more than four million people with diabetes in the UK. The likely increase has been blamed on rising levels of obesity and would be a 1.3 million increase on those currently thought to have the...

Firms to run weak PCTs.
June 11, 2008... Up to 10 trusts could be run by private companies within two years By Steve Nowottny Private companies could be running up to 10 PCTs within the next two years under tough new Government plans to tackle underperforming trusts. The...