Pulse articles from March 2005

Pulse archives from March 2005

Quality bar to be raised.
March 5, 2005... How quality framework could get tougher * New disease areas introduced * Easy clinical and organisational indicators scrapped * Higher minimum and maximum thresholds for scoring points * More indicators based on outcomes *...

New link to revalidation.(Brief Article)
March 5, 2005... GPs' performance against the quality framework is likely to be included in the new revalidation process, GMC president Professor Sir Graeme Catto has revealed. Sir Graeme told Pulse he expected more use would be made of IT systems to get...

NICE forces guidelines into quality talks.
March 5, 2005... GP pay is set to be tied to adherence to NICE guidelines in the next draft of the quality and outcomes framework, Pulse has learned. NICE believes it has secured an agreement from ministers to incorporate guidance into future quality...

GP first to test out paperless scripts.(Brief Article)
March 5, 2005... Dr Gordon Cunliffe's practice is the first in the UK to take on the Government's electronic transmission of prescriptions system. Developed by the National Programme for IT, the system sends script requests direct to the pharmacy. ...

GPs left in treatment limbo as NICE rations Alzheimer's drugs.(Brief Article)
March 5, 2005... GPs face having to manage seriously ill Alzheimer's patients with almost no options for treatment or referral, after NICE provisionally ruled out the use of the only available drugs. The decision will put practices under further pressure...

GPs angry as GPC fails to advise on PGEA claims.(Post Graduate Education Allowance)
March 5, 2005... GPs have condemned the GPC for failing to help them claim up to #3,000 in unpaid PGEA funding. LMCs reported large numbers of inquiries this week from GPs who believe they are entitled to the money. They say they are waiting for GPC...

GPs' Choose and Book fears `crap'.(Brief Article)
March 5, 2005... Health minister John Hutton says GPs' claims that the Choose and Book scheme will turn them into `travel agents' are `crap'. Speaking to a New Health Network conference this week Mr Hutton added: `And that's the legal term.' Mr Hutton...

NEWS IN BRIEF: London GP crisis worsening.(Brief Article)
March 5, 2005... NHS services in London are at breaking point because of the worsening shortage of GPs, a report by the King's Fund warns. Vacancies in London are at 7 per cent, double the rate for the rest of England. A total of 424 vacancies were...

NEWS IN BRIEF: GMC rewrites guidelines.(General Medical Council)(Brief Article)
March 5, 2005... The GMC is to rewrite its Good Medical Practice guidelines later this year to make them easier for patients to understand. The guidelines will be more concise and provide supporting guidance through case studies and examples of bad...

NEWS IN BRIEF: Shipman Inquiry cost #21m.(Brief Article)
March 5, 2005... The five-year inquiry into mass murderer Harold Shipman has cost taxpayers almost #21 million, the Government has revealed. Costs included #35,000 for legal representation for Shipman's wife. In a Commons written answer, health minister...

NEWS IN BRIEF: Flu vaccine problems solved.(Brief Article)
March 5, 2005... The Government has lifted the suspension on Chiron's licence to manufacture the influenza vaccine after being satisfied that problems in the manufacturing process have been resolved. GPs had to cancel clinics and scramble around for...

NEWS IN BRIEF: GPs get mobile panic button.(Brief Article)
March 5, 2005... A panic button device to offer more security to GPs doing house calls and other health service staff working alone has been launched by the NHS. If doctors find themselves in a vulnerable or violent situation they can press the button, hidden...

NEWS IN BRIEF: More data confirm MMR safety.(Measles-mumps-rubella vaccines)(Brief Article)
March 5, 2005... The rate of autism continued to rise in Japan after MMR was withdrawn and replaced with single vaccines,researchers claim. The joint UK and Japanese study, which has not yet been published, appears to provide further evidence that MMR and...

GPs deserting Labour in droves as election looms.(Brief Article)
March 5, 2005... GPs have given a resounding thumbs down to Labour's health policies and a Pulse poll shows support for the party has plummeted - Anna Goldie reports GPs will desert Labour in their droves at the forthcoming general election in protest at...

How will former Labour supporters vote this time?
March 5, 2005... Defecting to the Lib Dems Dr Jill Bartlett We all had high hopes for Labour for improving primary care but they have done exactly the same as the Tories in terms of privatisation and trying to lower the bill for public health at a cost to...

GPC acts to end confusion over enhanced services.(general practice)
March 5, 2005... New guidance goes part way to meeting LMCs' demands, writes Rob Finch The GPC has released a comprehensive list of enhanced services commissioned by PCTs to help GPs negotiate new deals for next year. Negotiators have also listed...

PCTs admit to short-term view.(primary care trusts)(Brief Article)
March 5, 2005... PCTs have admitted using enhanced services as a `quick fix' and failing to develop new and innovative schemes. But PCTs now want GPs to come up with radical alternatives to the way services are delivered, a survey of 96 PCTs by a GP has...

COMING YOUR WAY: `MRSA threat to babies'.(Brief Article)
March 5, 2005... THE STORY Hundreds of babies in hospital are being hit by the MRSA super-bug, the Sun reports. THE SOURCE The Patients' Association warned that in recent years a number of babies had been infected with MRSA in hospital after...

Government advisers doubt value of GP exercise plans.(Brief Article)
March 5, 2005... The Government's drive to make exercise promotion a routine part of GPs' work is based on `insufficient evidence', its own health advisory body has admitted. In a blow to ministers, the Health Development Agency said it could not make...

COMING YOUR WAY: `Pain relief in a simple patch'.(Brief Article)
March 5, 2005... THE STORY A patch impregnated with a morphine-like drug could provide relief from chronic pain for millions of patients, the Daily Mail reports. THE SOURCE A new fentanyl patch designed to be smaller and less likely to fall off...

COMING YOUR WAY: `No more open heart surgery'.(Brief Article)
March 5, 2005... THE STORY New keyhole surgery techniques could make open heart surgery a thing of the past, according to the Daily Mail. THE SOURCE A feature in the newspaper's health section reported that a new technique has been developed for...

COMING YOUR WAY: `Super-bug spread in gyms'.(Brief Article)
March 5, 2005... THE STORY A virulent new strain of the MRSA super-bug can spread through gyms and health clubs, warn the Daily Express and the Daily Mail. THE SOURCE During a newspaper interview, a Health Protection Agency researcher said there...

Wider role for pharmacists worries GPs.
March 5, 2005... Pharmacists in England could be allowed to prescribe from the full BNF for any condition without consulting a doctor, under options included in a new Government consultation. The GPC and RCGP pledged to resist such a radical move. ...

England left behind on GP vaccine pay.(Brief Article)
March 5, 2005... GPC members in Scotland and Wales are negotiating their own enhanced services for public health campaigns after growing frustrated with the Department of Health's refusal to implement a UK-wide agreement. Pulse has learned that plans are...

Getting ready for flu pandemic.(Brief Article)
March 5, 2005... GPs can expect to face an extra six million consultations during a flu pandemic with only antivirals to keep the disease at bay, the Department of Health is warning. The Department of Health this week unveiled its contingency plan to...

JOURNAL WATCH: Quit smoking schemes worthwhile.(Brief Article)
March 5, 2005... Smoking cessation programmes can have a substantial effect on long-term mortality, according to US and Canadian researchers. The study of 5,887 middle-aged patients evaluated a 10-week programme including discussions with a doctor, group...

JOURNAL WATCH: Antibiotics for pneumonia compared.(Brief Article)
March 5, 2005... Antibiotics active against atypical pathogens do not appear to be any better than Beta-lactam agents for treating non-severe community- acquired pneumonia. New Zealand researchers analysed 18 trials including 6,749 patients and compared...

JOURNAL WATCH: High homocysteine linked to CVD.(cardiovascular disease)(Brief Article)
March 5, 2005... High levels of homocysteine may increase the risk of dying from cardiovascular disease. Finnish researchers followed 802 men aged 46-64 without a history of heart disease or stroke. Over an average of 10.8 years of follow-up, 50 men died...

JOURNAL WATCH: Supplements cut hip fracture risk.(Brief Article)
March 5, 2005... Folic acid and vitamin B12 can reduce the risk of hip fracture in elderly stroke patients, a study suggests. Japanese researchers studied 628 patients aged 65 or older with residual hemiplegia recruited a year after a first ischaemic...

JOURNAL WATCH: Pneumonia a haemorrhage risk.(Brief Article)
March 5, 2005... Infection with Chlamydia pneumoniae may increase the risk of subarachnoid haemorrhage, a Japanese study suggests. Researchers measured serum C. pneumoniae IgG and IgA antibodies in 52 patients with subarachnoid haemorrhage and 104 healthy...

Ministers to consider overhaul of medical indemnity for GPs.
March 5, 2005... Thousands of GPs could have to change their medical indemnity policies under proposals being drawn up by the Government. Ministers plan to launch a consultation later this year on making insurance compulsory for all GPs. It is expected...

#95m e-booking `bribe' caused me to quit.
March 5, 2005... Exasperation over Choose and Book has driven Dr Francesca Lasman to resign as IT clinical lead for her primary care trust. Dr Lasman, a GP in Huntingdon, Cambridgeshire, said the #95 million `bribe' to get GPs involved in the electronic...

GPs left vulnerable to violence.(Brief Article)
March 5, 2005... Health boards in Wales are putting GPs at risk of attack because they are refusing to set up registers of violent patients. Boards have argued they cannot put patients who move to a new area in special treatment schemes if they have not...

New risk score shows steroid users need more bone protection.
March 5, 2005... A simple new risk scoring system could substantially cut fractures in patients on steroids by addressing the under-use of bone protection therapy, researchers conclude. The system allows GPs to calculate the precise absolute risk of...

Bisphosphonates cut elasticity of bones.(Brief Article)
March 5, 2005... Long-term treatment of postmenopausal osteoporosis with bisphosphonates reduces bone elasticity, a new study suggests. Patients taking the drugs for more than three years experienced a reduction in elasticity of 22 per cent compared with...

GP identifies one in 10 are carers.(Brief Article)
March 5, 2005... Dr Ninian Hewitt has used a postal survey to screen his patients and identify carers with unmet needs. One in 10 of his patients identified themselves as carers, yet none of them were known to social services. Dr Hewitt, a GP in...

Mammography may save lives from the age of 40.
March 5, 2005... By Emma Wilkinson Screening women as young as 40 for breast cancer could reduce mortality by 10 to 11 per cent, according to preliminary results from a major trial. Initial estimates from the UK Age trial, the first to specifically...

Study finds real toll of passive smoking.(Brief Article)
March 5, 2005... Passive smoking kills 11,000 people in the UK each year - far more than was previously thought - a study reveals. Smoke exposure in the workplace causes a fifth of passive smoking deaths among people aged 20 to 64 and half of those among...

Clopidogrel useful with aspirin therapy.(Brief Article)
March 5, 2005... Clopidogrel is cost-effective in combination with aspirin for treating patients with high-risk acute coronary syndromes, researchers conclude. The US study, published in the Annals of Internal Medicine, found clopidogrel increased quality...

GPs fear contract failures will make NI a `backwater'.
March 5, 2005... GPs in Northern Ireland are warning the province is becoming a primary care `backwater'. Failures in implementing the new contract and the Department of Health, Social Services and Public Safety's refusal to roll out initiatives such as...

My frustration over tsunami relief bid.
March 5, 2005... Dr Raj Chandran is being frustrated in his efforts to help the relief effort in tsunami-stricken Sri Lanka because he can't get a locum. Dr Chandran, a GP in Sutton-in-Ashfield, Nottinghamshire, said he had been let down twice and being...

`We don't collude on sicknotes'.(Brief Article)
March 5, 2005... GPs have condemned a law firm after it claimed that GPs `collude' with patients to give them sicknotes with non-specific diagnoses. Rowe Cohen Solicitors said employers were reporting a growing trend of sicknotes with vague symptoms. They...

Complaints over `useless' NHS 24 spark investigation.(Brief Article)
March 5, 2005... The Scottish Executive has launched an investigation into the performance of NHS 24 after a series of complaints from GPs and patients. GPs claim patients are being put at risk because the #36 million helpline is understaffed and cannot...

Protesting GPs go on minor injuries strike.(Brief Article)
March 5, 2005... GPs in the Lake District are to give up minor injuries work in protest at their PCT's continuing failure to commission it as an enhanced service. Four practices in Coniston, Grange-over-Sands, Windemere and Ambleside plan to take action...

`Obesity can be managed by GPs'.
March 5, 2005... Dr David Haslam, the GP who leads the National Obesity Forum, tells Nerys Hairon why GPs must embrace the obesity challenge Dr David Haslam, chair of the National Obesity Forum, is prepared for a fight. He is well aware of the...

EDITORIAL COMMENT: Where was GPC in unpaid PGEA case?(Brief Article)(Editorial)
March 5, 2005... In winning his legal fight to claim #3,000 unpaid PGEA money, Dr Cornell Fleming also won a victory for thousands of other GPs. But it should not have been left to a single GP to lead this battle on behalf of the profession. That is supposed to...

Letter: My 10 commandments.(Letter to the Editor)
March 5, 2005... Following your 10 commandments for GPs (Careers, February 12), here's a list to help managers. 1 Lots can be achieved if we work together. 2 Clear and honest communication goes a long way. 3 Giving an impression of being...

Letter: Contract lessons for us all from this GP's 6,000-patient hell.(Letter to the Editor)
March 5, 2005... Your lead story `My 6,000-patient hell' (February 26) illustrates one of the main problem areas of the new contract. The global sum has obviously been an area of concern and was further devalued by MPIG. Many doctors in hard-pressed socially...

Letter: How I deter demands for a sicknote.(Letter to the Editor)
March 5, 2005... Dr Christine Dewbury is correct in stating that GPs do not have to provide short-term certificates (Features, February 12). Rather than waste time arguing with patients who demand one, I hand over a copy of a standard note instead, for them...

Letter: Code for lithium monitoring.(Letter to the Editor)
March 5, 2005... I was interested to read your article (News, February 26) concerning the anomaly of lithium monitoring. The lower limit of the therapeutic range at our local lab is 0.5, and after discussion with our PCT IT adviser, she agreed it would be...

Letter: Here is evidence for the benefits of low-allergy diets.(Letter to the Editor)
March 5, 2005... Dr FM Hunter (Letters, February 26) wants evidence for menopausal symptoms and depression responding safely to low-allergy diets and repletion of nutrient deficiencies. The Lancet published proof of the effectiveness of low-allergy diets...

Letter: Hep B coincided with my first MS attack.(Letter to the Editor)
March 5, 2005... Regarding the articles `Hep B vaccine causing MS' (News, February 19) and `Am I at legal risk over hepatitis immunisation?' (Features, February 19). Before GPs and practice nurses rush off in droves to cover themselves against hepatitis B...

Letter: Why case management is still one of the best options.(Letter to the Editor)
March 5, 2005... Your recent reports on case management of the vulnerable elderly are overly pessimistic and go considerably beyond the evidence. You did not make clear that independent research by Picker Institute Europe showed that elderly patients and...

Letter: We must open up circumcision debate.(Letter to the Editor)
March 5, 2005... Pulse has shown real wisdom and courage in opening up the seemingly taboo subject of circumcision for dabate. It is not true, as claimed by one correspondent, that there is any link in my mind between male and female circumcision. One is...

Letter: My success with sign language.(Letter to the Editor)
March 5, 2005... Your article `GPs urged to make sign language available' (News, February 26) confuses those who are deaf (ie have no hearing) and those who are hard of hearing. I suggest Dr Langfield is unlikely to actually be deaf (I notice a hearing aid...

Choose Book - Part 2: Why I resigned as IT clinical lead for my PCT.
March 5, 2005... Last week Professor Michael Thick talked up the merits of Choose and Book - here, Dr Francesca Lasman, who resigned as IT lead last month, explains why she did so and why she feels there are problems at the heart of the Government's flagship IT...

The 10 biggest problems with Choose and Book.(service selection booking guidance )
March 5, 2005... 1. The referring clinician has to decide exactly which clinic the patient should attend, and whether the problem is urgent, instead of leaving the specialist service to sort this out. This is fine for an experienced clinician referring to a...

How Dr Lasman thinks Choose and Book should work.(Brief Article)
March 5, 2005... Step one GPs offer choice by accessing a spreadsheet from a dropdown menu of specialties. The spreadsheet would give the PCT-commissioned five providers for that speciality, with sub-speciality clinics and waiting times for day cases,...

Heartsink I see more than my own kids.(managing hypochondriacs)
March 5, 2005... Case history All the doctors in the practice have their share of heartsinks but one patient, Mrs X, is making your life a misery by booking her next appointment as she leaves. She also rings for telephone advice on an almost daily basis...

A freedom that bites.
March 5, 2005... The new Freedom of Information Act opens up GPs to public scrutiny and if they don't comply they will get bitten, says Dr Peter Stott Yet another set of regulations has been introduced to tie us to the computer screen. And they need to be...

What's new in Ophthalmology.
March 5, 2005... Mr Tony Moriarty outlines six new developments in his field 1. Age-related macular degeneration: a growing problem As our population grows, this will become an ever burgeoning medical complaint. Two forms exist: wet and dry. The wet...

FACE TO FACE: Investigating GI tract problems.(gastro-intestinal tract)
March 5, 2005... GP Dr Stefan Cembrowicz asks consultant gastro-intestinal radiologist Dr Jim Virjee about investigating the GI tract PRACTICAL POINTS * The endoscopy vs radiology question can only be answered by looking at your local hospital's audit...

Coping with nutritional problems of dysphagia.
March 5, 2005... In the second of our two-part series on dysphagia, Bella Talwar advises how GPs can manage the nutritional side-effects The social opprtunities and pleasures mealtimes present can be destroyed by dysphagia. This can affect the quality of...

Why I back national screening for abdominal aortic aneurysm.
March 5, 2005... A paper last year led to headlines that screening for aortic aneurysms does not reduce overall death rates. Not so, says Mr Shane MacSweeney, who argues that a national screening programme is long overdue As a surgeon operating on a...

Australian paper on AAA screening1.(Brief Article)
March 5, 2005... In November last year the BMJ published a paper from Western Australia by Norman et al on screening. The study looked at men aged 65-83 identified from the electoral register. No attempt was made to exclude those unlikely to benefit or to...

The Asian CHD epidemic: where do we go now?(Cardiovascular disease)
March 5, 2005... Cardiovascular disease remains the biggest killer of south Asians in the UK - Dr Kiran Patel, Professor Raj Bhopal and Professor Jaspal Kooner explain how knowledge has grown and what GPs can do South Asians have the highest overall and...

YOUR FIRST: Non-compliant patient.
March 5, 2005... What happens if your patient won't comply with the treatment you are prescribing? Dr Melanie Wynne-Jones offers a little practical advice Compliance is in fact no longer the right word to use in this context. It has fallen out of favour on...

Medical politics: how GPs can make the NHS better.(National Health Service)
March 5, 2005... Dr Chaand Nagpaul explains the buzz he gets from medical politics No GP working in the NHS is immune from the impact of medical politics. We all work in a system run by the government of the day, implemented nationally and locally, which...

CV: Dr Mary Church answers the Pulse careers questionnaire.(Brief Article)(Interview)
March 5, 2005... What/who made you decide to go into general practice? I thought it would be a more flexible option. I married a cardiologist and needed to follow him around the country as he scaled the hospital career ladder. Easier to do as a GP, so I...

CAREERS: WHY I LOVE BEING A SPORTS DOCTOR.(Brief Article)
March 5, 2005... * The chance to use my specialist skills in sports and exercise medicine * Continuing my involvement in sport (now that I have stopped playing) * Opportunity to travel worldwide with the teams * To work as part of a...

LET'S PRACTISE IN ISLE OF SKYE.
March 5, 2005... Where? `The Isle of Skye (An t-Eilean Sgitheanach), the most scenically spectacular of all the Scottish islands, gets its name from the Norse word for cloud (skuy) and so it obviously rains a lot here.' (Travel Scotland) What's so special...

CAREERS: Shrewd newcomer's guide to settling in.
March 5, 2005... Follow Jobhunter's tips on wheedling your way into your new practice and you could gather enough gossip to blackmail all the staff and GPs! Settling into a new practice is not something that's taught at medical school, but follow these...

Fighting for your future.
March 12, 2005... CAMPAIGN COMMENT: Pledge your support today This week we launch a new campaign - the Pulse Manifesto for General Practice. It will focus on the issues that you say matter most to you as GPs. The campaign is our reaction to the disturbing...

`Why I support the Pulse Manifesto for General Practice'.(Brief Article)
March 12, 2005... `It's an excellent campaign. I just want people to stop forcing me to become a manager and let me get on with being a GP.' Dr Lisa Silver, Henley-on-Thames, Oxfordshire `I agree with everything in the manifesto. The enhanced services...

MANIFESTO FOR GPs: You have spoken - now we will take up the fight.
March 12, 2005... You responded in huge numbers to our Agenda 2005 survey. You expressed grave fears for the future of your profession and profound frustration over the obstacles that make your daily working life more difficult than it needs to be. Here we set...

NEWS IN BRIEF: BMA's election rallying call.(British Medical Assocations)(Brief Article)
March 12, 2005... The BMA is demanding the next Government put GPs at the heart of primary care. In a `doctors' manifesto' released ahead of the general election it urges all parties to `recognise the value of GPs as being at the centre of primary care'....

NEWS IN BRIEF: Retirement at 65 unpopular.(Brief Article)
March 12, 2005... Changes to the NHS pension scheme will cause an `exodus' of doctors from the NHS, starting as early as next year, the BMA is warning. James Johnson, BMA chair, said a survey had shown the changes - which include increasing the retirement...

NEWS IN BRIEF: Big improvement in Ca care.(cancer care)(Brief Article)
March 12, 2005... Cancer services have improved significantly since publication of the NHS cancer plan, the National Audit Office reports. Some 99.2 per cent of patients with suspected cancer are now seen within two weeks of urgent referral from a GP, while...

NEWS IN BRIEF: Aspirin cuts stroke in women.(Brief Article)
March 12, 2005... Low-dose aspirin reduces women's risk of stroke by 17 per cent, the Women's Health Study reports. The major trial of 40,000 healthy women found aspirin reduced the incidence of major cardiovascular events by 9 per cent overall and by 26...

NEWS IN BRIEF: Script charges rise 10p.(Brief Article)
March 12, 2005... Prescription charges will rise 10p to #6.50 from April. Prescription prepayment certificates will increase by 50p to #33.90 for a four-month certificate, and by #1.40 to #93.20 for a 12-month certificate. The Government said the rise was...

NEWS IN BRIEF: Suicide verdict on GP.
March 12, 2005... The suicide of a GP who had been under investigation by his PCT for a high referral rate `should clearly not have happened', the coroner investigating his death has concluded. Dr Stephen Farley, a GP in Ibstock, Leicestershire, was found...

Labour planning to abolish practices' registered lists.(Brief Article)
March 12, 2005... GPs will have to compete with each other to attract patients if Labour wins a third term. Registered lists will also disappear with patients allowed to join more than one practice. The radical plans unveiled by Tony Blair in a...

GP to stand as independent MP in health protest.(Brief Article)
March 12, 2005... Dr Ivan Benett is on the verge standing as an independent candidate at the upcoming election as a protest at Government health reforms. He says if GPs give him their backing, he will stand for a seat in Manchester. Dr Benett has also...

GPs must screen for obesity.
March 12, 2005... GPs will have to screen the entire adult population for obesity under new Government plans. The Department of Health expects GPs to weigh every patient between the ages of 15 and 75 who visits their surgery and offer lifestyle advice to...