Pulse articles from May 2003

Pulse archives from May 2003

GP enhanced service pay is revealed.(general practitioners)
May 5, 2003... Pay rates for GPs providing enhanced services are emerging amid predictions the arrangements will prove a `bureaucratic nightmare'. Fees for directed enhanced services were included in the new ready reckoner sent to 60 practices for...

GPs' antibiotic scripts may be scrutinised.(general practitioners)(Brief Article)
May 5, 2003... Dr Gareth Hayes is worried GPs may come under scrutiny for their antibiotic use after Government research showed high-prescribing practices run an increased risk of antibiotic resistance in their own patients. Dr Hayes, a GP in Cardiff and...

Pulse is the best-read medical newspaper.(Brief Article)
May 5, 2003... Pulse has topped the latest independent readership survey* of medical publications. For the six months to March 2003, 77 per cent of GPs said they read Pulse - five points ahead of GP and 12 points ahead of Doctor. We thank you for this vote of...

GPs and accountants wary of pay and pension claims.(general practitioners)(Brief Article)
May 5, 2003... GPs and medical accountants are unconvinced by GPC promises of a 58 per cent pension increase and average salaries of #102,000 for GPs. GPC members have also accused the negotiators of `triumphalism' over the pledges, which came as part of...

GP moves into first NHS Lift surgery.(general practitioners, National Health Service)(Brief Article)
May 5, 2003... Dr Nick Mawby is the first GP to practise from premises funded by NHS Lift, even though his area is the second wave of the scheme. But his practice, which opened last month in Packmoor, North Staffordshire, is not in a permanent building....

Disease registers in quality pay equation.(Brief Article)
May 5, 2003... A deal to incorporate disease registers in the pricing of quality payments will be presented before the contract ballot, GPC negotiators have pledged. Dr Andrew Dearden, GPC Wales chair, said the move was necessary because GPs opting for...

Antibiotic resistance linked to practice prescribing rate.(Brief Article)
May 5, 2003... GPs who prescribe high levels of antibiotics may trigger resistance in their own patients, Government scientists warn. The alert came after research by the Health Protection Agency revealed a `strong' link between individual practices'...

Call for coroners to scrutinise GPs.(general practitioners)(Brief Article)
May 5, 2003... Coroners should be given the power to investigate individual GPs if dead patients' relatives raise suspicions over death rates, the Government-commissioned Review of Coroners has recommended. Mike Gallagher, secretary of the review, said...

Pilot fast-tracks NHS Direct calls to GPs.(National Health Service, general practitioners)(Brief Article)
May 5, 2003... Dr Michael Gordon is part of a pilot to fast-track urgent out-of-hours NHS Direct calls to GPs to try to reduce inappropriate referrals and cut GP workload. Dr Gordon, a medical director of Sheffield GP Out-Of-Hours Collaborative, said GPs...

Ethnic origin must feature in Carr-Hill.(general practitioners and labor relations)(Brief Article)
May 5, 2003... Government-funded research has found patients' ethnic origin is the major social factor affecting GP workload. The unpublished study is the first clear evidence of the link and prompted the academics behind the research and GPs with high...

Sex charge GP is found hanged.(Brief Article)
May 5, 2003... A GP accused of sex abuse has been found hanged at his home. Dr Ronnie Graham, 54, a GP in Glasgow, was facing charges of molesting a boy over a 10-year period. Dr Graham was formally suspended by the GMC's interim orders committee in...

PCTs going private to meet access target.(primary care trusts)(Brief Article)
May 5, 2003... Primary care trusts are negotiating with a private GP service in a bid to meet Government 48-hour access targets. U-First Healthcare has identified 250 Tesco stores as potential sites for private GP clinics. A spokesman said: `We are...

GPs get #10 a patient to improve diabetes care.(general practitioners)(Brief Article)
May 5, 2003... Dr Rodney Swallow has welcomed a #323,000 Government windfall to boost diabetes services. Some of the money paid to Coventry PCT will fund a city-wide audit of diabetes care and practices will be paid #10 per patient with diabetes to take...

`GPC vaccine advice puts GPs at legal risk'.(general practitioners)
May 5, 2003... GPs risk litigation if they follow GPC advice not to draw up patient group directions for practice nurses to give vaccinations, medicolegal experts warn. Confusion over the issue has sparked widespread `conflict and ill feeling' within...

GPs need money to treat alcohol abuse.(general practitioners)(Brief Article)
May 5, 2003... GPs need more resources to tackle alcohol abuse in thousands of patients, a report demands. The report, by the charity Alcohol Concern, said two-thirds of GPs were helping just six or fewer patients with serious drink problems when...

Specialist GPs threaten to pull out over pay rates.(general practitioners)(Brief Article)
May 5, 2003... GPs with special interests are threatening to pull out of providing the services unless primary care organisations fund them properly. The threat - which came as huge variations in pay rates emerged - could jeopardise the Government's...

Workload and risk force GP to quit.(general practitioners)(Brief Article)
May 5, 2003... Dr Tony Hall-Jones is being forced to quit his GP specialist post because of the workload and legal implications of the new contract for enhanced service providers. Dr Hall-Jones, a GP in Tring, Hertfordshire, who has a special interest in...

Minister in `cover-up' of survey on access to GPs.(general practitioners)(Brief Article)
May 5, 2003... The Department of Health has been accused of suppressing patient support for GPs after it refused to publish the findings of an opinion survey on GP services. Health minister David Lammy told MPs in a recent Commons answer he had no plans...

Seven GPs on the new GMC.(general practitioners)(Brief Article)
May 5, 2003... Seven GPs have been elected to the reformed GMC council. They are: Professor Michael Pringle, representing the Midlands; Dr Krishna Korlipara for the north of England; Dr Alex Freeman and Dr Nicola Toynton, for the south and south-west; Dr...

GPs can cut echo referrals with a new three-step LVSD screening tool.(general practitioners)(left ventricular systolic dysfunction)
May 5, 2003... GPs can drastically cut referrals to echocardiography units by using three criteria for identifying patients with suspected heart failure, a new study reveals. The findings will help GPs streamline referrals to overburdened echo units as...

Most GPs prefer to refer heart failure to partner.(general practitioners)(Brief Article)
May 5, 2003... Nine out of 10 GPs would rather transfer the management of patients with heart failure to a more experienced colleague than tackle it themselves and only a quarter feel confident prescribing Beta-blockers, according to a new study. ...

Nurse pay rise will dent practice income.
May 5, 2003... GPs would need a huge increase in practice income in the first three years of the new contract just to cover staff pay rises, NHS pay experts are warning. The increase would be needed to meet the cost of the Agenda for Change deal, which...

GPs want to charge #36 for home visiting.(general practitioners)(Brief Article)
May 5, 2003... Three out of five GPs believe they should be able to charge patients for missed appointments and home visits, a survey has found. Supporters of charging said an average price of #36 for a home visit and #11 for a missed appointment would...

GPs resist unfunded appraisal pressure.(general practitioners)(Brief Article)
May 5, 2003... GPs have complained they are being pressured to have appraisals even though their primary care trust is refusing to fund the scheme. Practices in North Manchester PCT said they were being telephoned by the trust during busy surgery times...

Child flu vaccine policy `unclear'.(Brief Article)
May 5, 2003... The Government should clarify its guidance recommending influenza vaccination for at-risk children because the evidence for its policy is `unclear', according to a study. The researchers said the guidelines were based on a theoretical risk...

GPs accused of `chaotic' treatment of suspected UTI.(general practitioners)(urinary tract infections)
May 5, 2003... Government advisers have accused GPs of `chaotic' management of suspected urinary tract infections after a study suggested poor understanding of national guidance. Many GPs sent samples unnecessarily for patients with `classic' symptoms....

Dipstick boosts GP diagnosis.(general practitioners diagnosis of urinary tract infections)(Brief Article)
May 5, 2003... Dipstick urine testing for suspected urinary tract infections increases GPs' diagnostic accuracy at least fivefold in symptomatic patients, research suggests. The study in Family Practice (April) found using the reactive strip dipstick...

Star ratings to cover GP sexual health care.(general practitioners)(Brief Article)
May 5, 2003... GPs' performance in providing sexual health care will be judged by the Government under PCO star ratings, Department of Health officials have made clear. The department is planning to introduce a performance indicator covering rates of...

TALKING POINTS.(interview with Dr. STephen McCabe)(Interview)
May 5, 2003... Dr Stephen McCabe practises in Portree, Isle of Skye. He has been a GP for eight years. Jo Carlowe spoke to him about the current hot topics in his practice New contract Is it fair to dock 100 quality points from practices opting for...

Target for e-prescribing in doubt as pilot ends early.(Brief Article)
May 5, 2003... Government plans for all GPs to transmit prescriptions electronically have been thrown into doubt after one of three pilot schemes testing possible systems was wound up early. The three consortia running the trials, involving hundreds of...

GPs want NHS 24 cash diverted.(general practitioners)(Brief Article)
May 5, 2003... GPs in Scotland have called for funding for NHS 24 to be spent on enhanced primary care services instead. The Scottish LMC conference voted overwhelmingly for a motion after co- ops piloting links with the Scottish version of NHS Direct had...

48-hour access `will hit quality'.(health care)(Brief Article)
May 5, 2003... Delivering the Government's 48-hour access target will mean major cuts in the quality and continuity of care, the Scottish LMC conference has warned. The conference instructed the Scottish GPC to ensure the Scottish Executive and the...

EDITORIAL COMMENT: They are the ones to sort out the mess.(general practitioners and labor relations)(Brief Article)(Editorial)
May 5, 2003... A motion calling for the GPC negotiators to resign failed to attract a single vote at the recent Scottish LMC conference. Even the GP who proposed the motion did not vote in its favour. The negotiators must be feeling well pleased. But...

Letter: Does Carr-Hill in fact oppose the contract?(Letter to the Editor)
May 5, 2003... Rather than blame Professor Carr-Hill for the nonsense being promulgated by our negotiators, we should examine what he has said in the past in what are clearly carefully constructed arguments for publication. It should be clear that...

Letter: Why are we playing down SARS problem?(Letter to the Editor)
May 5, 2003... I really do have to comment on your front-page story `GP condemns the hysteria over SARS' (News, April 28). First, I have a fairly large list size and since the beginning of the SARS outbreak have only had two patients asking questions...

Letter: Privy Council move is a wake-up call for GMC.(Letter to the Editor)
May 5, 2003... Although it is highly regrettable, a spate of GMC ruling has been reversed by the Privy Council on the verdict of serious professional misconduct by doctors (News, April 21). I am not a member of the GMC but I do have extensive experience...

Letter: Amateurs on GMC do nothing for the confidence of doctors.(Letter to the Editor)
May 5, 2003... Yet again we read of the Privy Council overturning a professional conduct committee verdict (News, April 21). On their own admission the six-person panel in the latest case consisted of five who were not GMC members (presumably not doctors) and...

Letter: Anything to learn from dentists?(Letter to the Editor)
May 5, 2003... It would appear from Dr Carnegy (Letters April 28) that some dentists may be failing their terms of service by being unavailable to their patients out of hours. From many adverts in the medical press it would appear the dentists'...

Is PMS worth a bet in case contract falls?(general practitioners and labor relations)
May 5, 2003... Many GPs are applying for PMS as an insurance policy against the possible collapse of the new contract - Dr Bob Button asks if it is a good move So you think it might be wise to put in a bid for the next wave of PMS as a safety-net in case...

Enhanced services could be flashpoint for some practices.
May 5, 2003... Dr James Graham believes the optional services element of the new contract could lead to partnership disputes by making GPs feel pressured The concept of the specialist GP is not a new one, but the new contract gives the opportunity for...

Attacked by bayonet wielding maniac, I'm the one in trouble!(violent patient)
May 5, 2003... Attacked and left bleeding profusely by a manic-depressive with a bayonet, it was Dr Charles Gould who ended up in the `dock' - he describes his ordeal before the GMC June 7, 2001 - general election day in the UK - is a day I will always...

Practice Q&As: I'm jaded: can I organise a sabbatical?(general practitioners)(Brief Article)
May 5, 2003... Q: I am 50, jaded and lack the stimulation I used to get from general practice. I thought a sabbatical might recharge my batteries. How should I proceed? A: A sabbatical can be an excellent way of invigorating and expanding your career....

Practice Q&As: Retaining my practice property share.(Brief Article)
May 5, 2003... Q: I am shortly due to retire and my partners have asked me if I want to hold on to my share of the practice premises for a further three years. Should I agree? A: It is common to link property owning to parity. When it took three years to...

Can I use our medical records against crash patient?
May 5, 2003... The problem The green Ford backed out of the parking space and crashed into my car. The driver, an elderly man, was agitated, confused and accused me of driving into him. Unfortunately there were no witnesses. Back at the practice I...

Practice Q&As: What is the practice capital account?(Brief Article)
May 5, 2003... Q: I have been offered a partnership with my ideal practice. Once I reach full parity (after six months) they say I must pay #10,000 in to the `practice capital account' - the same as my golden hello. A: It is coincidence that the two...

Practice Q&As: How do we prevent fraud?(Brief Article)
May 5, 2003... Q: A practice manager near us has just been prosecuted for defrauding the partners. How can we reduce the chance of this happening to us? A: There are many areas to guard against fraud. First, document the steps involved as income and...

Practice Q&As: How much national insurance for my two jobs?(Brief Article)
May 5, 2003... Q: I am starting work part-time in my first partnership soon and I will be doing three days a week plus three clinical assistant sessions at two hospitals. What NI should I pay? A: Your clinical assistant posts will be classed as employed....

Practice Q&As: My notional rent review is dragging.(Brief Article)
May 5, 2003... Q: How does an independent professional valuer argue the case for a better notional rent uplift? The district valuer offered us a 5 per cent uplift 11 months ago. Since then our own valuer has been `in negotiations' and is still hopeful of a...

Practice Q&As: When can a GP's golden hello be clawed back?(general practitioner)(Brief Article)
May 5, 2003... Q: Due to unforeseen circumstances our latest partner has just handed in his notice after only 15 months. He received a golden hello of #10,000 last year. Will he have to pay this back? A: The key point here is that although legally the...

Practice Q&As: Tightening up on our fees cash.(Brief Article)
May 5, 2003... Q: In our last set of accounts we noticed the amount we received from private fees had fallen by 25 per cent on the previous year. When we audited the figures the drop was entirely due to fees normally paid at reception such as private...

Patient wants a wheelchair for her eczema.
May 5, 2003... Case history Sabrina, 32, is insisting on a home visit as she absolutely cannot walk a step. She has a long history of eczema and now both her lower legs are red hot, very scaly, severely excoriated, swollen and in places weeping and...

Never a dull moment in student health care.
May 5, 2003... Treating university students is not just dishing out condoms, says Dr Dominique Thompson Let me say upfront I love my job. At a time when general practice is undergoing huge upheavals, getting to grips with appraisal, revalidation and a...

Q&As: How do I start practising acupuncture?
May 5, 2003... Q: I want to try out acupuncture in my practice, as there appears to be great demand locally. Can you give me advice on how I should get trained and whether there are professional qualifications? A: There is no legislation in the UK...

Patients suitable for metal on metal hip resurfacing arthroplasty.
May 5, 2003... Younger patients with hip disease can now benefit from a lasting alternative to conventional replacement - write Mr Thomas Saw and Mr Richard Villar The Government's health care watchdog last year gave its blessing to an innovative hip...

GUIDE TO COMPLEMENTARY THERAPY: Herbalism.
May 5, 2003... Dr Tanvir Jamil looks at the evidence base for some of the more popular herbal `medicines' Modern-day herbalism is probably the most commonly practised form of medicine worldwide and is gaining ground in the developed world. One in three...

Vulval skin conditions.
May 5, 2003... Don't be timid when diagnosing vulval skin problems - Dr Karen Gibbon offers advice to help with referral Recognising skin disease in the vulva depends on a sound knowledge of the normal anatomy and variations in the vulva's appearance. ...

TEST YOURSELF ON: Bowen's disease.(Brief Article)
May 5, 2003... Use our quick quiz to check your clinical knowledge QUESTIONS 1 Bowen's disease usually presents as multiple rapidly growing plaques. True or false? 2 Which areas of the body are most commonly affected? 3 It is usually very...

Making good referrals for dermatology.
May 5, 2003... Ensure your dermatology referrals are appropriate - Dr Melanie Wynne- Jones explains what steps to take Most GP registrars have little dermatological experience and find it difficult to manage at first. A good working knowledge of skin...

YOUR FIRST: Telephone consultation.
May 5, 2003... Consider phone contact a proper consultation not just `a bit of advice', urges Dr Tanvir Jamil One in four patients is unhappy with the advice they receive from doctors over the phone. Around half of callers say they would prefer a home...

Pulse-PDP virtual tour.(online information services)
May 5, 2003... Our online professional development learning environment is now up and running - if you want to see how it will work for you, why not take a virtual tour around the concept www.pulse-pdp.co.uk Pulse-PDP is the new tutor-supported, online...

ANSWER BACK: How should keratosis pilaris be managed?(Brief Article)
May 5, 2003... Q: How is problematic keratosis pilaris best managed? A: Keratosis pilaris can be defined as a disorder of hyperkeratosis which presents with discrete 1mm folliculocentric papules. These are commonly seen at the tops of the arms and legs....

ANSWER BACK: What are the best ways of predicting the fertile period?(Brief Article)
May 5, 2003... Q: Is there a role for basal body temperature recording in the management of delay in conceiving? A: Basal body temperature has been traditionally used to detect ovulation, but it may not be a reliable method as it can be affected by...

GPs' pay hopes revived.(general practitioners)
May 12, 2003... Negotiators' hopes of saving the contract have been given a significant boost after the new ready reckoner delivered the prospect of a big income rise for many practices. But the first signs of a turn in the tide of opinion in favour of...

GP persuades Carr-Hill to end silence.(general practitioners, Roy Carr-Hill)(Brief Article)
May 12, 2003... Dr Bill Spiegler has tempted Professor Roy Carr-Hill to end his silence about his controversial formula after contacting him with a message of support. Dr Spiegler sent the professor an e-mail saying he suspected his formula was sound but...

Little change on vaccine target pay.(pediatric vaccines)(Brief Article)
May 12, 2003... Payment for childhood vaccines under the new contract has finally been announced with pay rates much the same as the Red Book. An average practice with a list of 5,000 patients, including 59 children aged two, will get #2,655 for 70 per...

GPs with good notes to miss out on #5,000.(general practitioners)(Brief Article)
May 12, 2003... GPs who have already put in work to improve the quality of their patient notes will lose out financially. Summarising patient notes in preparation for the quality and outcomes framework will net the average practice between #1,000 and...

Enhanced services pay rates.(Brief Article)
May 12, 2003... DIRECTED ENHANCED SERVICES PAY RATES * Access - #8,750 per average practice (including #3,750 quality pay) except Scotland: total allocation #12m plus #7.6m over next three years * Childhood immunisations - average #2,655 for 70%...

Pay for violent patients won't protect GPs.(general practitioners)(Brief Article)
May 12, 2003... The pay on offer to GPs who treat violent patients will not be enough to ensure adequate practice security, claims Dr Richard Vautrey. Practices that opt in to treating violent patients as an enhanced service will receive a retainer of...

GPs face paper mountain for enhanced service pay.(general practitioners)(Brief Article)
May 12, 2003... GPs who opt in to enhanced services will have to wade through a mountain of paperwork before they can claim payments. Almost all directed and national enhanced services will require GPs to set up registers of patients and put robust call...

Cash-flow fear over quality pay setback.(Brief Article)
May 12, 2003... GP negotiators have failed in their bid to bring part of GPs' quality reward payments forward raising fears that high-aspiring practices will face a lag in cash-flow in the first year of the quality framework. Negotiators held discussions...

GP unconvinced despite pay boost.(general practitioners)(Brief Article)
May 12, 2003... Dr Tom Craig has not been persuaded to vote for the contract in the upcoming ballot even though the new ready reckoner has indicated his practice will get a 35 per cent increase in resources by 2006. Dr Craig's practice in Londonderry,...

Salaried GPs' pay rates set at #65,000 a year.(general practitioners )(Brief Article)
May 12, 2003... Salaried GPs employed by practices or primary care organisations will be paid around #65,000 a year, Pulse has learned. The benchmark figure, agreed by Ministers and the GPC, was leaked by a senior contract source after a model contract for...

GPs fear vaccine supply `disarray'.(general practitioners)(Brief Article)
May 12, 2003... Vaccine supply delays could cause `disarray' to the national Hib booster catch-up campaign, claim GPs. It was announced last week that GPs will get a #6.80 item-of-service fee for vaccinating any child who was under four on April 1. The...

Vaccine advisers condemn ministers' `wrong message'.(Joint Committee on Vaccination and Immunisation)
May 12, 2003... Government immunisation advisers have criticised ministers for sending out `the wrong message' on the importance of childhood vaccines. The Joint Committee on Vaccination and Immunisation is angry at the failure to include vaccine uptake...

Patients see little of NHS progress.(National Health Service)(Brief Article)
May 12, 2003... The NHS is improving because of new national standards but much of the progress is not being felt by the general public, a Commission for Health Improvement report has concluded. The report, Getting Better?, is based on CHI's reviews of 250...

GP backs drug rationing.(general practitioners)(Brief Article)
May 12, 2003... Dr Ivan Wisely is backing the rationing of expensive drugs by his local health board after facing `intolerable pressures' over prescribing costs. Grampian health board has been threatened with action by Scottish Executive ministers after...

GP registrars feel `second class'.(general practitioners)(Brief Article)
May 12, 2003... GP registrars feel they are treated like `second-class citizens' during the hospital component of their training, a BMA survey has found. Half the 160 respondents said they thought being a GP registrar affected their training. A further 70...

GPs face diabetes care scrutiny.(general practitioners)(Brief Article)
May 12, 2003... All GPs in England will face scrutiny from the Commission for Health Improvement over diabetes care as they struggle to meet national service framework targets. In a separate audit, the commission will also benchmark prescribing in elderly...

Arthritis surge from `fanatical' exercise.(Brief Article)
May 12, 2003... Dr Alasdair Wright says GPs should be alert to the risk of arthritis in young patients who over-exercise amid the surge in gym membership. Dr Wright, a GP in Wirral, Merseyside, who is setting up a PCT-funded intermediate orthopaedic...

GPs back plan for six-month ballot delay.(general practitioners)
May 12, 2003... GP negotiators have left the door open for a long delay in the contract ballot following a call from two GPC members to renegotiate the entire deal from scratch. The move gained extra weight after Dr Julian Neal, chair of this week's...

Dr Michael Silver.(correction notice)(Correction Notice)
May 12, 2003... In a story headed `GMC gets wake-up call as fourth guilty verdict overturned' (April 21) it was stated the Privy Council had concluded there was `little doubt' Dr Michael Silver had been negligent. Dr Silver would like us to point out that...

GPs urged to choose lab-based test to rule out heart failure.(general practitioners)
May 12, 2003... Research at the British Cardiac Society annual conference this month covered aspects of GP care. Brian Kelly reports One of two tests to be recommended by the Government for GPs to rule out heart failure is much better than the other,...

Statin use still not adequate in spite of CHD framework.(coronary heart disease)(Brief Article)
May 12, 2003... The proportion of patients with coronary heart disease prescribed statins has risen just 7 per cent since the introduction of the national service framework in 2000, a major study has revealed. It also revealed a rise of just 1.4 per cent...

Foundation hospitals furore buries threat of surge in GP complaints.(general practitioners)
May 12, 2003... GPs have been warned they face a surge in financially motivated complaints and a hike in defence subscriptions because of a clause `hidden' in the Government's controversial Health and Social Care Bill. The Medical Protection Society said...