Pulse articles from May 2004

Pulse archives from May 2004

Survival of the fittest.
May 3, 2004... * Top practices franchising services and bailing out failing GPs * Practices taking over commissioning from PCOs * More power for health maintenance organisations * Pharmaceutical companies taking on enhanced services and chronic...

`Politicians know more than clinicians'.(Brief Article)
May 3, 2004... Primary care tsar Dr David Colin-Thome believes `politicians are more in touch with what people want than clinicians'. In a speech last week, Dr Colin-Thome, who still practises as a GP, added he had heard a lot of `whingeing' from GPs...

Practice `franchise' plan.(government plans to increase competitions in general practice)(Brief Article)
May 3, 2004... Top-performing practices could open `franchises' in other areas as part of Government plans to increase competition in general practice, a think-tank with close links to ministers has revealed. The aim would be to develop `brand-name'...

Swedish visit.(Swedish general practitioners on a visit)(Brief Article)
May 3, 2004... Nine Swedish GPs visited a Brighton practice last week to learn about the UK primary care system. GP Dr John Condon said the visitors were shocked at the numbers of patients UK GPs have to handle. `They only see six patients in a morning,...

Drug companies may take over treatment.(service extension in disease management)(Brief Article)
May 3, 2004... Drug companies expect to take over treatment of patients with chronic conditions under a Government drive to increase the range of providers in primary care. Eddie Gray, senior vice-president and general manager for GlaxoSmithKline UK,...

Minister heralds a US-style future for NHS chronic care.(National Health Services)(health minister John Hutton)(Brief Article)
May 3, 2004... US-style chronic disease management schemes are `the future of the NHS', health minister John Hutton has revealed. The Government is poised to roll out the initiatives nationwide after announcing promising interim results from nine local...

`Gaming' fear over GP commissioning.(general practitioners)
May 3, 2004... The Department of Health has admitted its plans to allow practices to take over commissioning of certain services from primary care organisations could alienate GPs and lead to gaming. Richard Armstrong, the official in charge of the...

`Too hasty' CSM is called to book again.(Committee on Safety of Medicines under criticism)
May 3, 2004... A new study has called for more openness from the under-fire Committee on Safety of Medicines - Cato Pedder reports The Committee on Safety of Medicines has come under renewed fire for issuing urgent warnings on drugs without sufficient...

GPs' views `go unnoticed' by the CSM.(general practitioners)(Committee on Safety Medicines)(Brief Article)
May 3, 2004... GP views are ignored by the CSM, according to a former member who watched the committee recommend withdrawal of an important anti- psychotic despite his protests. Professor Hugh McGavoch, former GP and visiting professor of prescribing...

Premises cash plea by GPs is snubbed.(general practitioners)(Brief Article)
May 3, 2004... Government officials have ignored GPs' pleas and ruled out awarding any extra cash for premises this year. Professor Paul Corrigan, special adviser to Health Secretary John Reid, said funding for premises was at `an unprecedented level'....

EU GPs seek UK posts.(European Union general practitioners)(Brief Article)
May 3, 2004... The UK can expect an influx of GPs from the 10 new European Union states after primary care organisations revealed recruitment agencies are already offering dozens of candidates. The Department of Health also said last week it has started...

GPs attack `inaccurate' headcount.(general practitioners recruitment goes beyond the required number)(Brief Article)
May 3, 2004... GPs have poured scorn on Government figures showing it has beaten its NHS Plan target to recruit 2,000 more GPs by this year. The Department of Health last week trumpeted the headcount increase of 2,131 GPs in England since 1999 and claimed...

GPs lured to golden hello posts.(geenral practitioners under a new payment scheme)(Brief Article)
May 3, 2004... The Government has spent around #30 million on `golden hello' payments since the launch of the recruitment scheme in November 2001. Department of Health figure released last week showed that at least 3,888 GPs have received the awards of up...

More interest from doctors in GP training.(Brief Article)
May 3, 2004... More people than ever are inquiring about training to become a GP, latest figures show. Some 3,558 people made inquiries to the Joint Committee on Postgraduate Training for General Practice last year, a 66 per cent increase over 2002. ...

Protocol urged for domestic violence.(Brief Article)
May 3, 2004... GPs should have a practice policy in place for dealing with patients who are victims of domestic violence, Dr Matt Kearney told the conference. `Domestic violence probably happens much more often than we realise,' said Dr Kearney. `One in...

Doubts over cost-benefit of statins.
May 3, 2004... Researchers have cast doubt on the widely-held belief that statin therapy is cost-effective for treating patients at risk for coronary heart disease. Massive variance in the estimates of cost per life-year saved by prescribing statins to...

Quit smoking services fail most needy.(Brief Article)
May 3, 2004... Smoking cessation services are not helping those from the most disadvantaged groups to quit although they are more likely to seek help and have similar motivation to people from more affluent groups, the conference heard. A study of...

Pharmacies `should offer diabetes test'.(Brief Article)
May 3, 2004... Most GPs want pharmacies to offer blood tests for diagnosing type 2 diabetes, the conference was told. A survey carried out by Lloyds pharmacy a year after it introduced blood tests in partnership with Diabetes UK found 81 per cent of the...

System launched without research.(Chris Salisbury)(Brief Article)
May 3, 2004... Dr Chris Salisbury has attacked the Government for failing to evaluate advanced access before spending #48 million persuading GPs to adopt the system. Dr Salisbury, a reader in primary care at the University of Bristol and a GP in the...

Patients say 48hr access curbs choice and continuity of care.(survey report)(Brief Article)
May 3, 2004... The Government's `over-emphasis' on its 48-hour access target can adversely affect patient choice and continuity of care, an NHS-funded study reveals. The qualitative study based on interviews with 50 patients at practices in the East...

Appointment waits reduced by half.(Brief Article)
May 3, 2004... Advanced access cuts waiting times for GP appointments by half, according to a Government-funded evaluation of practices that have implemented the system. The study of 462 practices found the time to the third available GP appointment was...

NHS Direct and walk-ins `duplicate services'.(National Health Service)(Brief Article)
May 3, 2004... Government initiatives such as NHS Direct and walk-in centres are duplicating services instead of targeting hard-to-reach groups. A literature review found the two schemes could be worsening inequalities in access to health care because...

Fourth dose of Hib vaccine `should become routine'.(Brief Article)
May 3, 2004... A routine fourth dose of Hib vaccine should be added to the childhood immunisation schedule, according to a new Department of Health-funded study. Researchers - including senior Health Protection Agency personnel - concluded that the...

`Too few' vaccine suppliers.(Brief Article)
May 3, 2004... Immunisation programmes could be jeopardised because the Department of Health has too few vaccine suppliers, according to a report from MPs. The Commons public accounts committee criticised the department for failing to act on advice to...

GPs blamed for wrecking letters plan.(general practitioners)(Brief Article)
May 3, 2004... The patient choice tsar has blamed GPs for scuppering the Government's NHS Plan pledge on copying letters to patients. Harry Cayton said the plan for all letters between clinicians to be copied to patients by April 2004 had been wrecked...

Journal watch: RSV can lie dormant for years.(Respiratory Syncytial Virus )(Brief Article)(Excerpt)
May 3, 2004... Respiratory syncytial virus can survive in the body for many months and even years after infection, according to research from the UK and Germany. Samples taken from the airways of mice 14 days after infection with human RSV showed no...

Journal watch: Rofecoxib linked to heart attack risk.(Brief Article)(Excerpt)
May 3, 2004... Patients taking cox-2 inhibitor rofecoxib have an increased risk of acute heart attack, according to researchers from Harvard University. In the case-control study of more than 54,000 patients aged over 65, rofecoxib was associated with a...

Journal watch: Four signs of foot fungus identified.(Excerpt)
May 3, 2004... UK researchers have identified four diagnostic features strongly associated with onychomycosis. History of tinea pedis in the past year, scaling on one or both soles, white crumbly patches on the nail surface and an abnormal colour of the nail...

Journal watch: Postal questionnaire on incontinence.(Excerpt)
May 3, 2004... Responses to postal survey questionnaires are more closely linked with results of urodynamic tests than face-to-face questionnaires in women attending clinics for incontinence. When women were asked questions in person only severity of...

Journal watch: Weight loss needed for healthy heart.(Brief Article)(Excerpt)
May 3, 2004... Children who need to lose weight to improve their atherogenic risk profile must meet targets of at least 0.5 reduction in BMI over a year. German researchers studied cholesterol, blood pressure, triglycerides and insulin resistance in 130...

Journal watch: Musculoskeletal growing pain common.(Brief Article)(Excerpt)
May 3, 2004... Adolescents commonly present with musculoskeletal pain, according to Spanish researchers. The prevalence of musculoskeletal pain in children aged three is 2.4 to 5.7 per cent but by the time children reach 14 the prevalence is 27.5 to 36 per...

Ministers blamed for highest pneumonia deaths in Europe.(Brief Article)
May 3, 2004... Government underfunding and strategic failures are to blame for putting Britain among Europe's highest rates of respiratory disease, according to the chair of the British Thoracic Society. Dr Edmund Neville said: `A key factor is disease...

`Good Samaritan GPs a bloody nuisance'.(general practitioners)
May 3, 2004... GPs who do enhanced services for free are under fire - Rob Finch reports from the RCGP spring conference The Government is taking advantage of `good Samaritan' GPs to bludgeon the rest of the profession into doing work for nothing,...

Health market turns GPs from knights to knaves.(general practitioners)(economic management of health care industry)(Brief Article)
May 3, 2004... Successive Government policies aimed at promoting a market economy in health care have turned GPs from `knights to knaves' in the public's eyes, Dr Iona Heath believes. She told the RCGP conference the `professionalism of GPs is trapped in a...

Asian GPs behave as `tense chameleons'.(Asian general practitioners behavior inappropriate in western culture)(Brief Article)
May 3, 2004... GPs from south Asia act as `tense chameleons' in their consultations, adapting their style to suit the patient in front of them, new research finds. The study - carried out in Britain and Pakistan - found some behaviour that would be seen...

Government wants GPs to tackle mental health in young people.(general practitioners to bring in awareness for mental distress among young adults)
May 3, 2004... The Government is funding a drive to improve GP care of young people with mental health problems after research showed most do not see GPs as a source of help for mental distress. But GPs have criticised the plan, saying they are not best...

GPC defends new contract cervical screening targets.(general practitioners councils)(Brief Article)
May 3, 2004... The GPC has defended cervical screening quality payments under the new contract after an attack from GPs claimed costs were higher than potential rewards. Eleven quality points, worth #275 per GP, are available for reaching the top...

GPs could face #5,000 fines in Home Office staff checks.(General Practitioner)(Brief Article)
May 3, 2004... GPs face prosecution and fines of up to #5,000 if they fail to carry out new Home Office checks to ensure new staff are not working illegally. New laws that came into force on May 1 mean a national insurance number alone will no longer be...

New laws for employers.(Brief Article)
May 3, 2004... Step one GPs must ask new employees to provide one of the original documents from list one or two from list two List one * British passport * Document showing employee is a national of a European Economic Area country or Switzerland, eg...

Quarter of sicknotes `questionable'.(Brief Article)
May 3, 2004... An average GP gets 577 requests for a sicknote each year and believes a quarter are questionable, a survey finds. The survey of 250 GPs by Norwich Union Healthcare found more than a fifth of doctors had up to 20 per cent of patients unable...

Curbs placed on sex case GP.(coniditions placed on registration of the general practitioner by the Council for the Regulation of Healthcare Professionals)(Brief Article)
May 3, 2004... The GP at the centre of a landmark High Court legal battle has had conditions placed on his registration by the GMC. Dr Giuseppe Ruscillo was the first GP to be referred to the High Court by the new `super-regulator', the Council for the...

GP contract creates Cinderella specialties as focus narrows.(no feel good factor for general practitioners in the new general medical societies contract)
May 3, 2004... GP experts believe the narrow focus of the quality and outcomes framework of the new GMS contract is sidelining important general practice specialties - Rob Finch reports The quality and outcomes framework focuses on 10 key clinical areas...

EDITORIAL COMMENT: CSM must let in some light.(Committee on Safety of Medicines)(Brief Article)(Editorial)
May 3, 2004... It has been a bad year for the Committee on Safety of Medicines, the Government's pharmaceutical safety watchdog. A newspaper expose of members' affiliations, a high-profile resignation over its policy on SSRIs and disquiet over its role in the...

Letter: Superannuationrules will hit GP high earners.(Letter to the Editor)
May 3, 2004... I was surprised to read in the article entitled `Untangling new GMS arrangements for superannuation' (Features, April 19) Dr Bob Button stated that for GP contractors the 14 per cent employer contribution is paid by the PCO. This is not true....

Letter: Not furious, but very sad and concerned.(Letter to the Editor)
May 3, 2004... Your article on our recent difficulties with Sunderland Training PCT (News, April 5) reports that we are `understood to be furious'. Although we are unhappy that the trust has issued misleading statements, our main feelings are of...

Letter: GPC has not done U-turn on vaccine rules.(Letter to the Editor)
May 3, 2004... Contrary to your front-page headline (News, April 19), the GPC has not done a `U-turn' over nurse vaccine rules. The GPC is not finalising proposals that would back the need for patient group directions (PGDs) for vaccinations and...

Get high scores from holistic care, quality and access.(general practitioners to earn points for services)
May 3, 2004... Dr John Couch examines what practices need to do to earn points from providing holistic care, quality practice and patient access Total points available 180 2004/5 ...

Our controversial phones decision.
May 3, 2004... Dr Hugh Taylor explains why his practice took on a phone system that charges callers national rates Access has been the big topic this year. We have been encouraged to be ever more accessible for appointments and by phone. Our practice...

The stronger your team the more you will get out of the new contract.(health care teams)
May 3, 2004... Dr Sohail Butt continues his series by suggesting ways in which the practice team can work together more effectively Improved teamwork will be essential if practices are to get full value from the new contract, bearing in mind the...

May contract calendar.
May 3, 2004... Now the new contract is well under way Dr Bob Button advises practices on what they need to do during May There are no specific dates for the following, but each of these issues should be addressed during May. Provided you haven't...

Retirement at 60 will get harder.
May 3, 2004... Dr John Couch examines how new pension rules will affect GPs who want to retire at 60 The era of full pensions at 60 is rapidly drawing to a close. Life expectancy continues to rise, with the result that from age 60 men can currently...

Should locum blow whistle?(how to manage patient referrals)
May 3, 2004... Case history You are a non-principal and do regular sessions in a practice, which you like. You do four open surgeries a week, seeing all comers, and have started to notice that one particular partner's patients are over- represented. ...

Earning quality pay through asthma phone reviews.
May 3, 2004... Research shows two in three patients fail to attend for routine asthma review - Dr Hilary Pinnock says telephone-based consultation can transform routine care PRACTICAL POINTS * GPs face a challenge to hit the quality framework target...

CASE STUDY: Patients have to keep to the point.
May 3, 2004... We're edging towards our asthma review quality target - but there's more work to do, says Dr Robert Bawden My practice has been conducting asthma reviews by telephone for 18 months. We have found telephone consultations are a really useful...

Practical solutions to epilepsy care dilemmas.
May 3, 2004... With neurology waiting times running to several months in many areas, GPs are often left trying to fill in gaps in care - Dr Richard Grunewald and Carina Mack offer advice The management of the epilepsies is controversial. Although access...

Making sense of conflicting advice on epilepsy drugs.(Scottish Intercollegiate Guidelines Network's guidelines)
May 3, 2004... Dr Eleanor Guthrie argues that GPs should ignore NICE guidance on newer epilepsy drugs in favour of contradictory - but more patient-centred - advice from the Scottish Intercollegiate Guidelines Network Access to neurologists is not always...

LEARNING FROM ILLNESS: Gastritis.
May 3, 2004... Dr Michael Crawford explains how his emergency admission for gastritis gave him an insight into the fear an acute illness can cause Patients often live with debilitating symptoms for months or years before seeking medical advice. I know...

Use of eye drops and ointments - tackling patients' problems.
May 3, 2004... In his third article on common eye complaints, Dr Scott Fraser offers tips for handling compliance problems It is the responsibility of any prescriber to ensure the medication can be administered by the patient in the right place at the...

How to sail through the MRCGP orals without stress.(Member of the Royal College of General Practitioners)
May 3, 2004... MRCGP orals are looming, to test your decision-making skills and professional values. In two 20-minute exams you will be asked to talk about five topics, spending about four minutes on each. Pulse has spoken to GP tutors and to registrars...

YOUR FIRST: Excessive use of painkillers.
May 3, 2004... Dr Melanie Wynne-Jones explains what you should do if a patient is getting through repeat prescriptions too quickly Mr Owens has been put in as an extra by the receptionist because he has requested his painkillers two weeks early. All...

ANSWER BACK: Should we mix antibiotics in acne?(Brief Article)
May 3, 2004... Q: In acne I understood that we should not mix different oral and topical antibiotics. But I see patients coming from dermatologists on such combinations. I feel uncomfortable issuing these scripts - have I missed something? A: I...

ANSWER BACK: Does being sectioned affect travel rights?(Brief Article)
May 3, 2004... Q: What are the long-term social ramifications in terms of travel and emigration of a one-off section for an acute psychiatric illness under the Mental Health Act? A: This is a very interesting issue which has acquired urban myth status...

Ministers ban practices' full-list ploy.(general practitioners have no say to say 'no' to patients)
May 10, 2004... Ministers are demanding tough action to stop GPs claiming their list is `full' in order to refuse new patients. The crackdown means GPs who have followed GPC advice and adopted the `full list' policy to control their list size now face...

Come aboard, GP urges the job hunters.(general practitioners)(Dr David Moon's creative idea)(Brief Article)
May 10, 2004... Felixstowe GP Dr David Moon is using yachting to attract GPs to his region. Suffolk Coastal PCT put job adverts for GPs in yachting journals after Dr Moon, a member of the professional executive committee, put forward the idea. He said:...

PMS GPs earn #13,000 more than GMS.(primary medical services)(general practitioners)(general medical services)(Brief Article)
May 10, 2004... PMS GPs earned almost #13,000 more than their GMS counterparts last year, new figures reveal. Income statistics from a firm of medical accountants showed GMS GPs in England took home an average #82,381 in 2003 - a 5.7 per cent rise -...

GPs reprimanded over MMR strike-off threat.(general practitioners)(Measles-mumps-rubella vaccines)(Brief Article)
May 10, 2004... GPs have been reprimanded for threatening to strike off an entire family after the parents refused to give their daughter the MMR vaccine. GPs at the World's End Health Centre in Chelsea, west London, sent a letter to the parents of...

GPs cope with sarin attack by `terrorists'.(general practitioners tested for their ability to handle terrorist attacks)(Brief Article)
May 10, 2004... GPs' abilities to cope with a terrorist attack were tested when the Health Protection Agency staged a mock sarin attack. Dr Julian Bromly, a GP at the Saville Medical Group in Newcastle-upon-Tyne, took part in the exercise. `It was, for...

BMA floats patient charges.(British Medical Association)(free general practitioners consultations)(Brief Article)
May 10, 2004... A radical plan to limit patients to a set number of free GP consultations each year, after which they would have to pay, has been floated in a controversial BMA paper. The idea is one of a set of proposals devised to cut GP workload,...

Franchising fears for small practices.(general practitioners on to franchising)(Brief Article)
May 10, 2004... Small practices will be under even greater threat if GPs are given the power to set up franchises. GPs and academics warned PCOs were more likely to see larger practices as `experts' at certain services than small or singlehanded...

Pulse is still leading field.(newspaper publishing)(Brief Article)
May 10, 2004... Pulse is still the best-read medical publication, according to the latest industry survey. During the last six months, 75 per cent of GPs have read Pulse each week compared with 70 per cent who read GP and 58 per cent who read Doctor. Pulse is...

GPs urged to band together to fight off private firms.(general practitioners)(Brief Article)
May 10, 2004... Practices are being urged to mount a pre-emptive strike against private firms by forming in-hours co-operatives to bid for additional and enhanced services. The move, which has won the backing of the GPC, would enable GPs to take advantage...

GPC condemns OTC proposals for statins.(general practitioners council)(over the counter drugs)(Brief Article)
May 10, 2004... The GPC has raised serious objections over Health Secretary John Reid's plan to make statins available over the counter for patients at `moderate risk' of coronary heart disease. The POM to P switch for simvastatin 10mg - due to be...

GP down in the mouth over his lost seniority pay.(files a case for stopping payment benefits due career switch over)(Brief Article)
May 10, 2004... Dr James Flynn is missing out on seniority payments after making the unusual switch from dentistry to general practice. A former maxillofacial surgery registrar, Dr Flynn retrained 20 years ago and now practises in Cheltenham. He said he...

GPs to shun health tourist crackdown.(rules for the charges levied on patients by the physician)
May 10, 2004... GPs will refuse to obey proposed Government rules forcing practices to check patients' entitlement to free NHS care as part of a crackdown on so-called health tourists. The early-warning signals were sent out last week after health...

Patients urged to check GP records.(survey report)(Brief Article)
May 10, 2004... The Consumers Association is calling on patients to check their medical records more frequently to avoid mistakes being made in their care. A Which? report found several inaccuracies in records, mostly relating to hospital treatment. ...

New warning on dangers of paroxetine.
May 10, 2004... A European-wide review of paroxetine (Seroxat) has found the drug might increase the risk of suicide-related behaviour in young adults. After reviewing published and unpublished scientific data, the EU's drug advisory body also wants...

GP takes fight to top.(John Havard's national campaign for one stop health shop)(Brief Article)
May 10, 2004... Suffolk GP Dr John Havard has launched a national campaign to save a pioneering `one-stop' health shop. Saxmundham Health provides a range of services, including a GP surgery, children's centre, ambulance station and dentist's surgery. But...

Let GPs retain `old age' as cause of death.(general practitioners)(Brief Article)
May 10, 2004... GPs must retain the right to cite `old age' as a cause of death on death certificates, the GPC has warned. The move comes in response to a Home Office position paper outlining proposed reforms to the coroner and death certification...

GPs protest at extra half-hour surgeries.(general practitioners)(Brief Article)
May 10, 2004... GPs in Leeds are protesting against a PCT plan to force practices to keep their surgeries open for an extra half hour in the evening when trusts take over out-of-hours. Practices say surgeries and staffing would be disrupted and safety...

Yellow card review supports pay for adverse reactions follow-up.(general practitioners cooperate)
May 10, 2004... GPs should be rewarded for helping with research on adverse drug reactions, according to the Government's review of the yellow card scheme. A report based on the review stopped short of recommending paying GPs a fee for submitting yellow...

Review asthma patients more often, GPs urged.(general practitioners)(Brief Article)
May 10, 2004... A leading charity is urging GPs to review their asthma patients more often than stipulated in the quality and outcomes framework. In a new report, Asthma UK calls for adults to be reviewed on a yearly basis and children once every six...

Government campaign could swamp GPs with hep C work.(general practitioners)(hepatitis C)(Brief Article)
May 10, 2004... GPs could be inundated with patients asking to be tested for hepatitis C when a campaign to raise awareness of the infection is launched later this year. Up to 600,000 people may be infected with hepatitis C in the UK - most of whom will...

GPs don't see primary prevention as part of their job.(general practitioners)(preventive interventions)(Brief Article)
May 10, 2004... GPs have not taken on board key public health aspects of national service frameworks and do not see it as their job to undertake primary prevention, according to early results from a new study. The findings support a drive from the King's...

Expert patients cut consultations 9%.
May 10, 2004... GP workload could be cut by 9 per cent by the Government's expert patient programme, pilot results suggest. The GPC said the study confirmed the scheme was a cost-effective means of cutting GP consultations for chronic diseases, by giving...