Pulse articles from May 2007

Pulse archives from May 2007

`Opt-in care record is 100 years' work'.
May 3, 2007... Government claims opt-out model is essential to ensure GPs aren't overwhelmed by work By Steve Nowottny Asking every patient to opt in to the controversial new electronic care record would take 100 years of GPs' time, the Government is...

New GPSI standards `unachievable'.(General Practitioners with Special Interest )(Brief article)
May 3, 2007... Hundreds of GPSIs could be stripped of their titles under `unachievable' new Government standards, GPs are warning. Critics of the complex accreditation scheme said it would undermine Government plans to shift care into the community,...

Surge in salaried GPs threatens traditional practice.(general practitioners )
May 3, 2007... Fears raised as NHS figures reveal partnerships are getting harder to find By Steve Nowottny A huge shift towards a salaried workforce has raised fears for the future of traditional general practice. The number of salaried GPs...

Number of registrars falling.(general practitioners)(Brief article)
May 3, 2007... The number of GP registrars last year fell for the first time in more than a decade. NHS workforce statistics show there were 2,278 GP registrars in 2006, down 11.2% from the previous year. Dr Richard Vautrey, GPC negotiator, said the...

GP pay row: the story so far.(general practitioners)(Brief article)
May 3, 2007... Leaked figures from the Association of Independent Specialist Medical Accountants show some GPs earning #250,000 a year. Overspend on GPs hits #300m, according to the Department of Health. Figures from the NHS Information Centre reveal...

PMS GPs feel pressure as pay lead shrinks.(Personal Medical Services general practitioners)
May 3, 2007... Government drive to squeeze PMS contracts sees GMS pay catch up By Christian Duffin PMS practices are feeling the heat after a Government drive to crack down on their funding, with latest figures showing they are losing their pay...

GPC wins right to fight for pay.(General Practitioner Committee )(Brief article)
May 3, 2007... The GPC has won its fight to separate pay talks from negotiations over the GP contract. NHS Employers confirmed negotiators could approach the pay review body with evidence supporting an uplift to the global sum, rather than having to...

InBrief: Blair regrets reform delays.(Tony Blair)(Brief article)
May 3, 2007... The pace of reform in the NHS was too slow in the first years of the Labour Government, Prime Minister Tony Blair has said. Mr Blair made his comments at a King's Fund briefing, where he also criticised the idea of an independent NHS board,...

InBrief: Updated ADHD advice.(attention deficit hyperactivity disorder)(Brief article)
May 3, 2007... Drug treatments for ADHD and other child hyperactivity disorders `should only be used as an adjunct to other interventions, such as behavioural and educational approaches, and under the supervision of a specialistin the condition'. The...

InBrief: Cold remedy workload fear.(Brief article)
May 3, 2007... The MHRA is consulting on plans to remove or restrict pack sizes of decongestant cold remedies, after fears they are being used to process the Class A drug methylamphetamine into the highly addictive form, crystal meth. RCGP chair Professor...

InBrief: 96% of practices do PBC.(practice based commissioning)(Brief article)
May 3, 2007... The number of GP practices claiming payment under the practice-based commissioning DES has risen to 96%, according to the latest Department of Health statistics. The figure for March is slightly up on the February total. A department...

InBrief: NHS Direct complaints up.(United Kingdom National Health Service )(Brief article)
May 3, 2007... The number of complaints received by NHS Direct has jumped by 50% in three months. In December, the service was receiving 1.3 complaints per 10,000 calls but by March, the figure had increased to 1.9. A spokesperson blamed the increase on...

InBrief: Firms downplay costs.(Brief article)
May 3, 2007... Drug manufacturers consistently estimate lower average costs for their drugs compared with other assessment groups when submitting them for appraisal by NICE, new research has found. The analysis published in the latest International...

InBrief: Asthma admission divide.(Brief article)
May 3, 2007... There is a six-fold variation in the number of people who are hospitalised for an asthma attack, new figures show. Heart of Birmingham PCT has the highest emergency admission rates for asthma at 114% above the national average. West Essex PCT...

One in four GPs will not refer for abortion.(general practitioners)(Survey)
May 3, 2007... Most GPs think 24-week limit should be reduced, Pulse survey reveals By Daniel Cressey Experts in women's health have warned of a `lottery' in access to abortion after a Pulse survey found one in four GPs was refusing to sign referral...

`I quit over beliefs on abortion'.(Rob Hardie, general practitioner)(Brief article)
May 3, 2007... Dr Rob Hardie left his Wiltshire practice in 2004 in disgust at the new GP contract and specifically its guidelines on abortion. He told Pulse: `With abortion, there's the ethical problem of destroying a life, and even if you have different...

US giant bids for commissioning role.(UnitedHealth Group Inc.)(Brief article)
May 3, 2007... Private companies, including US giant UnitedHealth, have provoked fears of a conflict of interest after entering discussions on commissioning services as well as providing them. Private firms have met officials from the Department of Health...

GPSIs face assessment every three years.(general practitioners with special interests )
May 3, 2007... Get accredited under new standards by 2009 or lose title, GPSIs told By Christian Duffin GPSIs will be assessed every three years under onerous new standards unveiled last week by the Department of Health. GPSIs must be accredited...

Review rules out rosuvastatin use.(Brief article)
May 3, 2007... Fluvastatin and rosuvastatin should not be used in routine management of patients, an influential review journal concludes. The Drug and Therapeutics Bulletin reviewed previous research on statins and concluded that fluvastatin and...

Risk-benefit query over aspirin use.(Brief article)
May 3, 2007... Use of antithrombotic drugs has risen in parallel with an increase in haemorrhagic stroke deaths in the elderly, researchers warn. Their study appears to question preventive use of aspirin in healthy older people. Although it found a...

MediaWatch: `One in four has high BP'.(blood pressure)(Survey)(Brief article)
May 3, 2007... The story One in four British people is unaware they are suffering from high blood pressure, report BBC News online and the Daily Express. The source A survey of 20,000 conducted by the Stroke Association found nearly a quarter of people in...

MediaWatch: `Pylon ban to cut diseases'.(banning home constuctions near power lines)(Brief article)
May 3, 2007... The story Banning the construction of new homes near electricity pylons and power lines could prevent children dying from leukaemias and possibly other diseases, report the Guardian and Daily Mail. The source A report last week by the...

MediaWatch: `Baby charts risk obesity'.(Brief article)
May 3, 2007... The story Out-of-date weight charts for babies are causing overfeeding and raising the risk of obesity in later life, according to the Daily Mail. The source A study conducted by Professor Bert Koletzko from Munich University and reported...

GP infertility warning.(general practitioners)
May 3, 2007... Researchers say GPs lack knowledge and often do not fully investigate By Lilian Anekwe New research suggests GPs are frequently failing to conduct key pre- referral investigations before referring for infertility. Further problems...

NICE set to end use of separate inhalers.(National Institute for Clinical Excellence)(Brief article)
May 3, 2007... New NICE guidance is set to end the use of separate inhalers for prevention and symptom relief in patients with asthma, writes Jennifer Rigby. The institute has provisionally ruled that combination devices should be used ahead of separate...

CKD alert in osteoporosis patients.(chronic kidney disease)(Brief article)
May 3, 2007... The majority of osteoporotic patients have chronic kidney disease and identifying it is `essential', a conference was told last week. Patients with moderate kidney disease have significantly more bone- related problems than other...

GP confusion over VAT rules.(general practitioners)
May 3, 2007... BMA urges GPs to seek advice to avoid falling foul of VAT changes starting this week By Christian Duffin Confusion surrounds new VAT rules coming into force this week with many GPs in the dark about which aspects apply to them. ...

Peer's doubts on sliding scale plan.(patient safety)
May 3, 2007... A Labour lord has cast doubt over the effectiveness of a civil `sliding scale' standard of proof in fitness to practise hearings, warning that a low standard of proof could cause miscarriages of justice. Lord Turnberg's comments in the...

Care record evaluation plan `nonsensical'.(Summary Care Record)
May 3, 2007... The GPC has attacked proposals for an evaluation of the Summary Care Record early adopter programme in Bolton as `nonsensical', after it emerged that Connecting for Health will be setting the evaluation's barometer of success, writes Steve...

New lapses blow to records rollout.(United Kingdom National Health Service)(Brief article)
May 3, 2007... Two major security lapses that revealed junior doctors' messages and personal records to the public have intensified concerns among GPs about the roll-out of the NHS Care Records Service. The Department of Health last week temporarily...

GPs may have to close lists.(general practitioners)
May 3, 2007... The Scottish LMCs conference warns pay freeze could hit patients wanting to enrol with GP By Steve Nowottny The pay freeze may force GPs in Scotland to close their doors to new patients, the annual conference of Scottish LMCs heard....

New deal on ambulance delays.(Brief article)
May 3, 2007... The Scottish Ambulance Service has been forced to rethink its call- taking procedures for admissions from GPs, after a fourfold rise in urgent requests over the past year. GPs in Scotland have reported frequent delays in ambulance...

How Scottish LMCs voted.(local medical committees)(Brief article)
May 3, 2007... Pay rise `Conference deplores the recent DDRB ruling for GPs, which will result in a reduction in pay for all GPs without any reduction in workload' - passed unanimously `Spin' `Conference deplores the inaccurate media coverage of...

Drugs not justified for diabetes prevention.(lifestyle changes in diabetic patients)
May 3, 2007... New analysis finds lifestyle changes are as effective as rosiglitazone By Lilian Anekwe GPs cannot justify prescribing drugs to prevent diabetes as lifestyle modification can achieve equally effective results at a lower cost,...

Near-patient tests not the answer.(diabetes tests)(Brief article)
May 3, 2007... Researchers assessing near-patient testing for diabetes have been unable to recommend a wide rollout in primary care. Despite finding high levels of satisfaction among patients and primary care professionals, they stopped short of...

JournalWatch: CAD statins dose query.(coronary artery disease)(Brief article)
May 3, 2007... Use of high-dose statins may not be cost-effective in patients with stable coronary artery disease, an analysis by US researchers concludes. Their study collated data from four trials comparing use of high doses and conventional doses of...

JournalWatch: Fish-eating in pregnancy.(Brief article)
May 3, 2007... Eating fish while pregnant appears to protect children from developing atopic disease, Mexican researchers conclude. Their study looked at data from a cohort of 462 women who were enrolled when pregnant, and followed up their children until...

JournalWatch: Migraine raises CVD risk.(cardiovascular disease)(Brief article)
May 3, 2007... Men with migraine appear to be at an increased risk of cardiovascular disease, a US study shows. The researchers followed up more than 20,000 participants in the Physicians Health Study over an average period of 15.7 years. Men who...

JournalWatch: SSRI use enhanced by HRT.(selective serotonin reuptake inhibitors)(hormone replacement therapy)(Brief article)
May 3, 2007... HRT appears to enhance the effectiveness of treatment for depression, according to an Italian study. Researchers analysed the potential influence of HRT in 170 postmenopausal women taking SSRIs for depression. Women on HRT successfully...

JournalWatch: Aspirin no cognition value.(Brief article)
May 3, 2007... Long-term use of low-dose aspirin has little benefit for cognition in healthy women, a US study concludes. The researchers examined data from 6,377 participants in the Women's Health Study, each of whom received three cognitive assessments...

GPs need UTI script guide.(general practitioners, urinary tract infections)
May 3, 2007... Further research is being demanded to guide GP prescribing after a study showed decisions to give antibiotics bore little relation to the actual presence of urinary tract infections, writes Helen Crump. The study found six out of 10...

`I'm not paranoid, but my camera is at hand'.(harassed general practitioners)
May 3, 2007... GPs are a target for stalkers - the effects on the victim can be far- reaching By Christian Duffin It is not to take snaps of the countryside, but in case his worst nightmare recurs. For Dr Wedderburn, a GP in Aberdeen, this comes in...

Advice for GPs being harassed.(general practitioners)(Brief article)
May 3, 2007... * Store any gifts given by the patient and log all incidents of harassment with times and dates * Seek free legal advice from the NHS's Security Management Service via a PCT * Be assertive but fair in deterring patients who are acting...

LETTER: Don't believe all you read.(Letter to the editor)
May 3, 2007... From Dr John Havard, Saxmundham, Suffolk Patricia Hewitt recently launched Maternity Matters offering pregnant women childbirth choices. Offering choice must be a vote-winner but the public need to be mindful of just how much more...

LETTER: Broken promises to overseas GPs.(Letter to the editor)
May 3, 2007... From Dr Mark Reed and Dr Catherine Sweeney, Reading The Government seems to have realised, finally, that it is wrong to steal doctors from poor countries who have spent years training them for our `first-world NHS'. But the result of...

LETTER: Spectre at drug company feast.(Letter to the editor)
May 3, 2007... From Dr Manju Hardas, Liverpool We are all aware of the evening meetings of doctors, often held in expensive restaurants, sponsored by drug companies across the UK. The meetings are preceded by a medical talk, usually delivered by a...

SOAPBOX: `Consent' amounts to data rape.
May 3, 2007... Dr Bernard Newgrosh, a GP in Bolton, has serious concerns about the confidentiality of the NHS care records and the presumed `consent' of patients to having their data uploaded The young man is very anxious. His solicitor has insisted all...

LETTER: How we can improve health for all.(Letter to the editor)
May 3, 2007... From Dr Kausar Jafri, Stoke-on-Trent, Staffordshire I have been mulling over what the next few years might bring for us as GPs and for our colleagues and patients. Some of the things on my wishlist are probable, some unlikely and the...

LETTER: How is ethics survey kept confidential?(Letter to the editor)
May 3, 2007... Name and address supplied The medical ethics survey - `Respond to our confidential survey and you could win a digital camera worth #300' (5 April) - wends through the bog standard issues of assisted suicide, abortion and so on. It then...

LETTER: Time to tackle a killer disease.(Letter to the editor)
May 3, 2007... From Malcolm Miller, chief executive, The London Clinic In 2005, the Commons Health Select Committee raised concerns over the number of deaths of hospitalised patients as a result of venous thrombo- embolism. Every year in the UK...

For the record: Comments from RCGP.
May 3, 2007... We are happy to make clear that the comments from RCGP chair Professor Mayur Lakhani included in last week's story `NHS to rate GPs for new patient guide' were made in an interview with Pulse last month as part of a wider discussion about the...

Opinion: A grand breach of confidentiality.(Department of Health)
May 3, 2007... As the furore over care records escalates, Dr Paul Thornton says the threat to patient confidentiality is much wider than realised As a parting shot just before Christmas, then health minister Lord Warner announced unequivocally that...

The great statins folly.
May 3, 2007... As statins take on a sort of messianic role, a perplexed Phil says they're a very naughty boy I think I'm quite a good GP. It's a complex job and it's difficult to quantify these things, but the small amount of evidence we do have (patient...

Dinah'sDiary: Dinah finds she could easily be a woman of letters.(Diary entry)
May 3, 2007... Monday Practice manager meeting: what's our policy on people who can't take their exams? Confused - does she mean the forthcoming hand-washing exams that all practice staff must pass? No - she means students who want a doctor's letter to...

PulseFinance: Farewell to a tried and trusted friend.(Dr John Couch )(Obituary)
May 3, 2007... While finding it cheaper to use the Central Sterilising Services Department, Dr John Couch retains a soft spot for the trusted practice steriliser which new regulations have consigned to the skip An internal email appeared on my screen...

PulseFinance: A great program for maximising your QOF points.(quality of framework)
May 3, 2007... Dr Simon Clay writes from experience aobut a highly effective QOF support tool Q `I've heard some good things about a program called Contract+. Can you give some information on it please?' A Contract+ is a QOF support tool written by...

PulseFinance: GP business motivating staff.(Survey)(Brief article)
May 3, 2007... In the second of his series on good business sense in general practice, Dr Sohail Butt stresses the prime importance of motivating staff In the developing primary care marketplace GPs will need to manage and motivate their staff in a more...

PulseClinical: How far should we avoid prescribing antibiotics?
May 3, 2007... In this occasional series experts explain clinical controversies and explore the fall-out for GPs. Here, Professor Paul Little advises on dealing with demands for antibiotics TIMELINE Antibiotic prescribing * Standing Medical...

PulseClinical: Orlistat for weight loss maintenance.
May 3, 2007... Q After patients have lost weight, can long-term orlistat help them keep it off? Synopsis Scandinavian researchers conducting this study began by enrolling obese patients (50% female) with a mean body mass index of 37.5kg/m2 to follow...

PulseClinical: Five nuggets on...dermatology.(managing childhood dermatological diseases)
May 3, 2007... In this series, experts give their top learning points on a particular condition or disease - this week Dr Elizabeth Ogden advises on avoiding common pitfalls in childhood dermatology This article is based on a lecture given at Pulse's...

PulseClinical: Need to know anxiety and panic disorders.(Interview)
May 3, 2007... In panic attacks or severe anxiety a higher SSRI dose may be needed Take-home points * Minor tranquillisers and hypnotics do not treat anxiety - they mask it briefly, and can encourage the sufferer to avoid seeking a solution. Always...

PulseClinical: Cancer in primary care - histories in young patients.
May 3, 2007... Many patients present with symptoms that may be cancer - Dr William Hamilton presents two case studies Simon - lump in right testicle Simon, a 29-year-old postman and father of two, noticed a painless small lump in his right testicle...

PulseClinical: Snippets on... ophthalmology.
May 3, 2007... Dr Amar Alwitry advises on dry and wet age-related macular degeneration Dry age-related macular degeneration (AMD) What's going on? Age-related wear and tear is affecting the macula and thus central vision. Central vision is...

PulseRegistrar: Managing a request for an acne cure from a teenager.(Disease/Disorder overview)
May 3, 2007... Dr Melanie Wynne-Jones discusses the issues CASE HISTORY Rachel is 17 and `fed up of being fat and spotty'. She asks if she can take Dianette as it's helped her friend who has had problems with her ovaries. What does Rachel need?...

PulseRegistrar: Where's that ironing pile?
May 3, 2007... As MRCGP exam time looms nearer, our diarist shares his own special techniques for coping with exam stress Geoff Tipper's Registrar diary It's the crack of dawn and I'm woken by either the screaming infant (SI) or my drug-company alarm...

LITTLE GEMS: How hot are you on... thalassaemia?
May 3, 2007... Test your knowledge for the nMRCGP with this little GEM from GPnotebook Shakira is a 23-year-old woman of Pakistani origin who comes to see you after having a positive pregnancy test. Her sister has told her she needs to be tested for...

PulseRegistrar: MRCGP to NMRCGP a smooth transition.
May 3, 2007... Lost in the maze of different MRCGP assessments?Dr Andrew Wilson guides you through GP and specialist training is in the process of a massive change. Modernising Medical Careers has redesigned the training pathways for all specialties...

PulseCareers: Why I work as...A media GP.
May 3, 2007... Dr Sarah Jarvis explains how her stimulating career as a media doctor came about - by accident I am often asked by younger doctors for my tips on embarking on a career as a media doctor, and I have to tell them to seek advice elsewhere -...

CareerCoach: How to read practice accounts.
May 3, 2007... You may feel uncomfortable about it, but if you're considering joining a new partnership it is vital to bite the bullet and ask to see the practice accounts, advises Dr Stefan Cembrowicz. When to ask for them When you are seriously...

PulseComment: Too much too late on GPSIs.(general practitioners with special interests)(Brief article)
May 3, 2007... `Care closer to home' is one of the Government's buzz phrases, and in chasing that lofty ambition the GPSI has become one of its tools of choice. Critics have attacked the drive to recruit specialist GPs as an oxymoron and a threat to...

Last word: Katherine Burn.(Interview)
May 3, 2007... Dr Katherine Burn... on humanity, talking too much and tea The best thing about my practice is we have very good clinical care and we serve a diverse group of patients. The worst is when Choose and Book isn't working and simply adds...

Revealed: Choose and Book to cost taxpayers #210m.
May 10, 2007... Pulse launches Common Sense on IT campaign amid `criminal waste' and confidentiality fears #210m projected cost of Choose and Book 83% of GPs say care records threaten confidentiality By Steve Nowottny Choose and Book is set...

CAMPAIGN: COMMON SENSE ON IT.(Brief article)
May 10, 2007... Our demands: * Choose and Book should be scrapped * No sharing of care records without explicit consent * A watertight system to anonymise records for research purposes Pulse today launches a campaign to prevent the National...

Audit reveals ban on co-proxamol is hitting pain control.
May 10, 2007... Study of drug's phase-out finds most former users wanting to return to it By Daniel Cressey Patients who have switched from co-proxamol suffer a sharp decline in the quality of their pain control, concludes the first review of the...

CASE STUDY: `HOW I FELL THROUGH THE CARE GAP'.(Brief article)
May 10, 2007... Dr Jane Bowskill knows from first-hand experience how it feels to fall between primary and secondary care. After being diagnosed with breast cancer, Dr Bowskill, a GP in Kingston upon Thames in Surrey, attended hospital for biopsy, only to...

NICE to plug gap from GPs to hospitals.(Brief article)
May 10, 2007... NICE is to produce guidance to prevent patients falling through the gap between primary and secondary care amid concerns over communication breakdowns. News that the institute is working with the National Patient Safety Agency and the...

Patients' vote of confidence in GPs.
May 10, 2007... Survey of 400,000 patients shows increased satisfaction with access and high ratings for overall care By Helen Crump A major survey of GP practices has found patient satisfaction with access has increased sharply in the past 12 months....

BMA demands `mature approach' to PBC.(British Medical Association)(practice based commissioning)
May 10, 2007... The BMA is demanding a more mature approach to practice-based commissioning relationships in a wide-ranging challenge to Government health policy, writes Helen Crump. In a report described as a `green paper' for healthcare, the association...

InBrief: Super surgeries protest.(Brief article)
May 10, 2007... More than 20,000 patients from 16 practices in Warrington, Cheshire, have signed a petition opposing their PCT's plan to replace existing surgeries with five `super surgeries'. GPs said they feared patients would lose continuity of care under...

InBrief: GPs drink more alcohol.(general practitioners)(Brief article)
May 10, 2007... GPs drink more alcohol than their patients - 15% more GPs reported drinking alcohol compared with the rest of the population surveyed in a study in Northern Ireland. But they also exercise more and smoke less. The research suggested that...

InBrief: Malaria warning.(Brief article)
May 10, 2007... There were 1,758 cases of malaria reported in UK travellers in 2006 and eight fatal cases, Health Protection Agency figures show. Some 57% of cases of known cause were reported in people visiting friends in the tropics. Professor Peter...

InBrief: Referral champion named.(Neil Betteridge appointed as patient and public champion)(Brief article)
May 10, 2007... Neil Betteridge has been appointed by health minister Andy Burnham as the first patient and public champion, to work on improving patient-NHS relationships. Mr Burnham said the appointment was another step towards the NHS achieving its...

InBrief: Self-management drive.(self health care)(Brief article)
May 10, 2007... Strategies that promote self-management need to be embedded into the routine care of patients with chronic conditions, a report concludes. The National Primary Care Research and Development Centre also suggested that health professionals...

InBrief: Muscle patients use CAM.(complementary and alternative medicines)(Brief article)
May 10, 2007... New research shows most primary care consulters with chronic musculoskeletal pain have used complementary and alternative medicines. In 138 patients interviewed by researchers at the University of Keele, 84% had used complementary and...