Pulse articles from May 2008

Pulse archives from May 2008

Wheels come off care record plans.
May 7, 2008... IT bosses set to backtrack on implied consent model after report finds huge patient confusion By Steve Nowottny Government IT bosses have been forced into a fundamental rethink of plans for electronic care records, after a damning...

A summary of care record failures.
May 7, 2008... CONSENT Report recommends move to `consent to view' model, with implied patient consent for uploading of records, but explicit consent every time the records are viewed at point of care PATIENT AWARENESS Found patients showed...

Phone reviews for asthma get clinical backing.
May 7, 2008... Telephone reviews for asthma are backed by new clinical guidelines, which say they may be suitable for those unwilling to attend regular appointments. Reviews by telephone were rejected for inclusion in the QOF in 2006, after an...

Choose & Book finally offers full hospital choice.
May 7, 2008... GPs using Choose and Book can now refer patients to hospitals anywhere in the country, after an upgrade to the controversial booking system was finally launched this week. The Department of Health's flagship `free choice' initiative...

Safeguard for GMS practices in flu pandemic.
May 7, 2008... NHS Employers and the GPC this week announced a new agreement to safeguard GMS practices in the event of an influenza pandemic. The agreement ensures that GP practices responding to a pandemic emergency would not lose out if routine GMS...

Underdoctored areas to get #1.1m each.
May 7, 2008... Health secretary Alan Johnson has revealed plans to expand the list of underdoctored areas it is to target with new GP practices. Mr Johnson said 12 additional PCTs would each receive more than #1.1m by 2010/11 as their share of the #250m...

PMS contracts: PMS contracts `overfunded'.(Paramedical service contracts)
May 7, 2008... Report to ministers says PMS GPs are `overcompensated' for extra work and get a better deal than GMS GPs EXCLUSIVE By Lilian Anekwe PMS practices have been `over-compensated' for the extra services they provide, according to a...

PMS contracts: DESs target alcohol, HF and osteoporosis.
May 7, 2008... Government plans to plough #50m of new clinical funding into enhanced services rather than the QOF By Gareth Iacobucci Ministers have announced plans for a series of enhanced services for conditions ranging from osteoporosis to alcohol...

PMS contracts: Where the #50m will go.
May 7, 2008... * New measures to improve prescribing in heart failure * Investment in best practice on osteoporosis treatment * Annual health checks for people with severe learning disabilities * Better data to improve patient care for people from black...

PMS contracts: Ministers abandon plans to muscle in on flu campaign.
May 7, 2008... Government plans to wrestle control of the ordering system for the annual flu vaccine campaign from GPs have been scrapped, Pulse can reveal. The Department of Health launched a independent review of the mechanism for ordering supplies for...

Save Our Surgeries: NHS claims polyclinic support.
May 7, 2008... Managers say public backs moving `almost all GPs' into polyclinics as plans gain pace in London and Birmingham EXCLUSIVE By Nigel Praities NHS managers are claiming to have won a public mandate to shift thousands of GPs into...

Save Our Surgeries: Key results of London consultation.
May 7, 2008... * 51% strongly agreed or tended to agree almost all GP practices in London should be part of a polyclinic, compared with 29% strongly disagreeing or tending to disagree * Opposition to polyclinics was strongest among older patients, with...

Save Our Surgeries: GPs invited to join protests.
May 7, 2008... Pulse: SOS - Week of Protest Pulse this week launches plans for a week of protest, in which GPs can join our fight against the Government's plans for dramatic changes to primary care. We are inviting GPs to take part in symbolic...

Community-acquired infections rocketing.
May 7, 2008... Fivefold rise in admissions from staphylococcal infections as antibiotic-resistant bacteria circulate freely Serious staphylococcal diseases are soaring in general practice, as community-acquired MRSA and other resistant infections begin to...

Bone drug linked to AF.
May 7, 2008... Women taking alendronate have an 86% raised risk of atrial fibrillation By Emma Wilkinson A commonly used osteoporosis drug appears to substantially raise women's risk of atrial fibrillation, US researchers warn. Their study found...

Risks of taking alendronate.(Brief article)
May 7, 2008... * Women taking alendronate at 86% higher risk of atrial fibrillation than those who had never used the drug. * Up to 3% of cases of atrial fibrillation in the population of older women studied could be explained by alendronate use. *...

Homeopathy `effective' in child eczema.(Clinical report)
May 7, 2008... Homeopathy is as effective as conventional therapy for treating eczema in children, claim researchers on the first prospective cohort study to compare the treatments. The startling conclusion, from a trial of 118 children with eczema, may...

Media Watch: This week's top... Miracle cure.(Brief article)
May 7, 2008... The Independent, Daily Mail and Mirror claim to have unearthed the holy grail for sunbathers, in the form of the humble tomato. Scientists found that the secret of eternal youth was eating five tablespoons of tomato paste every day, leaving...

Media Watch: This week's top... Scare story.(Brief article)
May 7, 2008... Prince Charles describes them as an `horrendous blot on the landscape' but wind farms could also trigger epileptic seizures, reports the Daily Mail. An epilepsy expert warns that the flickering of sunlight through the spinning turbine...

Media Watch: This week's top... most pointless research.(alcohol drinking affects brain)(Brief article)
May 7, 2008... Drinking alcohol makes people braver and more likely to take risks, apparently. Researchers at the National Institute of Alcohol Abuse in Maryland - who perhaps have not heard of Dutch courage - found as few as two pints or a large glass of...

JournalWatch: Buteyko asthma benefits.
May 7, 2008... Buteyko breathing therapy - which teaches people with asthma how to `breathe less' - reduces use of inhaled steroids and improves symptoms and quality of life in people with asthma, a Canadian study suggests. A trial of the therapy in 129...

JournalWatch: NSAIDs cut Alzheimer's.
May 7, 2008... Long-term use of ibuprofen is associated with a lower risk of Alzheimer's disease, a large US study suggests. The analysis of more than 250,000 US veterans found patients who used ibuprofen for more than five years were 40% less likely to...

JournalWatch: TB drug resistance rises.
May 7, 2008... Resistance to drugs for tuberculosis is rising sharply in England, Wales and Northern Ireland, a Health Protection Agency study reports. The researchers analysed susceptibility data among a cohort of 28,620 tuberculosis cases dating from...

JournalWatch: Alzheimer's drug trial.
May 7, 2008... Use of tarenflurbil in patients with mild Alzheimer's disease appears to slow decline in functional ability compared with placebo, a UK phase II trial shows. In patients with mild disease taking 800mg of tarenflurbil twice a day, there was...

JournalWatch: Quit combination doubts.(nicotine replacement therapy )(Brief article)
May 7, 2008... Nortriptyline and NRT are both useful in helping smokers to quit, but there does not appear to be any benefit in combining the two, UK researchers report. The study looked at 900 smokers who chose their preferred method of NRT and were...

SSRI cut drives suicides.
May 7, 2008... Warning on use of drugs in children linked to increase in suicides By Lilian Anekwe Warnings over use of antidepressants in young people have been accompanied by a leap in their number of suicides, researchers report. A series of...

IN BRIEF: Otitis media smoking risk.
May 7, 2008... GPs should encourage parents of children diagnosed with otitis media to quit smoking, a GP has urged. Parental smoking increases the risk of acute otitis media by 70%. An audit of parents of children with otitis media found only 27% were...

IN BRIEF: Overseas GP ban `illegal'.
May 7, 2008... The law lords have overturned rules banning overseas doctors from applying for UK training posts unless there are no suitable home-grown candidates. By four-to-one, they ruled the guidance drawn up by former health secretary Patricia...

IN BRIEF: Nurse prescribing success.
May 7, 2008... An evaluation of nurse prescribers has found that nurses adhere to guidelines on prescribing antibiotics for minor illnesses in more than four in five cases. The analysis of three nurses at a Lancashire practice found 200 out of a total...

Inhaler switch warning.(Clinical report)
May 7, 2008... PCTs restricting combined inhaler use endangering patients, says study By Nigel Praities PCTs that restrict use of combined inhalers for asthma are ignoring the evidence and endangering patients, researchers on a UK study warn. ...

One in five with CKD and diabetes are anaemic.
May 7, 2008... GPs are being urged to routinely test patients with diabetes and chronic kidney disease for anaemia after research by the Government's renal tsar suggested large numbers of affected patients were slipping through the net. The study will...

Calls for attack alarms as GP tells of stabbing.
May 7, 2008... NHS body responsible for issuing alarms has not yet sent out a single one By Nigel Praities A GP has told a court of her brutal stabbing by a patient amid warnings that the Government has reneged on its promise to do more to protect...

Plan to ease abortion approvals.
May 7, 2008... MPs to vote on proposal to scrap the requirement for two doctors' signatures before abortion can proceed By Gareth Iacobucci MPs are set to vote on proposals to end the requirement for abortions to be signed off by two doctors. ...

Heart risk patients underdiagnosed.
May 7, 2008... Large numbers of patients at high cardiovascular risk remain underdiagnosed despite major advances under the QOF, a new study concludes. The researchers said their work underlined the need for cardiovascular screening, but GPs warned it...

Focus on... The MPIG freeze fightback.(Minimum Practice Income Guarantee )
May 7, 2008... The BMA is confident it can make ministers back down, but an obscure contract clause could undermine its case By Gareth Iacobucci It would be interesting to be a fly on the wall the next time Government negotiators suggest their BMA...

Debate: Are recertification plans good for general practice?
May 7, 2008... YES The proposals will be fully consulted on, and will be fair and transparent, argues the RCGP's Professor Mike Pringle Are recertification and revalidation really necessary? Well, my view is that it is no longer sufficient to qualify...

LETTER: Polyclinics are like some Stalinist nightmare.(Letter to the editor)
May 7, 2008... From Dr John Cormack South Woodham Ferrers, Essex Open letter to David Cameron I wasn't a big fan of Thatcher's NHS reforms and voted for Blair and Brown in 1997, thinking they could bring about genuine improvements. How daft can you...

LETTER: Don't restrict abortion, open up access.(Letter to the editor)
May 7, 2008... From Dr Wendy Savage Retired senior lecturer in obstetrics and gynaecology, north London Nobody is pro-abortion - they are pro-choice (`Abortion policy makers should visit a clinic', pulsetoday.co.uk/letters). Many of us have performed...

LETTER: We must be vigilant on GP mental health.(Letter to the editor)
May 7, 2008... From Dr Christopher Hughes, Brighton I think Dr Atkins is very brave to have confronted his problems and to share them with us all (`I failed to spot I was cracking up', pulsetoday.co.uk/working life). The culture of getting on with it and...

LETTER: Stand firm on Choose & Book infringements.(Letter to the editor)
May 7, 2008... From Dr Michael Blackmore Retired GP, Cyprus Why do GPs tolerate this gross infringement of their clinical freedom and duty to their patients (`Hospitals bar named-consultant referrals via Choose and Book', pulsetoday.co.uk/news)? I never...

Glitazones are a worthwhile use of NHS money.
May 7, 2008... From Professor Anthony Barnett Professor of medicine, University of Birmingham I read with interest your recent news article (`Glitazones "not worth the money"', pulsetoday. co.uk/news) and would like to respond with my own experience...

LETTER: Reduce out-of-hours visits and patients will die.(Letter to the editor)
May 7, 2008... From Dr K Rukmani, Coventry It is most foolish for any out-of-hours service to curb GPs' home visits or referrals to hospital (`OOH providers curb GP visits and referrals', pulsetoday.co.uk/news). It is through such activities that...

LETTER: This request really takes the biscuit.(Letter to the editor)
May 7, 2008... From Dr S B Patel Colwyn Bay, Wales I've just had the best request for a supporting letter of my career. The young insulin-dependent diabetic had 1,000 cigarettes confiscated by Customs and Excise when he returned from his Spanish...

60-second interview: Professor David Price.
May 7, 2008... Professor David Price is a part-time GP in Norwich and professor of respiratory medicine at the University of Aberdeen - a 550-mile commute. He heads the research committees of the General Practice Airways Group and the International Primary...

Editorial: IT concerns now on record.(Editorial)
May 7, 2008... When Pulse campaigned last year for an overhaul of the Government's plans for electronic care records, we got short shrift from Connecting for Health. Our campaign called for patients to have to give explicit consent before records were...

PulseClinical: STROKE.
May 7, 2008... Stroke physician Dr Anthony Rudd answers questions from GP Dr Kathryn Griffith on depression, the importance of blood pressure control, the use of Beta-blockers and antiplatelet combinations 1 In a patient with previous TIA, can we assume...

PulseClinical: PAINFUL ARM SWELLING.
May 7, 2008... Dr Mike Wyndham describes a case where a boy's swollen arm was causing huge worry The patient A 12-year-old boy presented with a swelling that had been `growing out of his arm' over the previous six months. It had started to cause...

PulseClinical: ANAL FISSURE.
May 7, 2008... Evidence-based advice for conditions not covered by official guidelines Basic rules Conservative treatment should be preferred in new and mild cases. A chronic fissure requires surgery. Remember IBD and cancer in the differential...

PulseClinical: MRSA.
May 7, 2008... Consultant microbiologist Professor Barry Cookson offers advice on spotting and managing MRSA in primary care References 1 Coia JE, Duckworth GJ, Edwards DI et al. Guidelines for the control and prevention of methicillin-resistant...

PulseClinical: THE ASYMPTOMATIC CHILD WITH A HEART MURMUR.
May 7, 2008... Paediatric cardiologists Dr Rodney Franklin and Dr Zdenek Slavik explain which murmurs are innocent and which are pathological Heart murmur is the most frequent paediatric cardiology problem facing GPs. Up to 90% of children - if carefully...

HOW DOES CICLESONIDE COMPARE WITH OTHER STEROIDS FOR CHRONIC ASTHMA?
May 7, 2008... A new review from the Cochrane Library to inform your clinical practice Inhaled steroids are an integral part of asthma management, and act as an anti-inflammatory agent in the airways of the lung. These agents confer both significant...

PulseClinical: FACIAL RASH.
May 7, 2008... In the second part of their new series on how to make sense of common presentations, GPs Dr Keith Hopcroft and Dr Vincent Forte look at facial rash The GP overview Facial rash is a common presentation, with a wide differential and...

Should we switch to lower-dose cox-2?(Brief article)
May 7, 2008... Q I was interested to read about the recent NICE guidance on osteoarthritis. It states that patients shouldn't be on the 60mg dose of etoricoxib but that the 30mg dose might be okay. I don't prescribe cox-2 inhibitors very often but have a few...

Does calf DVT really require anticoagulation?
May 7, 2008... Q In your recent Need to Know article on venous thromboembolism (`Need to know - VTE, pulsetoday.co.uk/clinical), the author stated that for a calf DVT the current recommendation is six weeks' anticoagulation. But I was recently told that if...

PulseWorking Life: HOW TO FIGHT OFF THE PAY FREEZE.(Report)
May 7, 2008... Practice finance GPs have had their pay effectively frozen for the third year running. Accountant Bob Senior outlines the facts and advises on how practices can minimise the effects The recent report of the Review Body on doctors' and...

NonPrincipal'sDiary: Dr Ruth Chapman.
May 7, 2008... I have to say that the month could have started better. I had applied for a salaried post `with a view to partnership' and survived the first cull of applicants but my application was to go no further. After reading the practice manager's...

PATIENT INSISTS ON UNNECESSARY REFERRAL.
May 7, 2008... Dr Emma Cuzner on a medicolegal situation your practice could face A patient asked her GP for a referral to an orthopaedic surgeon because she had chronic back pain. The GP had previously made a referral to another orthopaedic surgeon and...

PulseWorking Life: WHAT IT'S LIKE TO WORK IN OCCUPATIONAL HEALTH.
May 7, 2008... Working in occupational medicine is intellectually stimulating, though not necessarily a huge generator of income, writes Dr James Heffer In the town where I live there is a 60-year-old man with severe ankylosing spondylitis. He is unable...

CareerCoach: Use email effectively.
May 7, 2008... Dr Pam Brown offers tips on how best to use this form of communication Email is used by all doctors for practice and personal communication. It can be a fast, effective, communication method that allows messages to be dealt with in...

PulseWorking Life: SAVING LIFE AND LIMB IN RWANDA.(Personal account)
May 7, 2008... The genocide of 1994 has left physical and mental scars on Rwanda, as GP Dr Sharon Bennett discovered when she worked there recently as a medical missionary One of the best ways of learning about a developing country is to practise...

Thanks a bunch, Brown.
May 7, 2008... Phil's not doing extended hours - and he predicts that you'll regret it if you do Thousands of practices across the land are starting to open their doors to provide extended access to their patients. My practice isn't one of them. ...

GP resistance breaks on extended hours.
May 14, 2008... NHS managers see first signs of success in drive to ramp up competition between practices EXCLUSIVE By Steve Nowottny Many PCTs are already meeting the controversial target to force half of practices to offer extended hours - 10...

PCTs' opening hours success.
May 14, 2008... 88% of PCTs are offering or planning to offer a local enhanced service, some mirroring the interim DES, others offering greater flexibility or hourly payment 50% of PCTs currently signing up practices to do extended hours 50% GPs in...

GPs will win APMS deals, says Johnson.
May 14, 2008... Health secretary Alan Johnson claims he has `no doubt' the majority of contracts for new surgeries in under-doctored areas will be awarded to existing GP practices. His pledge came as he denied charges by the Liberal Democrats that GP practices...

Patients need performance ratings for GPs.
May 14, 2008... Practice performance ratings should be made more widely available to patients to improve access to GP services, says the NHS Confederation. In a briefing on improving access to primary care, the confederation said providing patients with more...

Varenicline claims prompt disagreement.
May 14, 2008... Marketing claims that the smoking cessation drug varenicline has a favourable safety profile are `questionable', concludes the Drug and Therapeutics Bulletin. The Medicines and Healthcare Products Regulatory Agency recently warned...

New Choose and Book fault emerges.
May 14, 2008... A fresh security flaw in the Choose and Book system means patient records could have been accessed by users without an NHS smartcard, Connecting for Health admitted this week. A GP in Essex alerted IT bosses after he discovered he could...

GP-led centres to take on 50% of A&E work under Darzi plan.
May 14, 2008... Proposals include GP-led urgent care centres with 888 number and major shake-up of out-of-hours By Gareth Iacobucci New GP-led urgent care centres will be asked to take on up to half the workload of A&E departments under radical plans...

PULSE CAMPAIGN: College adds to SOS momentum.
May 14, 2008... The RCGP has thrown its weight behind Pulse's Save Our Surgeries campaign, which has passed a major milestone by gaining its 500th GP signature. The organisation joins a long list of campaign backers - including the BMA, the Conservative...

PULSE: SOS - Save Our Surgeries: Join our Week of Protest.
May 14, 2008... Dr Catherine Faarup is preparing to take part in the Pulse Save Our Surgeries Week of Protest, after running her own patient petition against polyclinics at her small practice in Burton-on-Trent, Staffordshire. `I've got about 350...

BIDDING WAR: Tender war is `survival of the fittest'.
May 14, 2008... An out-of-hours company bidding to run more than a third of the polyclinics being rolled out across the country under Lord Darzi's plans has called for a major consolidation of GPs' contracts, likening the process to survival of the fittest....

NEW SERVICES: Ministers want polyclinics to offer abortions.
May 14, 2008... Early medical abortion could be among the services offered by polyclinics under new Government proposals. The move follows a positive evaluation of a Department of Health pilot initiative aimed at improving access to abortion and making it...

Plan to spread CVD screening load.
May 14, 2008... National screening programme to be phased in over two years with pharmacists doing some of the work By Nigel Praities The new national cardiovascular screening programme will be phased in more slowly than planned because of concern...

GPs to manage more CKD cases under new referral rules.
May 14, 2008... Strict Government-approved criteria for chronic kidney disease referrals could see GPs forced to treat more patients - including those with more severe disease. In a bid to stem rising referrals, which are overloading hospital clinics and...

18-week wait distorts clinical priorities.
May 14, 2008... Patients not covered by key target are left to languish in pain, study finds By Nigel Praities The Government's flagship 18-week waiting time target is distorting clinical priorities and increasing the suffering of many patients with...

GPs back cannabis reclassification.
May 14, 2008... GPs have voiced their support for the Government's reclassification of cannabis, citing their concerns over the increasing number of patients presenting with complications related to the drug. Home secretary Jacqui Smith said she would `err...

BMA launches fightback over anti-GP spin.
May 14, 2008... The BMA is launching a long-demanded national PR campaign to counter anti-GP spin by the Government. The Support Your Surgery initiative - which has strong echoes of the Save Our Surgeries campaign launched by Pulse in March - will aim to...

Media Watch: This week's top... Miracle cure.
May 14, 2008... According to a vision of the future conjured up by the communications regulator Ofcom, Bluetooth chips could be implanted into older patients to remind them to take their medicine, or alert their nearest GP practice or hospital if they are at...

Media Watch: This week's top... Scare story.
May 14, 2008... Babies, cancer and `gender-bending' chemicals are a sure-fire recipe for media outrage. Sure enough, both the Daily Telegraph and Daily Mail stepped up to the plate after reports of a chemical in plastic feeding bottles which is allegedly...

Media Watch: This week's top...most pointless research.
May 14, 2008... A systematic review of the relationship between fast food consumption and increased calorie intake has found the following overwhelming conclusion: the more fast food people consume, the more likely they are to gain weight. The analysis in...

Yearly cholesterol test `not needed'.
May 14, 2008... Checks every three to five years sufficient as annual monitoring often detects false positives, say researchers By Emma Wilkinson Annual checks for patients under treatment for high cholesterol should be scrapped, a new study claims....

IN BRIEF: DH `inept' over MMC.(Modernising Medical Careers )
May 14, 2008... A report by the health select committee has criticised the Government over its handling of the Modernising Medical Careers fiasco. The report said the Government failed to address problems with the system, which left hundreds of junior...

IN BRIEF: Plan to make DNAs pay.
May 14, 2008... Patients could be charged for missing GP appointments or for unnecessarily dialling 999 for an ambulance, under radical new plans. Welsh health minister Edwina Hart is considering the introduction of a `cost system' for patients who miss...

IN BRIEF: Early use of ARBs urged.
May 14, 2008... GPs should prescribe angiotensin-receptor blockers as early as possible to get patients to blood pressure targets, say researchers. NICE recommends that ACE inhibitors should be used first-line in those under 55 with hypertension, but the...