Pulse articles from May 2009

Pulse archives from May 2009

Out-of-hours locums probe after man dies.
May 6, 2009... The use of locums by out-of-hours providers is under scrutiny after a man died following an overdose of an opiate delivered by an overseas GP, according to an investigation by The Guardian. David Gray died at his home in Fenland, Cumbria,...

Wanted: GP volunteers to guide the GMC.
May 6, 2009... The GMC is seeking GP volunteers to join a new advisory panel to guide the council on controversial regulatory issues. The new GMC reference community - consisting of 25 medical and 25 lay members - will advise on contentious topics such as...

Warning on use of ARBs in breast-feeding.
May 6, 2009... ARBs and certain ACE-inhibitors should not be used by breast-feeding mothers, according to the MHRA. The regulatory body says there is not enough evidence to rule out a risk of profound neonatal hypotension - especially in pre-term babies....

SWINE FLU: GPC criticises `foolish' lack of GP pandemic planning.
May 6, 2009... Practices and PCTs caught unprepared as GPs face difficulties isolating patients and accessing masks and antivirals Exclusive By Steve Nowottny The GPC has criticised thousands of GP practices as `foolish' for failing to draw up...

SWINE FLU: HOW THE OUTBREAK SPREAD.
May 6, 2009... 1 Ayrshire Scotland's fourth case - man understood to have picked up virus in Texas 2 Falkirk First case of human-to-human transmission in the UK 3 Polmont UK's first two swine flu sufferers diagnosed after returning from honeymoon in...

SWINE FLU: Mixture of confusion and support for GPs at coalface.
May 6, 2009... For some, it was business as usual. For other GPs this was the week the nation's defences against a potential flu pandemic were tested and found wanting. As Pulse went to press, there had been 28 confirmed cases of swine flu in the UK,...

Off-licence antivirals approved for infants with suspected swine flu.
May 6, 2009... GPs cleared by MHRA to provide Tamiflu to children aged under one year and Relenza to those under five Exclusive By Lilian Anekwe GPs have been given the go-ahead to prescribe antivirals to children and babies with suspected swine...

SWINE FLU: Guidance for GPs.
May 6, 2009... Investigate using nose and throat swabs all patients, or contacts of patients, who: * have returned from areas where sustained human-to-human transmission of swine influenza is occurring, and; * have a fever of 38C degrees or more or...

SWINE FLU: Surge in cases still possible.
May 6, 2009... Swine flu appears less deadly than first thought, but the low number of cases so far does not preclude there being a surge in the coming weeks or the autumn, infectious disease experts have told Pulse. The virus has been sequenced by...

SWINE FLU: What could happen in a flu pandemic?
May 6, 2009... Best case * Has low mortality rate (for example 0.4%) and low clinical attack rate * Antivirals reduce transmission of the virus * Able to produce targeted vaccine quickly * Peters out because of warmer weather Worst case...

SWINE FLU: Seasonal vaccine production at risk.
May 6, 2009... The production of the annual seasonal flu vaccine could be thrown into jeopardy if a flu pandemic is declared, the RCGP is warning. In the event of a full-blown pandemic, the Government will ask pharmaceutical companies to cease production...

GPs `don't need to monitor BP so regularly'.
May 6, 2009... Regular monitoring of BP in hypertensives isn't necessary and can be misleading, says new study By Lilian Anekwe GPs do not need to regularly monitor the blood pressure of their hypertensive patients, and doing so can even be...

Safety reports to be enforced.(Brief article)
May 6, 2009... GPs are set to be given a legal duty to report patient safety incidents under plans being discussed by the Government and its new regulator. The Department of Health wants to make reporting of safety incidents mandatory to address what has...

Darzi U-turns at polyclinic opening.
May 6, 2009... London polyclinics are far cry from original vision - and minister admits they will not be replicated elsewhere By Gareth Iacobucci The first full-scale polyclinics in the UK have finally arrived across London, 659 days since being...

How Lord Darzi's polyclinic plans are progressing in London.(Brief article)
May 6, 2009... * NHS London recently revealed it was planning a `rapid implementation plan' to open 115 polyclinics by 2010/11 before NHS funding is hit * Healthcare for London launched its first seven polyclinics last week in Hammersmith and Fulham,...

IN BRIEF: ISTCs overpaid up to #1bn.(independent sector treatment centres)(Brief article)
May 6, 2009... The NHS may have overpaid the private sector by almost #1bn during the first wave of independent sector treatment centres, according to researchers. Their study, published online by the BMJ, analysed data from the only ISTC in Scotland,...

IN BRIEF: Tick-borne disease alert.(Brief article)
May 6, 2009... A leading scientist is urging GPs to do more to prevent cases of tick- borne encephalitis from escalating. Professor Michael Kunze, chair of the international scientific working group on TBE, said cases had been confirmed in UK travellers...

IN BRIEF: Mental health and debt.
May 6, 2009... The Royal College of Psychiatrists is sending `debt first aid' advice to 100,000 GPs to help them support patients with debt and mental health problems. Statistics due out shortly will show that one patient in every two with debts also has...

Call for funds for polypill production.
May 6, 2009... The Government should incentive pharmaceutical companies to produce polypills from combinations of generic drugs, as a powerful means of driving down cardiovascular deaths, a new report concludes. A pill combining a statin with low doses of...

Disciplinary postcode lottery.
May 6, 2009... GPs face starkly different odds of being hauled before a national disciplinary and retraining body depending on where they practise, Pulse can reveal. Referrals to the National Clinical Assessment Service between 2001/2 and 2007/8 show...

GP wins battle to ban misleading choice ad.
May 6, 2009... Advertising body rules NHS claims on patient choice could be misleading By Steve Nowottny An NHS advertisement trumpeting the Government's flagship choice policy has been banned by the Advertising Standards Authority after a GP...

`Keep one-third of slots for urgent care'.(Brief article)
May 6, 2009... Practices should reserve a third of daily appointments for patients seeking urgent care, according to a think tank. The Primary Care Foundation's report recommends practices also make better use of phone consultations to cater for patients...

Steroid side-effect warning.
May 6, 2009... GPs should discuss the potential risks of pneumonia, osteoporosis and adrenal suppression with all patients with COPD who might benefit from inhaled steroids, say NHS prescribing advisers. A MeReC bulletin recommends that GPs should look...

Stop-smoking targets hinder long-term care.
May 6, 2009... Stop smoking services find it difficult to support smokers to quit long- term because of strict Government four-week targets, researchers claim. Their study into the support for quitters found four-week targets were a `substantial barrier'...

JOURNAL WATCH: Exenatide Beta-cell boost.
May 6, 2009... Treatment for one year with exenatide improves Beta-cell function compared with insulin glargine in patients with type 2 diabetes treated with metformin. An international team of researchers found both exenatide and insulin reduced HbA1c...

JOURNAL WATCH: Psoriasis risks assessed.
May 6, 2009... Women with psoriasis have an increased risk of diabetes and hypertension, US researchers from the Nurses' Health Study report. The researchers studied 78,061 Caucasian women free of hypertension and diabetes in 2005 and assessed them over four...

JOURNAL WATCH: Smoking ups RA risk.(rheumatoid arthritis)(Report)(Brief article)
May 6, 2009... Smoking is the only significant lifestyle-related risk factor for rheumatoid arthritis, according to a study of the UK general practice research database. Spanish researchers identified 579 patients with a first-ever diagnosis of RA from a...

JOURNAL WATCH: Tea lowers stroke risk.
May 6, 2009... Tea consumption lowers the risk of a stroke, a meta-analysis by US researchers concludes. An analysis of nine studies, including 4,378 strokes in 194,965 people, found consumption of three or more cups of green or black tea a day lowered the...

PULSE IN FOCUS: GPs in dock over patient safety data `black hole'.(general practitioners)
May 6, 2009... Voluntary reporting system under attack as Government considers how to make incident reporting mandatory By Nigel Praities It's part of the fabric of being a doctor: the Hippocratic oath and its key principle of first doing no harm....

EDITORIAL: Making a pig's ear of flu pandemic planning.(Editorial)
May 6, 2009... It's not as though we weren't warned. Over recent years, a string of nervous-looking infectious disease scientists have told us a flu pandemic was long overdue. Just last December, guidance from the RCGP and BMA set out a worst-case scenario in...

VOX POP: How has swine flu affected your practice?
May 6, 2009... Dr Peter Moore GP in Torbay, Devon `At the end of the day, this is the flu, not the plague. For young people it may not be any worse than normal flu but for old people it could be more serious. We are still making preparations at our...

LETTER: We are not equipped to deal with swine flu pandemic.(Letter to the editor)
May 6, 2009... From Dr David Barrett, Coventry Coventry PCT and the Health Protection Agency have been advising GPs to visit patients at home, swab them and deliver the samples to our local hospital ourselves by 6pm each day (`London GP: my ordeal dealing...

FOR THE RECORD: Steve Field.(Brief article)
May 6, 2009... In the interview with Professor Steve Field last week, we said the RCGP wanted GPs to review two significant events for revalidation - but in fact it is asking for five events. Also last week, seniority pay is actually worth #80m a year,...

LETTER: EBM prophets are going too far.(Letter to the editor)
May 6, 2009... From Dr Jim Sherifi Sudbury, Suffolk The undermining of a profession through doubt and innuendo has far- reaching and unexpected consequences. So it is with the revisionist philosophy of evidence-based medicine and its prophets at NICE and...

LETTER: Switching GP proposal is a recipe for disaster.(Letter to the editor)
May 6, 2009... From Dr Paul Charlson Brough, East Yorkshire I'm writing regarding your article reporting that PCTs are pushing for frequent switching of GP - just like switching between gas suppliers (pulsetoday.co.uk/news). This is a recipe for...

LETTER: A hub-and-spoke future.(Letter to the editor)
May 6, 2009... From Dr Paul Caldwell Goole, East Yorkshire If you decided to set up primary care now, you would not come up with the current model. It perpetuates divisions between members of the primary healthcare team, other practices and hospitals, and...

DEBATE: Could Government control solve GP jobs crisis?
May 6, 2009... YES A return of the Medical Practices Committee might not be popular, but it would be better at distributing partnerships than market forces, says GPC chair Dr Laurence Buckman It has been a central political belief for the past 20...

PULSECLINICAL: NEED TO KNOW - COPD.(chronic obstructive pulmonary disease)
May 6, 2009... Respiratory physicians Dr Mahendran Chetty and Dr Graeme Currie answer GP Dr Pam Brown's questions on reversibility testing, pneumonia risk with high-dose steroids and managing extrapulmonary manifestations Take-home points *...

SNAP SHOT DIAGNOSIS: Prolonged vomiting and abdominal pain.(Case study)
May 6, 2009... This young patient normally looked pale and jaundiced due to a hereditary condition. But why has she suddenly started vomiting? Dr Mike Wyndham describes the case The patient This nine-year-old girl has the hereditary haemolytic...

BUSINESS BRIEFING: Keeping staff motivated in hard times.
May 6, 2009... In the second in his series on the profit squeeze in general practice, accountant Paul Samrah looks at how to get the most from staff in a recession The press headlines are depressing reading. `Record job losses announced', `Dole queue set...

BUDGET BITES - 10 ways the Budget may have an impact on GPs.
May 6, 2009... 1 New 50% top rate of tax for taxable income over #150,000 from 5 April 2010. 2 From 5 April 2010, the income tax personal allowance will reduce for people with taxable income of more than #100,000 a year. Personal allowances will...

Ill-prepared for the inevitable.(swine influenza control )(Column)
May 6, 2009... Ministers say we're well prepared for pandemic flu, but Phil reckons they're living in cloud cuckoo land `I phoned NHS Direct to ask about pig flu, but there was a lot of crackling on the line.' I guffawed with laughter. `Good one!'...

Minor surgery victory for GPs.
May 13, 2009... Thrashed-out deal frees ordinary GPs from meeting tough requirements Exclusive By Lilian Anekwe Thousands of GPs are set for the green light to continue doing minor surgery after GP leaders won a key victory in their long-running...

The compromise.(general practitioners with special interests)(standards to perform skin surgery and skin cancer treatment)(Brief article)
May 13, 2009... * GPSIs in dermatology and GP surgeons who regularly remove BCCs and other suspected skin tumours will be required to work in a multidisciplinary team with secondary care staff, complete advanced training and perform around 40 procedures a year...

Cervarix comes out ahead of Gardasil in trial.
May 13, 2009... The first head-to-head trial of the two cervical cancer vaccines has shown Cervarix, used in the national immunisation campaign, elicits a stronger immune response in women than Gardasil. The trial of 1,110 US women aged 18-45 found...

Tool to assess Alzheimer's risk in over-65s.
May 13, 2009... A new tool may allow GPs to assess the risk of Alzheimer's disease in people over 65. Researchers allocated points on a dementia risk index for older age, poor cognitive tests, BMI, alcohol consumption and other factors. Some 4% of...

Expenses were within rules, says Lansley.(Andrew Lansley redecorated his second home before selling it)(Brief article)
May 13, 2009... Shadow health secretary Andrew Lansley has admitted that the parliamentary allowance system has become `discredited' but denied having used it to maximise his expenses. The Daily Telegraph claimed Mr Lansley spent #4,600 to redecorate his...

GPC joins with NHS Choices to develop ratings website.
May 13, 2009... Negotiators reluctantly agree to help work up ratings plans after being persuaded of key safeguards Exclusive By Steve Nowottny The GPC has dropped its opposition to controversial plans for patients to anonymously rate GP...

How the website will work.
May 13, 2009... What's in * Patients will be able to leave anonymous comments, and state whether they would recommend the practice to a friend based on their overall experience * Patients will be asked to score practices on five key areas, such as...

GPs to be rated on 85 areas.
May 13, 2009... The Department of Health has hired external management consultants to draw up a new assessment system to be used for GPs across the country. International consultancy firm McKinsey has been paid an undisclosed fee to help draw up a model...

Homeopathy gets first MHRA licence.
May 13, 2009... The MHRA has granted its first ever licence to a homeopathic medicine under a controversial scheme for extending licenses to complementary therapies. The agency has granted an arnica homeopathic product a licence for the relief of sprains...

The scorecard so far.
May 13, 2009... * Balanced scorecards were originally pioneered by NHS Tower Hamlets, which rated practices annually against 19 indicators, including access and prescribing cost-effectiveness * A Pulse survey last June found as many as two-thirds of PCTs...

Local flu planning `mad', GPC says.
May 13, 2009... The GPC has condemned the Government's locally led response to the swine flu outbreak as `mad' and urged it to develop clear national guidance on preparing staff and accessing swabs, face masks and antivirals. GPC chair Dr Laurence Buckman...

Training cash to attract new doctors.
May 13, 2009... The Government has revealed plans to deliberately skew distribution of new GP training practices in an attempt to attract GPs to underdoctored areas. It will commit 80% of its planned #100m investment in GP training practices to the half...

Outcome targets may not work, says QOF chief.
May 13, 2009... Plans to radically revise the QOF to focus heavily on outcome targets are unlikely to be practical, says the head of the new indicator selection panel. Dr Colin Hunter, chair of the QOF Indicator Advisory Committee at NICE, warned pushing...

COMPLEMENTARY THERAPIES: `Kitemark' scheme for alternative therapies.
May 13, 2009... Plan to award practices a quality symbol for offering integrated healthcare By Nigel Praities An organisation backed by Prince Charles is planning a `kitemarking' scheme recognising the provision of complementary therapies in general...

COMPLEMENTARY THERAPIES: Sham acupuncture works.
May 13, 2009... Real and simulated acupuncture are both more effective than usual care for treating back pain, a US study reports. The researchers showed there was little difference between conventional Chinese methods of acupuncture and so-called sham...

SSRIs raise warfarin risk.(Clinical report)
May 13, 2009... Antidepressants raise the risk of clinically significant bleeding in patients on warfarin by more than three times, Swedish researchers warn. Their study of 234 patients taking warfarin for atrial fibrillation found those who were also on...

MEDIA WATCH: THIS WEEK'S TOP... Scare story.(parents of overweight children)(Brief article)
May 13, 2009... The `great puppy fat myth' has been busted by research reported in the Daily Mail. A study has shown that 70% of parents with overweight or obese children refuse to accept their child has a weight problem and think their son or daughter's...

MEDIA WATCH: THIS WEEK'S TOP... Miracle cure.(testosterone injected in men to prevent conception)(Brief article)
May 13, 2009... A `male pill', which is actually an injection, could be as effective as its female counterpart - if men can get over their fear of needles. A study by male scientists in China, whose population control is high on the agenda, found a...

MEDIA WATCH: THIS WEEK'S TOP...most pointless research.(eating more calories increases obesity)(Report)(Brief article)
May 13, 2009... Research has concluded the rise in obesity in the US since the 1970s was `virtually all due to increased food intake'. Professor Boyd Swinburn, chair of population health and director of the WHO centre for obesity prevention, studied 2,400...

How locums could successfully navigate revalidation.(National Association of Sessional General Practitioners)(Royal College of General Practitioners)(Brief article)
May 13, 2009... Option 1 Affiliate scheme: locums to be adopted by practices, giving them ongoing practice support and a mutually beneficial relationship Option 2 Locum chambers: locums form networks in a chambers-style model, to create stronger...

GPs may be asked to `adopt' a locum in revalidation plan.
May 13, 2009... Locums would attend practice meetings under buddying-up proposal to help them pass scheme By Gareth Iacobucci Every practice could be asked to `adopt' a locum, under innovative plans being considered to help sessional GPs through the...

Tendering costs at PCTs varies hugely.
May 13, 2009... A Pulse investigation has revealed huge variation in the money being spent on the nationwide procurement of GP-led health centres and underdoctored practices. A survey of PCTs has found that a string of trusts have spent six- figure sums...

Fewer children to be treated as underweight.
May 13, 2009... New child growth charts adopted by the Department of Health are set to class far fewer children as underweight or as requiring treatment for failure to thrive. But the World Health Organization charts, which the DH said last week should...

IN BRIEF: One in 10 NHS staff is failing, says CQC chair.(Care Quality Commission)(United Kingdom. National Health Service)(Brief article)
May 13, 2009... The head of the Government's new health and social care regulator has vowed to use all its powers to crack down on `the bottom 10%' of NHS staff performers. Care Quality Commission chair Baroness Young said: `We will do a bit of a number...

IN BRIEF: Sex starts at 12 for some.
May 13, 2009... A survey on sexual health issues in young people found one in every 20 teenagers now has sex at the age of 12, and nearly half of all teenagers are having underage sex. But the poll of 2,750 patients aged 16 to 30 - half of whom were in their...

IN BRIEF: GPs miss out on alarms.
May 13, 2009... The Government is giving personal attack alarms to 30,000 lone NHS workers, but there are no guarantees that GPs will receive any. The devices, which use Location Based Service (LBS) technology to help locate users, will link to trained...

JOURNAL WATCH: Early AMD cognitive link.
May 13, 2009... Early age-related macular degeneration is associated with cognitive impairment, say US researchers. Their study in 2,088 people aged 69 to 97 years evaluated their cognitive function and dementia, and also assessed signs of early AMD using...

JOURNAL WATCH: Breath test for smokers.(Brief article)
May 13, 2009... GPs can demonstrate the damage a smoker is doing to their lungs via a simple breath pH test, according to UK researchers. Their study of 35 people compared exhaled-breath condensate pH with biomarkers of airway inflammation and oxidative...

JOURNAL WATCH: Vitamins link to asthma.
May 13, 2009... Deficiencies of certain vitamins are linked with an increased risk of asthma or wheeze, a meta-analysis of 40 studies has confirmed. UK researchers looked at the association between dietary intake and serum levels of antioxidant vitamins A,...

Child role stepped up.
May 13, 2009... GPs' child protection duties rise in BMA drive to help prevent another Baby P By Nigel Praities GPs are being asked to hold weekly meetings with health visitors, attend child protection case conferences and maintain registers of...

What the BMA guidance says.
May 13, 2009... * GPs are likely to be the first professionals to come into contact with at-risk children, and should always bear in mind the `child behind the adult' * Practice teams should know how to act on concerns over a child, with written protocols...

Too many patients with gout on high-dose colchicine.
May 13, 2009... GPs should avoid using high doses of colchicine in patients with acute gout, concludes an audit of the implementation of current gout guidance. The audit - carried out last year - found that many GPs were unaware of the British Society for...

Call for open-access fertility test.
May 13, 2009... Giving GPs direct access to hysterosalpingography could fast-track IVF referrals and save funds By Lilian Anekwe Giving GPs open access to an imaging test for infertility could save the NHS millions by improving identification of women...

Death of GP's father sparks GMC criticism.
May 13, 2009... A GP whose father died following a prescribing error by a German locum has joined leaders in the profession calling for an investigation into how the GMC registers overseas doctors. David Gray died at his home in Fenland, Cambridgeshire, in...

What is hysterosalpingography?(Brief article)
May 13, 2009... * Hysterosalpingography (HSG) is an X-ray imaging test to investigate the shape of the uterine cavity and the shape and patency of the fallopian tubes * A radio-opaque material is injected into the cervical canal * A normal result...

PULSEIN FOCUS: Race against time to plug gaps in pandemic planning.
May 13, 2009... With experts predicting a second, more serious, wave of swine flu, we ask what lessons have been learned so far By Steve Nowottny Back in January, the BMA and RCGP released a 61-page document urging GPs to prepare for a flu pandemic...

PULSE IN FOCUS: RCGP vice-chair at centre of outbreak.(Royal College of General Practitioners)(Brief article)
May 13, 2009... Dr Clare Gerada, RCGP vice-chair and a GP in south-east London, found herself at the centre of the swine flu outbreak when six pupils at Alleyn's School in Dulwich were confirmed to have contracted the virus. `I was called by the PCT...

EDITORIAL: It's GP surgeons versus the BAD guys.(Editorial)
May 13, 2009... The British Association of Dermatologists seems to have been making a concerted effort to live up to its acronym. It has demonstrated, over the past few years, just what an effective lobbying organisation it is for the interests of dermatology...

VOX POP: Should all practices offer alternative therapies?
May 13, 2009... An organisation back by Prince Charles has proposed a `kitemarking' scheme to encourage use of complementary therapies - but should GPs be using them? Dr Nigel Watson GP in New Milton, Hampshire, and chief executive of Wessex LMCs ...

LETTER: GPs will be left to mop up after the swine flu media cyclone.(Letter to the editor)
May 13, 2009... From Dr Catherine Hutchinson Locum, north-east England I find it interesting that scaremongering is going on yet again, on this occasion over swine flu, without access to the full facts. I have encountered patients with very similar...

LETTER: Are there hidden costs to drug savings?(Letter to the editor)
May 13, 2009... From Dr Tony Lee Alderney, Guernsey Dr Mark Spencer says he has saved #360,000 on his practice's prescribing budget by changing its prescribing habits (`How I saved #360,000 on drug costs', pulsetoday.co.uk/ business). But it would be...

LETTER: The real genius is in getting to keep savings.(Letter to the editor)
May 13, 2009... From Dr David Iles, Southampton The processes described in this article are what any good GP practice should be doing routinely. The prescribing lead in the practice should be monitoring generic prescribing, using Scriptswitch software...