Pulse articles from November 2006

Pulse archives from November 2006

Justice for GPs hangs in balance.(general practitioners)
November 2, 2006... As consultation on medical regulation enters its final week, the BMA savages CMO's plans CAMPAIGN: JUSTICE FOR GPs By Helen Crump Lowering the level of proof needed to deprive doctors of their livelihood would `massively increase'...

`He's no idea what we do'.(Brief article)
November 2, 2006... The Chief Medical Officer has failed to take into account how locum GPs work in drawing up his recommendations, Dr Richard Fieldhouse believes. Dr Fieldhouse, chief executive of the National Association of Sessional GPs, said Sir Liam's...

Trainers to meet cost of registrars.(Brief article)
November 2, 2006... The contribution GP registrars and foundation scheme trainees make to practices will be taken into account when calculating GP trainers' pay, the Department of Health has confirmed. An overhaul of funding will also see pay for GP training...

Psychological therapies set for Government cash.
November 2, 2006... Department of Health praises success of `milestone' pilot study Pulse Action on depression By Gareth Iacobucci The Government is set to move at last on psychological therapies after releasing positive early data from one of its...

Talking therapy's tangible benefits.
November 2, 2006... Dr Lis Rodgers, a Doncaster GP who helped set up the talking therapy pilot, believes it is bringing tangible benefits for both GPs and patients. `Patients I've referred had really good results in terms of their mental health and improving...

Scots GPs pilot cardiovascular screening programme.(Brief article)
November 2, 2006... The first stage of an ambitious new programme for GP cardiovascular screening has been launched in Scotland. Practices will deliver half-hour health checks and regular monitoring to high-risk patients as part of a pilot in north Lanarkshire...

GPs warned CKD burdenis only tip of the iceberg.(chronic kidney disease)
November 2, 2006... GP workload over chronic kidney disease could rise still further after a new study detected huge numbers of hidden cases, writes Lilian Anekwe. Researchers found a screening strategy similar to the QOF's was identifying only half of all...

Phil notches up a second award.(columnist Dr Phil Peverley wins double award)(Brief article)
November 2, 2006... Pulse columnist Dr Phil Peverley is now a double award winner, after picking up the columnist of the year prize at the prestigious Press Gazette Magazine Journalism Awards. Phil beat off challenges from food writer Nigel Slater and...

New guidance to clarify exception reporting rules.(Brief article)
November 2, 2006... GPs must send three invitations specifically addressed to each patient before exception reporting is allowed, new guidance warns. The BMA and NHS Employers said generic invitations, such as a call to come for flu vaccination printed on a...

CVD software tool may ease GP screening burden.(cardiovascular diseases)(Brief article)
November 2, 2006... A new software tool could allow GPs to screen their patients automatically for cardiovascular risk, easing the burden of CVD screening. The `e-nudge', developed by a network of GP researchers, sends screen alerts on the opening of notes of...

InBrief: Tariff up 2.5% next year.(Brief article)
November 2, 2006... The Payment by Results tariff for NHS procedures is to be uplifted by 2.5 per cent next year, the Department of Health has announced. It has also taken the first steps to `unbundle' the cost of some diagnostic services from overall acute...

InBrief: Statin scripts surprise.(Brief article)
November 2, 2006... GPs in deprived areas actually prescribe statins more often than those in affluent ones, contrary to expectations, a new study concludes. But the analysis of QOF data, published in the Journal of Public Health, found GPs did continue to...

InBrief: BMA opposes elections.(plans to introduce direct elections to health boards )(Brief article)
November 2, 2006... Scottish Executive plans to introduce direct elections to health boards will do nothing to improve public consultation on NHS services, the BMA is warning. In a submission to a consultation on plans to introduce the elections, the...

InBrief: Skin Ca cameras little use.(Brief article)
November 2, 2006... GP use of digital cameras in diagnosis of skin cancer is unlikely to dramatically reduce the need for conventional consultations, an NHS analysis concludes. The Health Technology Assessment found only `modest' concordance in diagnoses...

InBrief: HIV rises in drug users.(intravenous drug users risks HIV infections)(Brief article)
November 2, 2006... HIV infection is continuing to rise among intravenous drug users and has now reached 2.1 per cent, a new report concludes. Prevalence in 2005 was 4.3 per cent in London and 1.6 per cent outside the capital - more than double the figure in 2004....

InBrief: IT deal signed in Scotland.(Brief article)
November 2, 2006... NHS Scotland has signed an agreement with Microsoft to license its desktop and mobile computing software for the next three years. The deal covers 75,000 computers and mirrors a similar agreement signed in England in 2001. Copyright: CMP...

InBrief: Pharmacists encroaching.(general practitioner-pharmacists relations)(Brief article)
November 2, 2006... GPs are concerned that pharmacists are encroaching on their territory, the BMA has told the All-party Pharmacy Group's inquiry on the future of pharmacy. But MPs on the group responded that improvements in NHS services would never happen unless...

InBrief: #10m occupational health.(government funding to help move occupational health services for National Health Service staff)(Brief article)
November 2, 2006... The Government has pledged to invest #10 million in capital funding to help move occupational health services for NHS staff out of acute hospitals and into the community. The cash will fund up to 12 pilot sites and extend the reach of NHS Plus,...

Angry GPs pledge to battle for pensions.
November 2, 2006... Legal and industrial action threatened if new contract rises are capped By Christian Duffin GPs are pledging to take legal and industrial action if the Government pushes ahead with a cap on their new contract pension rises. The...

Medical expert witnesses plan.(Brief article)
November 2, 2006... NHS organisations should develop local networks of medical expert witnesses who can share knowledge and help train other clinicians in the role, a review by the Chief Medical Officer has proposed Sir Liam Donaldson said the system of...

New SSRI doubts during pregnancy.(Brief article)
November 2, 2006... The safety of SSRIs in pregnancy has been thrown into further doubt by a new expert committee review. The pharmacovigilance expert advisory group warned product information would need to be revised to reinforce the potential risks. It...

MediaWatch: `Pill puts paid to PMS'.(premenstrual syndrome)(Brief article)
November 2, 2006... The story A new pill is set to end the misery of premenstrual syndrome, the Daily Mail reports. The source Wyeth Pharmaceuticals, manufacturer of the continuous contraceptive pill Lybrel, claims it will ease the effects of hormonal...

MediaWatch: `Ca drug's sight-effect'.(Brief article)
November 2, 2006... The story Patients with a common form of blindness are getting `astounding' benefits from a cancer drug, says the Daily Express. The source Avastin has completed stage three cancer trials in Europe and the US and its manufacturer, Roche, is...

New study sparks flu vaccine controversy.
November 2, 2006... Department of Health's claims of 75-80% efficacy branded a `fantasy' By Lilian Anekwe Vaccination against influenza has little or no effect on rates of the disease and may be a waste of time and money, concludes a major new review of...

Confidentiality fears in access DES.
November 2, 2006... GPs warn that identification of patients who have visited the practice recently could put doctors at legal risk By Ian Cameron GPs could risk breaching patient confidentiality if they take part in the controversial access directed...

Dermatology switch may deskill GPs.(Brief article)
November 2, 2006... Moving too much dermatology work into primary care purely in order to save money risks deskilling doctors and will damage patient care, GPs are warning. The Primary Care Dermatology Society is arguing that hospital-based training for GPs...

Contract `highly inequitable'.
November 2, 2006... Practices are paid far less for the same clinical care in deprived areas than in affluent ones By Gareth Iacobucci The new contract is `highly inequitable' and pays practices far less for the same clinical care in deprived areas than...

GMS practices are better value.
November 2, 2006... GMS practices are better value for money than PMS surgeries or those run by primary care trusts and private firms, a study has concluded. The GP-led research found GMS practices scored more quality points relative to their funding than...

Square root formula `a joke'.(Brief article)
November 2, 2006... Dr Jonathan Fluxman, a GP in an inner-city area of west London, believes the square root system for calculating funding is a `complete joke'. He said: `The more patients you have, the less reward you have for each patient.' Dr Fluxman...

PBC claim ridiculed by GPs.(general practitioners)(practice based commissioning)(Brief article)
November 2, 2006... GPs and policy experts have ridiculed Department of Health claims that PCT mergers have had no impact on practice-based commissioning uptake. Latest figures show 82 per cent of trusts have plans in place for universal PBC coverage -...

Small practices need more help.
November 2, 2006... Smaller practices are offering equally high-quality clinical care as their larger counterparts, but need more help in future to keep their good performance going, research concludes. The study of more than 600 practices in Scotland found...

NHS care `is improving'.(national health service)(Brief article)
November 2, 2006... Care in the NHS is improving but more attention needs to be given to patient safety, the Healthcare Commission's annual State of Healthcare report concludes. The commission also called for more attention to be given to helping people self...

JournalWatch: Tiotropium an aid in COPD.(Brief article)(Clinical report)
November 2, 2006... Tiotropium reduces exacerbations and related hospitalisations in patients with COPD, a US study reports. The systematic review pooled results from nine trials testing tiotropium for at least 12 weeks in 8,002 patients. The studies compared...

JournalWatch: Drug helps obese diabetics.(Brief article)
November 2, 2006... Rimonabant can promote weight loss and improve control of blood glucose in patients with diabetes, Belgian researchers report. Their study examined the effects of rimonabant in 1,047 overweight or obese patients with type 2 diabetes, whose...

JournalWatch: Antipsychotic diabetes risk.(Brief article)
November 2, 2006... A series of different atypical antipsychotics increase the risk of developing diabetes, a US study concludes. The observational study examined the risk of diabetes in 15,767 patients on the US Veterans Health Administration database who...

JournalWatch: Statins in pneumonia.(Brief article)
November 2, 2006... Statins do not, after all, reduce mortality or admission to intensive care in patients with community-acquired pneumonia, a Canadian study reveals. The researchers prospectively followed 3,415 patients with pneumonia admitted to hospital,...

JournalWatch: Traffic fumes stroke alert.(Brief article)
November 2, 2006... Traffic fumes may trigger ischaemic stroke, according to Canadian researchers. Their study assessed levels of six airborne pollutants at fixed-site monitoring stations. After adjusting for temperature and humidity, the overall risk of...

Homoeopathy furore.(Brief article)
November 2, 2006... Peers condemn new licensing regulations for homoeopathic medicines Peers have strongly condemned new regulations bringing homoeopathy into the mainstream of the NHS during a House of Lords debate, writes Lilian Anekwe. The UK drug...

`Prepare for year of conflict'.
November 2, 2006... The Government will keep piling unfunded work on practices over the coming year unless GPs become more militant in saying No, leading GPs are warning. Local medical committees are predicting a year of conflict between GPs and ministers...

GPs cut cost and waits with PBC.(Brief article)
November 2, 2006... A practice-based commissioning consortium in Essex is proposing to slash up to a third off the cost of carpal tunnel services in its first year. Dr Shane Gordon, chief executive of the Colchester practice-based commissioning group, said a...

`Dumbing down' of GP training.(Brief article)
November 2, 2006... GP training risks being `dumbed down' because of continued cuts in deanery budgets, GP educationalists are warning. The Association of Course Organisers last week condemned the `sudden withdrawal' of plans in Modernising Medical Careers for...

Dramatic benefits for lung cancer screening.
November 2, 2006... New research spotlights cancer screening, diagnosis and referral By Lilian Anekwe Screening for lung cancer using spiral CT has spectacular benefits in cutting mortality from the disease, a major international trial reports. The...

Anaemia marks colon Ca mortality.(Brief article)
November 2, 2006... GPs should be more willing to investigate for colorectal cancer in patients with mild anaemia, researchers advise. A new study found GPs were `more alert' to rectal bleeding as a symptom, but that it was patients diagnosed after presenting...

DVT justifies GP cancer suspicion.(Brief article)
November 2, 2006... An unexplained thromboembolism is enough to justify cautious investigation for cancer, new primary care research concludes. The analysis of 813 patients with colorectal, lung or prostate cancer calculated that deep vein thrombosis...

Stopping aspirin a risk in artery disease.(Brief article)
November 2, 2006... Patients with coronary artery disease who come off aspirin see their risk of a major cardiac event leap, a new Italian study reveals. The researchers found withdrawal of aspirin or non-compliance more than tripled the overall risk of a...

Depression risk doubled in diabetes.
November 2, 2006... Having depression is twice as common in men with type 2 diabetes as in those without the disease, a major new systematic review concludes. The analysis also found the risk of depression was increased by around 30 per cent in women with...

Study backs statin treatment for all elderly diabetes patients.(Brief article)
November 2, 2006... Statin treatment has relative and absolute benefits for patients with type 2 diabetes across age groups, a UK study concludes. The researchers found older patients in particular gained substantial reductions in absolute risk of...

Cost of switching IT system will be met.(Information)(information technology)
November 2, 2006... Connecting for Health pledges to ensure GPs get free choice of system By Ian Cameron Practices that change clinical software providers after April next year will have most of the cost of migration paid by Connecting for Health. ...

Welsh GPs assured choice.(Brief article)
November 2, 2006... GPs in Wales have been assured they will be free to choose between all major clinical IT systems and new entrants to the market. The news is contained in a strategic framework for practice clinical software in the country, endorsed by the...

Clampdown on NHS fraud.(Brief article)
November 2, 2006... Health workers who defraud the NHS will immediately face a three- pronged legal attack under new regulations. In the past, civil and disciplinary action has been taken following criminal action. But the NHS Counter Fraud and Security...

ISTCs not yet up to speed say ministers.(independent sector treatment centres )(Brief article)
November 2, 2006... Independent Sector Treatment Centres have not integrated fully with the NHS, the Government has admitted. Its response to a Health Select Committee report said the centres were still in their early stages and were an `excellent...

Automatic opt-in to records.(Brief article)
November 2, 2006... Patients will be automatically opted in to the NHS Care Records Service unless they state they do not wish to participate, health minister Lord Warner has confirmed. The move comes despite widespread opposition from GPs to the `opt-out'...

Can sliding scale of proof work?
November 2, 2006... Sir Liam Donaldson might now favour it, but there's no basis for a sliding scale standard in English law Campaign: Justice for GPs By Ian Cameron The highest standard of proof in serious cases where a doctor could be struck off, a...

PulseFinance: How to...Keep on top of phone costs.(Brief article)
November 2, 2006... New developments in the provision and use of telecommunication services mean that practices need to review all aspects of their phone service provision. The objective is to have systems that allow efficient but cost-effective communications...

PulseFinance: Value experience in your practice team.
November 2, 2006... Balancing cost with stability of your team requires skill, says Dr John Couch Last week a friend in the banking industry told me it was not unusual to bring in a round of redundancies toward the end of a financial year in order to balance...

PulseFinance: Beating private firms at the tendering game.
November 2, 2006... GPs must sharpen their act to win PCT tenders, writes Dr James Gillgrass Implementation of the new GMS contract in 2004 introduced a number of new opportunities, including the option for providers other than GPs to bid for the provision of...

Letter: I'd march to save my pension!(Letter to the editor)
November 2, 2006... From Dr Jim Beatson Troon, Ayreshire Open letter to GPC chair Dr Hamish Meldrum I, like many GPs of my vintage, have based my retirement and pension planning on the content of a signed legal contract (News, 26 October). The...

Letter: Industrial action in air on pensions.(Letter to the editor)
November 2, 2006... From Dr Robert Park Shrewsbury, Shropshire I am very alarmed at the pension comments attributed to Lord Warner (News, 26 October). I cannot believe the Government could be so disingenuous or so potentially fraudulent as to go back on...

Letter: Getting statins facts right.(Letter to the editor)
November 2, 2006... From Dr Anthony Fox Barton-on-Sea Hampshire I am astonished at the general lack of knowledge in biochemistry displayed by my medical colleagues in many medical articles. Surely it is now well known that statins interfere with the Krebs...

Letter: How I'd sort out question of choice.(Letter to the editor)
November 2, 2006... From Dr Trevor StammersMerton Park, south-west London GPC negotiator Dr Richard Vautrey suggests GPs should waste yet more of our time reinforcing three or four times to patients the fact that we have offered them a choice of hospitals...

Letter: Users of co-proxamol are not all addicted.(Letter to the editor)
November 2, 2006... From Dr Jeremy Cox Wareham, Dorset Dr Frank Shapiro's views on co-codamol are irrelevant (Letters, 26 October). No patient would be deprived if it were banned tomorrow. Both elements are available separately and probably better prescribed...

Letters: Sliding scale of proof is so unfair.(Letter to the editor)
November 2, 2006... Campaign: Justice for GPs From Dr John Mawdsley Aberdeen I am concerned by Sir Liam Donaldson's suggestion that a sliding scale of proof could be used in fitness to practise hearings (News, 26 October). All allegations should be...

Letter: Low carbs the way to go in diabetes.(Letter to the editor)
November 2, 2006... From Dr David FieldPeasdown St John, Somerset I have been interested in the recent letters about diet and diabetes as I have type 2 diabetes myself, which I suspect has a genetic cause since I am the same weight I was when I was 20. I...

Letter: Why we're so popular with patients.(Letter to the editor)
November 2, 2006... From Dr Anita Sharma Oldham My patients like me so much they want to see me at all hours. They do not want to go to the walk-in centre and nor are they happy with NHS Direct advice. The questions inserted by the Government into the...

Letter: Cutting your cloth shrewdly to combat a financial crisis.(Letter to the editor)
November 2, 2006... From Dr John Havard, Saxmundham, Suffolk The financial crisis in the NHS is most bitterly felt in the rural and typically Conservative areas of England. The Government reasonably argues that it needs to concentrate resources on the...

The relationship doctor.
November 2, 2006... These days broken relationships have become a medical problem, says Phil All relationships end. We are but mortal, and even the deepest soul mates must part eventually. It is an unavoidable aspect of the human condition. In effect, it is...

SecondOpinion - Andy Jones: It's not a level playing field.
November 2, 2006... When I read the direct enhanced service guidance notes for patient access last March I knew there was going to be trouble. That's why guidance notes are issued - to forestall trouble. And true to form, the whole patient access plan has gone...

PulseClinical: Five things...YOU MAY NOT KNOW ABOUT URTICARIA.(Disease/Disorder overview)
November 2, 2006... In this new series, dermatology experts update your knowledge on various skin conditions - consultant dermatologist Dr Nuala O'Donoghue kicks off this week with tips on diagnosis and management of urticaria 1. Urticaria is rarely due to...

PulseClinical: ACE INHIBITORS EFFECTIVE IN CORONARY ARTERY DISEASE.
November 2, 2006... Q Are ACE inhibitors effective in decreasing mortality and morbidity in patients with coronary artery disease but without heart failure or systolic dysfunction? Synopsis The French authors conducting this meta-analysis searched four...

PulseClinical: Equipment review Automatic BP monitor.(Blood Pressure)
November 2, 2006... Dr Melanie Wynne-Jones gives her verdict on this new piece of equipment after trying it out This automatic digital blood pressure device is on the British Hypertension Society list of validated blood pressure monitors suitable for clinical...

Hot tips for using SearchMedica.
November 2, 2006... Weekly tips to help you with commonly-used GP search terms * When searching for QOF Tip Choose `sites chosen by GPs' and find two `super links' to sites devoted to publishing the data produced from the quality framework of the GP...

PulseClinical: Need to know parkinson's disease.(dialogue between Dr Doug MacMahon and Dr Martin Hadley-Brown)(Interview)
November 2, 2006... Consultant physician Dr Doug MacMahon tackles dilemmas on this condition from GP Dr Martin Hadley-Brown 1. How can we best recognise Parkinson's disease and differentiate it from other movement disorders in general practice? The...

How I...set up an evening class to raise obesity awareness.
November 2, 2006... Dr Anita Sharma explains how she encouraged her patients to take an interest in obesity by organising an evening workshop Having run the health promotional programme for the last five years, I am convinced that educating and encouraging...

PulseClinical: Cancer prognosis and survival.
November 2, 2006... The role of the GP in a follow-up review * Check the patient has as much information about the cancer as they want. Sensitivity and respect for individual wishes are fundamental in the communication process. Prognostic information needs to...

PulseClinical: Snippets on... ophthalmology.
November 2, 2006... Dr Amar Alwitry gives a symptom-based approach on various eye conditions Bacterial conjunctivitis Vision? Normal - watering or purulent matter may cause slight transient blurring. Stickiness? Yes - eyelashes will be matted...

Clinical Casebook: Pharmacist picks up GP's Dangerous mistake.(General Practitioners)
November 2, 2006... Dr Melanie Wynne-Jones discusses CASE HISTORY Mrs Smith comes in to see you as an extra. She says that Dr A, one of the partners, prescribed something for her yesterday, but the pharmacist has told her it will react dangerously with...

10-minute examination of the...shoulder.(medical check up)(Brief article)
November 2, 2006... Dr Steve Brown gives a quick tour of the joint Things to remember * Remember that shoulder pain can be referred from the neck, apex of lung or gallbladder - take a careful history * Remember the different shoulder structures - the...

PulseRegistrar: Little gems: How hot are you on...Pain Management?
November 2, 2006... Test your knowledge for the nMRCGP with this little gem from GPnotebook This GEM covers aspects of pain management in palliative care. It is important for the primary care clinican to be aware of the various options for analgesia in...

Monthly memo: What you should be doing in November.(Brief article)
November 2, 2006... IN PRACTICE Formative assessment: most trainers do three or four formative assessments over the 12 months. This should tell you how you are doing, identify areas to focus on for the next few months and give you an early warning if there...

PulseRegister: Your first suspected skiver.
November 2, 2006... Sooner or later you will be asked for a sicknote by someone who seems perfectly well enough to work, writes Dr Melanie Wynne-Jones The doctor-patient relationship is supposed to be based on mutual trust so we don't like it when we feel...

PulseComment: Reasons to be cheerful?(Brief article)
November 2, 2006... It seems nothing ever changes, or not in the world of mental health at any rate. A report published this week on talking therapy had an oddly familiar ring to it, echoing the dismal findings of Pulse's own investigation into depression...

Last word: Pulse Action on depression.(Brief article)
November 2, 2006... Dr Richard More... on wine, impatience and GPs' future The best thing about my practice is when the chips are down you can rely on every single person. My idea of perfect happiness is good friends and a bottle of Chateau d'Yquem '83....

Warner issues star ratings ultimatum.(accreditation systems in primary care nursing)
November 9, 2006... Health minister says GPs must take part in accreditation scheme or put contracts at risk By Helen Crump Practices that refuse to take part in a proposed `star rating' accreditation system will have their contract questioned, the...

`Disaster' warning.(Brief article)
November 9, 2006... Any attempt to use a scheme such as the RCGP's Quality Practice Award to accredit GP surgeries would end in `disaster', says Dr Philip McCarthy. Dr McCarthy, whose Bristol practice got the award in March, said getting it had taken three...