Pulse articles from November 2007

Pulse archives from November 2007

Two sides are poles apart in pay talks.
November 7, 2007... Sub-inflation pay rise and longer hours forecast as NHS Employers seizes on out-of-date stats By Nigel Praities The two sides in GP pay negotiations are poles apart after NHS managers seized on the media storm over new pay figures to...

Site offers traffic-light health ratings.(Brief article)
November 7, 2007... Patients are to be given a `traffic light' rating of their health risk through a new online screening programme to be launched by the Department of Health. Visitors to the NHS Life Check site will be encouraged to visit their GP if rated...

Paper referrals to end as Choose and Book is enforced.
November 7, 2007... Half of trusts move to make electronic referrals mandatory by next year COMMON SENSE ON IT By Steve Nowottny The era of the paper referral is drawing to a close with PCTs across the country moving to make use of Choose and Book...

Phase-out of old system `appalling'.(Brief article)
November 7, 2007... Dr Clarissa Fabre, a GP in Uckfield, will join her LMC to meet East Sussex Downs and Weald PCT to hear `from the horse's mouth' about phasing out paper referrals. Though she said Choose and Book seemed to be working in Uckfield, she was...

Carrot removed as stick brandished.(Brief article)
November 7, 2007... Financial incentives for Choose and Book seem almost certain to end in March, after a warning from the GPC that the Choice and Booking DES will not be renewed. Negotiators told GPs: `The DES in England is expected to stop on 31 March 2008....

Security probe over care record crime.
November 7, 2007... NHS IT bosses have launched a review of security surrounding the Summary Care Record amid fears it will be targeted by blackmailers and identity thieves. Connecting for Health told Pulse the review had been ordered to assess the risk posed...

Are there two tiers of GP pay?
November 7, 2007... The average GP partner will earn #24,000 more than a salaried GP in the current financial year, after pension contributions, according to accountants. Sandison Easson said the average GP partner will take home #90,000 a year whereas...

Pay gap dividing profession.
November 7, 2007... GPs say gulf in pay between partners and salaried colleagues is creating a `two-tier' system The gulf in pay between salaried GPs and partners appears to be widening amid fears general practice is becoming a divided profession, writes...

GP profits set to fall by up to 20%.
November 7, 2007... Accountants this week warned the Government's latest, but out-of-date, figures on GP pay masked a profit crash looming on the horizon. Forecasts suggested GP profits could slump by as much as 20% by the end of the 2006/7 financial year,...

Tories propose to hand GPs #60bn for commissioning.
November 7, 2007... GPs would be handed up to #60bn to commission resources under radical new proposals from the Conservatives. The move would see GPs controlling about two-thirds of the annual NHS budget, and commissioning services directly rather than...

InBrief: PM's rush on IT scheme.
November 7, 2007... A former Whitehall official has confessed he was given just 10 minutes to make the case for the troubled #12.4bn NHS IT scheme to then Prime Minister Tony Blair. Sir John Pattison, the Department of Health's former director of research and...

InBrief: Diabetes care improves.
November 7, 2007... The rate of improvement in diabetes care has speeded up since the new contract, say authors of a review of data between 1999 and 2006. The QOF has led to more than 90% achievement in most measures except retinal screening (83%), foot...

InBrief: Knee operations too soon.(Report)(Brief article)
November 7, 2007... People suffering knee pain are being referred for surgery too soon, say UK researchers. Researchers at the Primary Care Musculoskeletal Research Centre in Keele interviewed 201 adults with knee pain. Three core treatments - written...

InBrief: Support team gets chop.
November 7, 2007... The Government is to pull the plug on the Clinical Governance Support team, a national body set up to oversee its drive towards a safe, high- quality health service. It has deemed it `no longer necessary' with closure set for March 2008 and its...

InBrief: NHS rallies round.(Brief article)
November 7, 2007... Dr Hamish Meldrum, chair of the BMA, launched a stinging attack on the Government's treatment of GPs as more than 7,000 NHS workers marched through the streets of London on Saturday. He told the `I Love the NHS' march, which saw GPs,...

BP treatment needs to be adjusted in winter.
November 7, 2007... Study finds wide BP variation by season - justifying new winter regimen By Lilian Anekwe Blood pressure levels vary seasonally in hypertensive patients, by enough to warrant a different treatment strategy in winter months, a major new...

UTIs during pregnancy raise baby's heart risk.
November 7, 2007... GPs should test all women trying to conceive for urinary tract infections, to protect infants from an increased risk of congenital heart defects, researchers suggest. Their study found women who had a UTI around conception or during their...

Exceptions rise in spotlight.(Report)
November 7, 2007... GPs are set to come under renewed pressure over exception reporting after new figures showed increased use of the system in the latest year of the quality framework. The rate of exception reporting in England increased to 5.9% last year,...

MediaWatch: `Magic bullet for tumours'.
November 7, 2007... The story British scientists have developed a technique for destroying tumours whereby beams of ultraviolet light trigger antibodies to act as `magic bullets', report the Daily Mail, Times and Independent. The source Scientists at...

MediaWatch: `Herpes link to Alzheimer's'.
November 7, 2007... The story Herpes, the virus that causes cold sores, could trigger Alzheimer's, report the Daily Mail and Telegraph. The source Researchers from the University of Manchester found that herpes, present in 80% of the adult population, produces...

MediaWatch: `C-sections twice as risky'.(Brief article)
November 7, 2007... The story Caesarean births are twice as risky as natural deliveries, report the Independent and Daily Mail. The source Dr Jose Villar, former director of maternal health at the World Health Organisation, now senior research fellow at the...

MRSA failings exposed.
November 7, 2007... Survey reveals gaps in GP training, support and infection control services By Lilian Anekwe Current procedures to deal with resistant infections in the community are inadequate and leaving GPs potentially dangerously exposed, a Pulse...

NHS Direct to take on asthma phone reviews.
November 7, 2007... Scheme seen as provocative after phone reviews barred from QOF By Emma Wilkinson NHS Direct is to be allowed to review GPs' asthma patients by telephone even as practices themselves are barred from doing so. The move - funded by a...

RCGP under pressure to change tack.
November 7, 2007... As he takes charge, new chair Professor Stephen Field faces demands for a more `pragmatic' approach By Gareth Iacobucci The RCGP is under pressure to deliver a shift in strategic direction and a more `pragmatic' approach as its new...

Self-management in heart failure queried.
November 7, 2007... Training heart failure patients in how to self-manage their condition may not be any more effective than simply giving them education. Self-management is often an important part of care plans for chronic disease, but new research questions...

GPs split over abortion proposals.
November 7, 2007... MPs spark controversy with proposals to scrap two-doctor rule and expand role of nurses By Clare Ryan Proposals to scrap the two-doctor rule on arranging abortions and give nurses a much more important role have provoked a fierce...

GPs miss diagnosis of HIV in half of patients, says study.
November 7, 2007... GPs are missing a diagnosis of HIV in half of patients who consult during their period of primary infection, a new study concludes. Researchers warned that HIV testing needed to become `normalised' in primary care after finding patients...

GPs urged to fight `nihilistic' hospital doctors over COPD.
November 7, 2007... GPs must counter the `nihilistic' approach of hospital doctors towards patients with severe COPD, say respiratory GPs and specialists. The comments follow a UK study suggesting hospital doctors are overly pessimistic about patients admitted...

NRT doubles quit rate even without support.
November 7, 2007... GPs told not to bother to develop stop smoking services By Nigel Praities Nicotine replacement therapy can double the long-term quit rate on its own, with no behavioural support, the authors of a major international study conclude. ...

Is smoking support worth it?(Brief article)
November 7, 2007... * NICE guidelines say all smokers who want to stop should be offered a referral to an intensive support service. If they are unwilling or unable to accept this referral they should be offered pharmacotherapy and additional support. * A...

NICE ignored over the use of LARCs.(National Institute for Clinical and Healthcare Excellence)(long-acting reversible contraceptives )(Brief article)
November 7, 2007... Prescribing of long-acting reversible contraceptives (LARCs) has fallen in the two years since NICE recommended they be used more often. A failure to provide GPs with training opportunities is being blamed for the drop. Figures from...

JournalWatch: Beta-blockers benefit COPD.
November 7, 2007... Patients with COPD could benefit from Beta-blockers, despite traditional fears the drugs impair lung function. US researchers looked at 825 patients admitted with acute COPD exacerbations and compared those taking Betaockers with those who...

JournalWatch: Aspirin doesn't cut VTEs.
November 7, 2007... Long-term, low-dose aspirin use does not seem to reduce the risk of venous thromboembolism, latest results from the Women's Health Study suggest. A total of 39,876 healthy US women aged over 45 were randomised to receive aspirin or vitamin...

JournalWatch: Methotrexate boost in RA.
November 7, 2007... Intensifying methotrexate early in rheumatoid arthritis increases the chance of remission, say Dutch researchers. The two-year study randomised 299 patients into two groups - a conventional treatment group seen every three months and an...

JournalWatch: Low LDL cuts stroke.
November 7, 2007... Aggressive treatment to cut LDL-cholesterol in patients who have had a recent stroke or transient ischaemic attack reduces the risk of a further stroke by a third, a major international trial concludes. Researchers analysed results from the...

JournalWatch: Early colectomies aid IBD.(Brief article)
November 7, 2007... Patients with inflammatory bowel disease should be having colectomies earlier, suggests a new UK study. Researchers compared mortality rates in 23,464 patients with IBD who either underwent elective colectomy, emergency colectomy, or who...

Pre-eclampsia a CHD risk.
November 7, 2007... Pre-eclampsia should be incorporated into cardiovascular risk scores as it doubles women's risk of heart disease, researchers conclude. A UK study published online by the BMJ has found the strongest evidence to date that pre-eclampsia not...

GMC `not engaging' on proof plan.(General Medical Council)
November 7, 2007... Consultation responses urge GMC to listen to the medical profession over its fitness-to-practise proposals CAMPAIGN - JUSTICE FOR GPS By Gareth Iacobucci The GMC has been accused of failing to engage in debate on its proposed...

Doubts over community treatment orders.(Brief article)
November 7, 2007... Supervised Community Treatment Orders - introduced as a central plank of the amended Mental Health Act earlier this year - are `unlikely to help' the problem of revolving-door care, according to new research. SCTOs were included by the...

Shortfall in attack alarms.(Brief article)
November 7, 2007... Thousands of GPs will miss out on receiving personal attack alarms, despite a #97m Government pledge to crack down on violence against NHS staff in the community. Pulse has learned that individual PCTs will decide how to distribute new...

Analysis: Is the NHS institutionally racist?(Viewpoint essay)
November 7, 2007... GMC launches potentially explosive survey of ethnicity in the ranks of UK doctors, incredibly the first of its kind By Gareth Iacobucci Organisations such as the police and local authorities have found themselves rocked in the past by...

Letter: Target culture is becoming dangerously absurd.(Letter to the editor)
November 7, 2007... From Dr Bernie Bedford, Southampton Now I read the target culture is about to get sillier, with new lower blood pressure targets for chronic kidney disease (News, 24 October). A target is fairly meaningless - simply the last blood...

Letter: Let's call it complementary.(Letter to the editor)
November 7, 2007... Dr James Anderson, Ferring, West Sussex Looking at how medicine is practised throughout the whole world, it's quite hard to define exactly what constitutes `alternative medicine'. In the West we've become so orientated to a drug...

Letter: How to take heat off GPs.(Letter to the editor)
November 7, 2007... Dr Bernard Newgrosh, Bolton Phil Peverley is right to complain about planning for heatwaves (Columnists, 3 October). But his criticism would be better directed against our medical leaders than the politicians. Why do they allow us to be...

Letter: Are GPs not allowed family values?(Letter to the editor)
November 7, 2007... From Dr Anthony DeWeever, Manchester The Government's pre-election plans to resume Saturday morning `emergency' surgeries and extend GPs' working days are definitely a no- go area. The thought of fragmenting out-of-hours provision once...

Letter: Consultation key to opening hours.(Letter to the editor)
November 7, 2007... Jeremy Hughes, chief executive, Breakthrough Breast Cancer, London WC1 Lesley Mayo's article on extending GP opening hours (Finance, 10 October) provides a good overview of the range of issues involved when redesigning services in primary...

Letter: We're here to listen on C&B.(Letter to the editor)
November 7, 2007... COMMON SENSE ON IT From Dr Stephen Miller, medical director, Choose and Book The BMA's survey of GP opinion is immensely helpful in that it highlights the continued importance of clinical engagement in what is a very challenging...

Letter: Nurse prescribers need training focus.(Letter to the editor)
November 7, 2007... Dr Paul Charlson, Brough, East Yorkshire I refer to your article `New nurse prescribing fear' (News, 17 October). We have to get nurse prescribing clear. Independent prescribers are just that. They do not require supervision. If they...

Letter: Reasons for limiting use of piroxicam.(Letter to the editor)
November 7, 2007... Dr June Raine, director of vigilance and risk management of medicines, Medicines and Healthcare Products Regulatory Agency Your article `Guidance to restrict NSAID prescribing ``is patronising'' (News, 17 October) does not address the...

Opinion: Framingham must be made history.
November 7, 2007... There is no longer any place in guidance for a risk score that discriminates against deprived populations, argues Dr Peter Brindle Whether you like it or not, the primary prevention of cardiovascular disease occupies more of our practice...

Stop it BMA, just stop it.(British Medical Association)(Viewpoint essay)
November 7, 2007... Phil's had it with the BMA and is fuming at the surrender of hard-won professional privileges I'm not a member of the BMA. I have been, on three previous occasions. With my background (family members in the mining and teaching community) I...

Dinah'sDiary: 07.11.07.(Calendar)
November 7, 2007... Dinah's feeling a bit paranoid - but the nice policemen will sort her out Monday Police follow me to work. I'm hands free on phone. What have I done? Do they know I'm telling my 11-year-old to avoid detention today or do they think...

PulseFinance: ASK THE EXPERT.(Column)
November 7, 2007... Our online team of specialists tackle more of your problems. To put a query to them, go to pulsetoday.co.uk/asktheexpert PARTNERSHIPS Andrew Lockhart-Mirams outlines the obligations to a retiring but returning partner Q Our senior...

PulseFinance: RECEPTIONIST IS SURFING NOT WORKING.
November 7, 2007... LEGAL LESSONS Advice on a common practice problem from barristers Michael Salter and Chris Bryden THE SITUATION My receptionist uses a PC which is linked to the internet. During working hours I often notice she is visiting sites...

PulseFinance: PERSONAL FINANCE - TAX PLANNING.
November 7, 2007... In the second feature in our series on personal finance, accountant Bob Senior looks at how GPs can cut the tax they pay Most people agree that the Government needs to raise money from the population by means of taxation to pay for vital...

PulseClinical: HOW TO RECOGNISE A CASE OF MEASLES.
November 7, 2007... Now that measles outbreaks are occurring again, Dr Eithine MacMahon gives an overview on how to detect the most severe of the common childhood diseases Prior to the introduction of vaccination in 1968, acute measles killed around 100...

PulseClinical: PRIMARY CARE EMERGENCIES - ANAPHYLAXIS.(Disease/Disorder overview)
November 7, 2007... In the third of our six-part series on common emergencies in primary care, GPs Dr Chantal Simon, Dr Karen O'Reilly, Dr Robin Proctor and Dr John Buckmaster guide you through how to deal with anaphylaxis Common causes Common causes of...

PulseClinical: NEED TO KNOW - MISCARRIAGE.(Clinical report)
November 7, 2007... Take-home points * The risk of miscarriage is about 15% for each pregnancy. * A further miscarriage is still 15% so the chance of two consecutive losses is 3%. * At eight weeks the presence of FH activity is associated with a 95%...

PulseClinical: TREATING BP TO TARGET.
November 7, 2007... GP Dr Terry McCormack's pointers on how to get as many hypertensive patients as possible down to target 1 Make sure you have a correct rested blood pressure measurement. If the blood pressure is raised initially this measurement should be...

PulseClinical: ENT PROBLEMS - MANAGING NOSEBLEEDS.
November 7, 2007... GP Dr Alex Watson and ENT consultant Mr Peter Robb advise on first-aid measures for active bleeding Advise patients to compress the soft part of the nostril tightly against the nasal septum. Sit the patient upright and lean forward over a...

CLINICAL CASEBOOK - SHOULD YOU ACT OVER TEENAGER'S CANNABIS USE?(Case study)
November 7, 2007... Dr Melanie Wynne-Jones considers a tricky presentation Case history Mrs Cartwright is worried about her 17-year-old daughter Joanna who has become secretive and suspicious. She has found some cannabis hidden in her daughter's room. ...

HASLAM'S HINTS: 10 tips for telephone consultations.(Brief article)
November 7, 2007... 1 Take and receive calls in a consulting room - not while you are having coffee with the team. 2 Make sure you can never be overheard. 3 The same rules apply on the phone as face-to-face - explore the patient's ideas, concerns, and...

PulseRegistrar: SELECTING YOUR COTS CONSULTATIONS.(Consultation Observation Tools)(Column)
November 7, 2007... In our second article on COTs, Dr Mei Ling Denney gives guidance on choosing suitable consultations COTs (Consultation Observation Tools) are an opportunity for you to gather evidence under any of the 12 units of competence detailed in the...

PulseCareers: CAREER PATH CHOICES.
November 7, 2007... Following last month's Pulse Finance blockbuster on GP employment, many young GPs have asked us to summarise the financial and tax implications of the three main career paths - Ian Tongue obliges Deciding which career path to take in...

CareerCoach - Manage your paperwork.(Brief article)
November 7, 2007... Dr Pam Brown gives advice on how to keep practice paperwork to a bare minimum We live in the information age. Everyone must tackle their daily dose of paper. Even a `paperless practice' receives a deluge of paper. Learning to manage...

CareerTaster - Family planning.
November 7, 2007... This week Dr Ruth Chapman talks to GPs working in family planning Why it's on my job menu The thought of seeing mainly well patients for relatively straightforward consultations appeals to me. The work seems varied within its field - there...

PulseComment: Damn lies and statistics.(General Practitioner's Council)(Brief article)
November 7, 2007... Statistics, and most particularly official statistics, are powerful things. So when gold-plated figures from the Information Centre were released last week, showing GP pay was rising inexorably, the national media had a field day. No matter...

LAST WORD: Dr Brian McGregor.
November 7, 2007... Dr Brian McGregor... on laser questing, PCT managers and OOH care The best thing about my practice is the staff, without whom the job would be unbearable. And the worst is working with a PCT in deficit - any innovation is impossible...

New regulator to be unleashed on GPs.
November 14, 2007... Care Quality Commission gets sweeping powers to monitor, caution and even imprison GPs EXCLUSIVE By Gareth Iacobucci GPs face a tough new layer of regulatory bureaucracy with the launch of hard-hitting plans to scrutinise and...

GPs to be asked to screen for COPD.
November 14, 2007... GPs are to be asked to screen high-risk groups for COPD as part of the upcoming national service framework on the disease, a leading Department of Health adviser has revealed. Dr Mike Morgan, vice-president of the British Lung Foundation...

Practices offered to high-street stores in franchise plan.
November 14, 2007... Report branded `insane' after claiming GP model currently `unsustainable' By Steve Nowottny GP practices are to be forcibly converted into franchises and offered up to high-street retailers to run under ambitious plans welcomed by...

The future of general practice?
November 14, 2007... What the Heart of England Teaching PCT report says: * `There is a growing interest in primary care as a future market from a number of non-health organisations such as Virgin, Tesco and ASDA.' * `It is hoped that in the heart of...

Extended hours `to cost #98k a year'.
November 14, 2007... Offering extended opening hours will cost an average GP practice in the region of #98,000 a year, according to GPC negotiators' private estimates. The `back of a fag packet' calculations, originally made by negotiators two years ago but...

GP pay freeze: Ministers accuse GPs of exploiting staff.
November 14, 2007... Treatment of practice nurses and salaried GPs `justifies pay freeze' DH SUBMISSION By Gareth Iacobucci Ministers have justified their push for a GP pay freeze with a swingeing attack on partners for exploiting their salaried...

LMCs push for DES boycott in pay protest.
November 14, 2007... LMC BATTLEGROUND LMCs are preparing for battle over a third successive GP pay freeze, with more than three-quarters prepared to boycott at least one national DES in protest. But a snapshot survey of committee leaders revealed most were...

InBrief: Darzi review criticised.(Lord Darzi)(Brief article)
November 14, 2007... A key adviser to health minister Lord Darzi has criticised his review of the NHS, saying it has caused practice-based commissioning to stagnate and that proposals for polyclinics resemble a `straitjacket' for GPs. Dr Dixon, who Lord Darzi...

InBrief: Secondary uses review.(summary care record plans)(Brief article)
November 14, 2007... The Government is to review the Secondary Uses Service - a key part of plans for the Summary Care Record - amid concerns on consent and confidentiality. Responding to a health select committee inquiry, the Department of Health said it...

InBrief: `Scrap scripts for the Pill'.(prescriptions for oral contraceptives)(Brief article)
November 14, 2007... Women should not need a prescription from their GP for oral contraceptives, according to Baroness Finlay, president of the Royal Society of Medicine. Baroness Finlay is pushing for MPs to table an amendment to the Human Fertilisation and...

InBrief: Infection control plea.
November 14, 2007... GPs in Wales are to be asked to implement a series of infection control measures as part of plans to reduce the number of patients with resistant infections who are admitted to hospitals. Under the plans, practices will need to record...

InBrief: GP alert on `lambing ears'.
November 14, 2007... Rural GPs are being warned to look out for a new skin disease plaguing sheep farmers, dubbed lambing ears. Ears become initially hot, itchy and sore but soon develop painful blisters. No other parts of the body are affected. Symptoms...

InBrief: MI risk in hospital distance.(myocardial infarction)(Brief article)
November 14, 2007... Distance from home to hospital is a major predictor of a patient's risk of dying from a first myocardial infarction, say UK researchers. They used data from 10,541 patients in Tayside who suffered an MI between 1994 and 2003. People living...

Social workers to access new child health record.
November 14, 2007... Plans for electronic health record covering vaccines and child protection EXCLUSIVE By Nigel Praities A new comprehensive electronic health record is planned for all children, to be accessible by GPs, nurses and even social...

Flu vaccine efficacy under microscope.
November 14, 2007... Government advisers are to carry out a series of studies this winter to assess the efficacy of flu vaccination, after serious questions were raised over its effectiveness. The move is the first indication that the concerns over flu...

GP boycott hits chlamydia screening programme.
November 14, 2007... Chlamydia screening has stagnated in the fourth year of the controversial programme, amid calls from some LMCs to boycott testing unless GPs are reimbursed for the work. Only 15% of GP surgeries offered the service in 2006/7, up just 1%...