Pulse articles from October 2006

Pulse archives from October 2006

Nurse prescribing `a threat to safety'.
October 5, 2006... Patients are being endangered by new nurse role, says survey of hundreds of doctors By Daniel Cressey Patients are being endangered by the reckless expansion of nurse and pharmacist prescribing, doctors are warning. A poll of...

New search engine - just for GPs.(SearchMedica)(Brief article)
October 5, 2006... SearchMedica, a pioneering internet search engine devised specifically for UK GPs, is launched by Pulse this week. In an overwhelmingly positive response, doctors are already heaping praise on SearchMedica for its search quality and design....

Hundreds of GPs sign our petition in first few days campaign.
October 5, 2006... Flood of support for our campaign against weaker standard of proof Justice for GPs By Helen Crump Support is flooding in from GPs for Pulse's campaign opposing a weakening of the standard of proof required to judge doctors'...

Threat to GPs' faith in the system.(Brief article)
October 5, 2006... Proposals to weaken the standard of proof in fitness to practise cases threaten to destroy the profession's faith in the regulatory system, Dr Fay Wilson is warning. Dr Wilson, who sits on GMC fitness to practise panels dealing with...

GPC clashes with DoH over flu chaos.(General Practitioner Committee (UK))
October 5, 2006... The GPC has clashed with the Government over the chaotic flu vaccine campaign after it emerged that this year's delays are set to be substantially worse than last year's, writes Lilian Anekwe. GPC chair Dr Hamish Meldrum insisted GPs could...

Why I am backing Pulse.
October 5, 2006... `I support Pulse's campaign. This is a further unjustified persecution of GPs and must be strongly resisted as it conflicts with basic principles of justice and human rights. Good luck.' Dr Mark Oliver, Stafford `I wholly support the...

NICE under fire on fracture prevention.(Brief article)
October 5, 2006... NICE has finally released its much anticipated draft appraisal for the primary prevention of osteoporotic fractures - with predictable controversy. The RCGP strongly criticised the long-delayed and newly-revised guidance for expecting GPs...

Therapy advised for ME patients.(chronic fatigue syndrome)(Brief article)
October 5, 2006... NICE has provisionally recommended talking therapy for patients with chronic fatigue syndrome after a review it commissioned found evidence of significant benefits. The systematic review of 70 studies found CBT and graded exercise therapy...

BNF alert on long-acting Beta-agonists.(British National Formulary )(Brief article)
October 5, 2006... The BNF warnings on long-acting Beta-agonists in asthma have been toughened after an initial review by the drug regulator. The Medicines and Healthcare Products Regulatory Agency is currently conducting a full review - as Pulse revealed in...

InBrief: PMS income protection.(personal medical services)(General Practitioner Committee (UK) )(Brief article)
October 5, 2006... GPC negotiators are drawing up plans that would allow PMS practices to return to GMS and have their income protected. The GPC said it would expect PMS practices to have a minimum practice income guarantee equivalent. The plan will be...

InBrief: Limit on drug combination.(Brief article)
October 5, 2006... GPs should only consider prescribing the combination of clopidogrel plus aspirin in a small number of conditions where the benefits are established to outweigh the risks. The advice from the National Prescribing Centre follows a review of...

InBrief: More GP training places.(Brief article)
October 5, 2006... More than 22,000 GP and specialist training places will be available from August 2007, a higher total than ever before, the Department of Health has announced. The GPC said it wanted to see `very clear evidence' that funding for the places...

InBrief: PMETB certificates issued.(Postgraduate Medical Education and Training Board)(Brief article)
October 5, 2006... The Postgraduate Medical Education and Training Board has issued more than 4,000 Certificates of Completion of Training in its first year. The board, which has been dogged by complaints it is taking too long to issue certificates, said it...

InBrief: GP screening feasible.
October 5, 2006... The planned screening programme for abdominal aortic aneurysm could feasibly take place in general practice, an evaluation concludes. The study, published in the Journal of Medical Screening, found there was a 72 per cent attendance at a GP...

InBrief: Physician assistant rules.(Brief article)
October 5, 2006... New `physician assistants' working in GP surgeries should be subject to a 12-month internship after their traineeship and five-yearly knowledge test, guidance from the Department of Health states. It also says physician assistants should...

InBrief: Women quitting smoking.(Brief article)
October 5, 2006... More women than men are being successfully encouraged to give up smoking, figures from NHS Stop Smoking Services reveal. Between 2003/04 and 2005/06, 183,707 women quit at four weeks compared with 145,974 men. Half of pregnant women who...

Referral centres make lottery of GP decisions.
October 5, 2006... Pulse investigation reveals vast discrepancies in how referrals are handled By Helen Crump GP referrals are increasingly being subjected to significant interference from referral management centres, a Pulse investigation has found....

How referral management is working.
October 5, 2006... S. LEICESTERSHIRE PCT * Musculoskeletal service * GPSI, extended scope physios and podiatrist * Set-up cost #2,000 a year * Cost #100,000 a year but also treats patients * 30 per cent of referrals redirected * Net...

Referrals `put in cupboard'.
October 5, 2006... A referral management centre in Milton Keynes physically locked GPs' letters in a metal cupboard for weeks to deliberately delay patients' treatment. Dr Peter Berkin, a GP and professional executive committee member at Milton Keynes PCT,...

QOF scores on the up.(Quality and Outcomes Framework )
October 5, 2006... 1,661 practices score full clinical points, compared with 564 last year By Ingrid Torjesen One in five practices in England scored full points in the clinical domains of the quality and outcomes framework last year. In total,...

QOF set to dip next year.(Quality and Outcomes Framework)(Brief article)
October 5, 2006... Practices are being warned to brace themselves for a dip in the number of quality points they earn this year, despite their excellent performance in 2005/06. Targets in the revised framework implemented in April 2006, such as for chronic...

Inner-city GPs find access tougher.(Brief article)
October 5, 2006... Practices in inner-city areas had the biggest problems hitting the Government's access targets, the quality and outcome framework results reveal. Overall, 97.6 per cent of practices in England picked up the 50 points access bonus. ...

Join the SearchMedica revolution.
October 5, 2006... Pulse has launched SearchMedica, the first internet search engine designed specifically for the GP profession By Alisdair Stirling More than 7,500 GPs - nearly one in five of the profession - have already tried SearchMedica, the...

Sites handpicked by GPs.(Brief article)
October 5, 2006... At the heart of SearchMedica is a list of medical sites chosen by GPs. By opting to search this `whitelist', GPs get direct access to about 1,200 handpicked, relevant, authoritative and reliable websites including all the relevant medical...

How to use SearchMedica.(searchmedica.co.uk)(Brief article)
October 5, 2006... * Go to searchmedica.co.uk * Choose whether you want to search `medical sites chosen by GPs' (the default option), `NHS sites' or `the entire web'. * Click in the `UK-only' box if you want to exclude non-UK results. * Enter your...

Smart results by category.(SearchMedica)(Brief article)
October 5, 2006... Results by category, access to password-protected sites and GP-focused vocabulary are among the features that set SearchMedica apart from other search engines. All SearchMedica results are intelligently sorted into useful categories and...

Research showed need for site.
October 5, 2006... Pulse decided to create SearchMedica in the wake of research that showed that more and more GPs are using internet search engines for work, but some 45 per cent were disappointed with search results relevance.* The research, which was on...

MediaWatch: `Hayfever vaccine near'.(Brief article)
October 5, 2006... The story A vaccine is set to relieve the suffering of 12 million Britons by providing a cure for hayfever, say the Sun and Daily Express. The source Swiss biotech firm Cytos Biotechnology tested weekly vaccination for six weeks in 20 men...

MediaWatch: `Steroids a brain cell risk'.(Brief article)
October 5, 2006... The story Use of some steroids can trigger a catastrophic loss of brain cells, report BBC News Online and the Daily Mail. The source Researchers from the Yale University School of Medicine exposed cultured cancerous neuroblastoma cells to...

Drug phase-out stalls.(co-proxamol)(Brief article)
October 5, 2006... GPs are still prescribing co-proxamol to nearly 80,000 patients By Daniel Cressey andLilian Anekwe Tens of thousands of patients are still being issued with prescriptions for co-proxamol, with the phase-out having apparently stalled,...

MMR vaccine uptake increases again.(Brief article)
October 5, 2006... Public confidence in the safety of the MMR vaccine appears to be returning, with new figures showing uptake has increased for a second successive year. Uptake by the age of two rose to 84 per cent in 2005/06, up from 81 per cent in 2004/05...

Private OOH firm draws complaints.(out-of-hours service )(Brief article)
October 5, 2006... A privately run out-of-hours service in Cornwall has received about 80 complaints from patients since it took over from a GP co-op in April. The service, run by Serco, had been provided by KernowDoc since the 1990s but the co-op lost out in...

GPs say PCTs must act now to stop PBC failing.(Primary Care Trusts)(practice-based commissioning)
October 5, 2006... Hospital spending will `run riot' unless trusts give practices full support By Helen Crump New PCTs have only a few months to save practice-based commissioning from failure, GPs are claiming. Managers of the new trusts, which came...

More GP influence on commissioning.(Brief article)
October 5, 2006... GPs will have a far stronger influence on the commissioning decisions of reconfigured primary care trusts, the NHS Alliance believes. It has been commissioned by the Department of Health to undertake the initial stages of a review of...

Mental health crisis deepens.
October 5, 2006... Access to therapies is getting worse, says watchdog By Gareth Iacobucci The crisis in access to psychological therapies is getting even worse, a damning report from the Healthcare Commission reveals. A survey of community mental...

Key findings of the Healthcare Commission report.(Brief article)
October 5, 2006... * 39 per cent of patients surveyed had received talking therapy in 2006, down from 40 per cent in 2005, and 42 per cent in 2004 * 35 per cent of patients who had not received therapy said they would have liked to * 52 per cent of those...

Statins backed for heart failure use.(Brief article)
October 5, 2006... New research suggests patients with chronic heart failure can benefit from treatment with statins, even if they have low cholesterol. There has been debate over whether statins should be used in heart failure, with recent research finding...

Breastfed children are no brighter.(Brief article)
October 5, 2006... Breastfeeding has little or no effect on children's intelligence, a large-scale prospective study concludes. The UK research, published in the BMJ, found any apparent positive effect of breastfeeding disappeared after controlling for...

New score for fracture risk.
October 5, 2006... A new risk score will make it easier for GPs to estimate the long-term risk of fracture in post-menopausal women, experts believe. A Medical Research Council study has stratified the five-year risk of fracture by a series of signs and...

JournalWatch: Lung cancer X-ray signs.(Brief article)
October 5, 2006... Chest X-rays showing signs of scarring, pulmonary fibrosis, COPD or other abnormalities could all signify the presence of lung cancer, a US study reports. The research team followed up more than 70,000 men and women who were enrolled in...

JournalWatch: PPI use a C. difficile risk.(Brief article)
October 5, 2006... Use of proton pump inhibitors does increase risk of C. difficile infection, a re-analysis of data from the UK general practice database concludes. Canadian researchers examined data on 317 cases of community-acquired C. difficile recorded...

JournalWatch: Adolescent depression.(Brief article)
October 5, 2006... Symptoms of major depression in adolescents may last for only a few days or weeks, US research concludes. The study assessed 66 adolescents aged between nine and 17 years who were admitted to hospital with a clinical diagnosis of major...

JournalWatch: Menthol smokers no safer.(Brief article)
October 5, 2006... Menthol cigarettes are as harmful as normal cigarettes and seem to be harder to give up, a US study shows. Researchers examined data on 972 smokers of menthol cigarettes and 563 smokers of non-menthol cigarettes. There was no...

JournalWatch: Asthma exposure trial.(Brief article)
October 5, 2006... Removing patients from exposure to causes of occupational asthma significantly improves outcomes, a study by Guernsey researchers reports. The team measured FEV1 in 156 consecutive patients with occupational asthma, with causes most...

Fears raised for IT plan.(Brief article)
October 5, 2006... Fears for the future of the Government's flagship NHS National Programme for IT have intensified after Accenture walked away from contracts worth #1.9bn, writes Emma Wilkinson. But GPs said practices in the North East and Eastern geographic...

Investigation clears walk-in centre.(services of general practitioners)
October 5, 2006... An investigation into working practices at a privately run walk-in centre has concluded the service is not a threat to patient safety. Concerns were raised about the centre in Canary Wharf, east London, by three GPs who felt nurses were...

Unison's censure for Government.(Unison halts National Health Service privatisation)(Brief article)
October 5, 2006... The Government suffered a blow to its plans for the NHS after delegates at the Labour Party annual conference called for a halt to privatisation. A motion from Unison for the Government to `rethink the headlong rush to a competitive...

Moral dilemma for rural GPs.
October 5, 2006... Report says rural practices and patients may have been disadvantaged by the new contract By Ingrid Torjesen The new GMS contract has left rural GPs facing a `moral dilemma' over whether to continue to provide services for free or...

NHS sexual orientation course need.(Brief article)
October 5, 2006... GPs are often unable to respond appropriately to issues of sexual orientation, a report commissioned by the Department of Health claims. A set of core training standards in sexual orientation for all NHS workers, including GPs, should be...

What rural GPs say.(general practitioners)(Brief article)
October 5, 2006... * `There are insufficient funds to pay for enhanced services and this may result in a withdrawal of services previously provided on a goodwill basis.' * `Patients face having to travel considerable distances to secondary care facilities...

Child asthma A&E concerns.(accident and emergency)
October 5, 2006... Panel finds a third of respiratory admissions `avoidable' By Daniel Cressey A third of children's hospital admissions for respiratory illness are potentially preventable, a panel of GPs and specialists has concluded. Their...

GPs initiate insulin as well as specialists.(general practitioners)(Brief article)
October 5, 2006... GPs can take on the initiation of insulin without any reduction in the quality of care, a new study concludes. Patient outcomes were about as good when GPs initiated insulin as when it was done by specialists in secondary care, the...

Steroids out for tennis elbow.(Brief article)
October 5, 2006... Steroid injections do not have long-term benefits for treating tennis elbow, a study reports. Patients treated with injections suffered high rates of recurrence and their long-term outcomes were worse than with physiotherapy. The...

Firm wined and dined GPs.(general practitioners)(breach of code in pharmaceutical industry)(Brief article)
October 5, 2006... Pharmaceutical company Merck, Sharp & Dohme provided hospitality with `no medical educational content' to a group of GPs, a disciplinary panel has ruled. The panel made the ruling - details of which emerged this week - on the basis of...

NRT doubts in young.(nicotine replacement therapy)(Brief article)
October 5, 2006... GPs who offer nicotine replacement therapy to young smokers to help them quit may be wasting their time. The results of a pilot study show young people are particularly unlikely to adhere to smoking cessation treatment. The trial of...

Analysis: GPs face lottery as UK loses its unity on health policy.(general practitioners)(United Kingdom)
October 5, 2006... Health tourism may affect UK as home countries go their own way on funding decisions By Gareth Iacobucci The term `postcode lottery' is now one of the most well worn in the medical lexicon, but in recent years it has come to reflect a...

Key differences in UK policy.(United Kingdom)(Brief article)
October 5, 2006... Age range for bowel cancer screening Scotland offers screening for patients aged 50-74; England restricts screening to 60-69s. Alzheimer's care England and Wales funding drug treatment only for moderate dementia; Scotland for...

LETTER: Proud of LIFT role in primary care.(Letter to the editor)
October 5, 2006... From Chris Whitehouse, chair, LIFT LOBI The revelation that up to 1,500 GP premises in the country may be unfit for purpose is indeed shocking (News, 14 September). Dr Holden comments that the Government is spending `peanuts on...

LETTER: Cardiac rehabilitation target achieved if teams work together.(Letter to the editor)
October 5, 2006... From Dr Philip Evans, Director, Peninsula Primary Care Research Network, and Dr HM Dalal, Truro It is possible to achieve the national service framework target to offer cardiac rehabilitation to more than 85 per cent of eligible patients...

LETTER: High-carb diabetes diet is a nonsense.(Letter to the editor)
October 5, 2006... From Dr Katharine Morrison, Mauchline, Ayrshire In response to Dr Jo Lowther (Letters, 21 September) regarding Dr Malcolm Kendrick's article about low-carb diets for diabetics, I agree that more practical guidance for diabetics and medical...

LETTER: Golden silence over my `hello'.(Letter to the editor)
October 5, 2006... From Dr John McKay, Birkenhead, Wirral Three years ago I returned to general practice after an MI. During the negotiations with the PCT, as I was going from a singlehanded practice to joining a neighbouring practice, I was offered a `golden...

LETTER: Trainers must get time for students.(Letter to the editor)
October 5, 2006... From Neel Sharma, fifth-year medical student, Manchester As a final-year undergraduate, I can safely say I have covered almost all aspects of the core medical curriculum. However, my confidence is scarce. At times, non-existent. ...

LETTER: Registrars aren't drain on practices.(Letter to the editor)
October 5, 2006... From Dr Amee Bhatt and Dr Niraj Patel, London As GP registrars, we are writing in response to the GPs who set out the reasons they would not be prepared to contribute to the cost of having a registrar in their practice (Letters, 28...

Proud to be a proper doctor.(narratives)
October 5, 2006... A typical consultation really ticks Phil's boxes `Good morning Doctor PeverleyG' says my next patient, and I raise an admonitory hand. `Stop right there. It's Professor Peverley to you.' In this day and age, titles are becoming fluid....

Fighting our corner.(relations)
October 5, 2006... `My rash has gone, said the patient, but I thought I'd come in anyway' Recently a colleague of mine came across a 10-year-old letter from the chief executive of a health authority. The paper was yellow, the typeface dated, but the issues...

How to...Keep your career fresh.
October 5, 2006... GPs are fortunate in having well-paid jobs with clear career pathways. The downside is that we can get locked into a treadmill following rigid tramlines of career progression. Recent entrants to general practice are more likely to keep options...

Computer glitches: anticipation pays.(primary care nursing)
October 5, 2006... Don't let computer failures wreak havoc, writes Dr John Couch Few practices can avoid having their computer system crash from time to time (usually on a Monday morning), and we are now so computer reliant that it is extremely difficult to...

PulseClinical: Need to know Depression.(dialogue with Philip Timms )(Interview)
October 5, 2006... Consultant psychiatrist Dr Philip Timms answers burning questions on common dilemmas from GP Dr Louise Warburton Take-home points * About 15-20 per cent of depressed patients will end up with a chronic illness lasting two years or more...

PulseClinical: Clopidogrel plus aspirin no better than aspirin alone.(drug therapy)
October 5, 2006... Q Is the combination of clopidogrel and aspirin better than aspirin alone for patients with, or at high risk of, vascular disease? Synopsis The combination of aspirin and clopidogrel has been recommended for selected patients with...

PulseClinical: Sexual health update.(sexual health management)
October 5, 2006... Dr Neil Lazaro advises on the diagnosis and management of the most prevalent bacterial STI in the UK and, on page 48, a common complication Background1 * There are four species of chlamydia. One does not affect humans, one is a...

PulseClinical: Sexual health updat - Epididymo-Orchitis.(care and treatment)
October 5, 2006... Background * This results in inflammation of the epididymis with or without testicular inflammation * Usually (especially if * Sometimes (especially if >35 ) complication of UTI * Rarely blood spread, eg Streptococcus, etc, or...

PulseClinical: Improved patient education using Clinical indications.(patient communication)
October 5, 2006... Dr Penelope Barley explains how she used an innovative project known as clinical indications to improve patient communication and knowledge Some patients have been taking a drug for a long time but are not sure what it does for them and...

PulseClinical - Recent studies: Diabetes.(care and treatment)
October 5, 2006... Summaries of two new Cochrane reviews that could apply to your next consultation How effective is exercise in type 2 diabetes? Exercise is generally recommended for people with type 2 diabetes mellitus. However, some studies evaluate...

PulseClinical: Neck pain.(treated with acupuncture )
October 5, 2006... Does acupuncture work for neck disorders? Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Treatments are varied, as are the perceptions of benefits. Acupuncture has been used as an...

PulseClinical: Practical lowdown on...substance abuse.(reports)
October 5, 2006... The most common symptoms of cannabis dependence are difficulties controlling use and withdrawal Cannabis * Four per cent of the US population is dependent on cannabis at some point in their lives. This is higher than any other drug of...

PulseClinical: My top five websites for...respiratory diseases.
October 5, 2006... Dr Dermot Ryan, a GP with an interest in respiratory medicine, shares his favourite websites for patients and professionals Asthma UK www.asthma.org.uk Most GPs have an adequate knowledge of asthma but there is still a large...

PulseRegister: Desperate mum claims you failed ADHD son.(Attention Deficit Hyperactivity Disorder )
October 5, 2006... Three GPs share their approach to a practice problem CASE HISTORY Sam is 12 and has attention deficit hyperactivity disorder. He takes methylphenidate which helps, but the dose has been reduced because of side-effects. His mother...

PulseRegistrar: Little gems how hot are you on... genetics?(questions and answers)
October 5, 2006... Test your knowledge for the nMRCGP with this little GEM from GPnotebook Q What is the chromosomal abnormality accounting for 95 per cent of Down's syndrome? A Approximately 95 per cent of affected individuals have trisomy 21, with a...

10-minute examination of the...eye.(loss of vision)(Brief article)
October 5, 2006... In the second of our new series, Dr Steve Brown looks at the causes of sudden painful loss of vision Things to remember with the history * You are relying on getting a clear history so ask lots of questions * Ophthalmology...

PulseRegistrar: Jot topics - obesity.(care amd treatment)
October 5, 2006... Dr Sue Ford gives a round-up of the latest thinking on another key subject area Importance * Defined as BMI >30. In addition, weight circumference should be taken into account, especially regarding insulin resistance - BMJ...

PulseRegistrar: Your first...patient who won't be reassured.(medical consultations)
October 5, 2006... Sometimes no matter what GPs say or do patients continue to worry about their health and are very difficult to reassure. Dr Melanie Wynne-Jones discusses Most consultations include an element of patient reassurance. We tell them that...

PulseComment: Stop spread of prescribing.(Brief article)
October 5, 2006... When the Department of Health unveiled its plans for nurse and pharmacist independent prescribers, it did so with a sense of drama. They would gain access to `any licensed medicine for any medical condition' it proclaimed. It was one of the...

Dr Mike Dixon...on fishing, massage and colonic irrigation.
October 5, 2006... My idea of perfect happiness is a warm day in May on an English chalk stream with a plentiful hatch of mayfly. My greatest fear is getting stuck in a small lift during a power cut. The trait I most deplore in myself is being incapable...

Only GPs can rescue chlamydia screening, NHS report warns.
October 12, 2006... #80m national programme is failing to achieve the uptake it needs to cut burden of disease EXCLUSIVE By Lilian Anekwe The Government's flagship #80m national chlamydia screening programme is failing and only general practice can save...