Pulse articles from September 2003

Pulse archives from September 2003

PCTs defy deadline to aid stressed GPs.(primary care trusts)
September 1, 2003... Stressed GPs are being left without support because one in five PCTs has misspent Government cash allocated for their care. The BMA last week launched a naming and shaming exercise after its survey of English LMCs exposed the postcode...

GPC fails to find proof of flu pay.(Brief Article)
September 1, 2003... GP negotiators have failed to turn up any evidence to prove the NHS Confederation agreed to pay GPs in England for immunising at-risk under- 65s against flu this winter. The failure means negotiators face their crunch meeting with health...

New contract will breed `nine to five' generation.(Brief Article)
September 1, 2003... The new contract risks breeding a generation of `nine-to-five doctors' because it makes no provision for training registrars in out-of-hours work, claims Dr Sureshini Sanders. Dr Sanders, chair of West Lothian GP Trainers Group and a GP in...

GPs fall short in fight to avert diabetes timebomb.(Brief Article)
September 1, 2003... One of the UK's most eminent doctors has told GPs they are still not doing enough to prevent diabetes in high-risk patients. The alert from Professor Sir George Alberti was prompted by new figures on the soaring burden of impaired glucose...

GP plans switch to surgery.(Brief Article)
September 1, 2003... Dr Raj Dhumale, who believes he is the only GP in Britain performing hernia surgery, is hoping to take up the work full-time under the new GMS contract. Dr Dhumale, who was a surgeon before switching to general practice, began performing...

PCT exposed for bending rules.(primary care trusts)(Brief Article)
September 1, 2003... The GPC has begun exposing PCTs it accuses of bending the rules on enhanced service funding. GP negotiators outed South East Oxfordshire PCT for using enhanced service cash to fund urine testing, GP appraisals, golden hellos, clinical...

GPC forces trust to scrap incentives to cut referrals.
September 1, 2003... A PCT has been forced to abandon plans to pay GPs rewards for cutting emergency referrals after the GPC condemned the scheme as `immoral'. South Worcestershire PCT wanted to offer financial incentives to GPs who cut emergency referral...

GPs less likely to see patients who live far from co-op centre.
September 1, 2003... GPs working out-of-hours are less likely to see patients face-to-face if they live far away from the primary care centre, research reveals. The decision to make a home visit or see a patient at the centre was inversely related to the...

MP drawn into row on sacked salaried GP.(Brief Article)
September 1, 2003... Tory MP Ann Widdecombe has been dragged into a row over a salaried GP who was sacked after failing to cope with a 7,000-strong list at a cottage surgery. Dr Ken Hammond is to claim unfair dismissal at an employment tribunal. The BMA said...

`BMA must do more for minorities'.(British Medical Association)(Brief Article)
September 1, 2003... GPC member Dr Kailash Chand has criticised the BMA for failing to do enough to ensure proper representation of ethnic minority GPs. Manchester GP Dr Chand, whose experiences of racism in the NHS were featured in The Guardian last week, told...

NICE curbs GP use of glitazones.(National Institute for Clinical Excellence)(Brief Article)
September 1, 2003... The number of patients with type 2 diabetes who are eligible to receive glitazones on the NHS will fall by 30 per cent under updated guidance released last week by the National Institute for Clinical Excellence. The guidance limits the use...

GPs reject advice to forget NSFs and get quality points.(national service frameworks)
September 1, 2003... GPs have denounced GPC advice to ignore national service frameworks in order to maximise their income under the new contract. Negotiators have recommended GPs only do work that can net them points under the quality and outcomes framework....

Falls in elderly costing #1bn.(Brief Article)
September 1, 2003... Falls among the elderly cost the NHS almost a billion pounds a year in secondary care costs alone, according to research funded by the National Institute for Clinical Excellence. The study, which will inform NICE guidelines on falls due...

GP's doubt over NICE plan for free IVF.(National Institute for Clinical Excellence, in-vitro fertilization)(Brief Article)
September 1, 2003... The controversial NICE proposals on NHS-funded fertility treatment may not be implemented across the country, a GP who helped draw them up has pointed out. The draft guidance proposes that women aged 23 to 39 with any appropriately...

GPs criticised for prescribing unnecessary antidepressants.(Brief Article)
September 1, 2003... GPs are prescribing antidepressants unnecessarily to patients with mild depression despite only `weak' evidence that they are effective in primary care. The Drug and Therapeutics Bulletin accused GPs of `loosely' diagnosing mild depression...

Practice helps teens with Q&A website.(Brief Article)
September 1, 2003... Dr Martin Davis's practice is attempting to provide a better service to teenagers by creating a confidential question and answer forum on its webite. Instead of a formal consultation, any patient aged 12 to 20 registered with the practice...

BMA builds picture of PMS GPs' lives.(British Medical Association)(Brief Article)
September 1, 2003... The BMA is to ask PMS GPs in England how satisfied they are with pay, working conditions and staff in a bid to build a better picture of their working lives. The survey could uncover big variations in pay and funding. The BMA, which is...

Caution urged on Ritalin prescribing.(Brief Article)
September 1, 2003... GPs in South Wales have been advised to stop prescribing Ritalin (methylphenidate) until a local health board extends its shared-care local development scheme to cover it. Dr Gareth Hayes, chair of Bro Taf LMC, said a number of GPs were...

GPs may have to immunise school leavers for pertussis.
September 1, 2003... GPs may be asked to vaccinate 16-year-olds against whooping cough to protect younger children and babies. If the pre-school pertussis campaign fails to halt the rising tide of infection in infants, school leavers may need to be vaccinated,...

GPs are warned over sectioning warrants.(Brief Article)
September 1, 2003... Any GP named on a warrant to section a patient under the Mental Health Act must attend when the patient is detained, the Court of Appeal has made clear. Failure to do so could lead to a claim for damages for unlawful detention,...

Shipman was a one-man crimewave.(murder statistics)(Brief Article)
September 1, 2003... Half of all murders by poisoning in England and Wales in 1997 were the work of Harold Shipman, according to official statistics. An analysis by the Office for National Statistics, published in Health Statistics Quarterly (autumn), found...

DNAs fall as GPs urge fines for missed appointments.(Brief Article)
September 1, 2003... Seven in 10 practices want patients fined for missing appointments, a large survey has revealed. But the number of DNAs has fallen three million in a year, the survey of 10,758 practices found. The Doctor Patient Partnership, which...

Talking POINTS.
September 1, 2003... Dr Terry John, a GP since 1981, practises in Walthamstow, north-east London. He is also a GP trainer. Jo Carlowe asked him about the hot topics in his practice. Flu pay deal The NHS Confederation and GP negotiators cite different...

GMC hits back over capital recruitment.(Brief Article)
September 1, 2003... The GMC has hit back at a London Assembly health committee report claiming it needed to do more to recruit overseas doctors to the capital to alleviate the GP recruitment crisis. The July report complained qualified GPs from countries such...

New super regulator can pursue `too lenient' misconduct cases.(Brief Article)
September 1, 2003... GPs cleared of misconduct by the GMC could face High Court action if a new super-regulator rules the decision has been too lenient. The Council for Regulation of Healthcare Professionals, which came into being in April, has the power to...

#1.1m scheme for IT mentors.(Brief Article)
September 1, 2003... Mentors who will give advice and tuition on information technology will be available to every practice in Scotland under a #1.1 million scheme. The Scottish Executive has approved an extension of an `IT mentoring' pilot in Lanarkshire...

EDITORIAL COMMENT: Must good care and good pay be mutually exclusive?
September 1, 2003... GPC negotiators have responded to growing GP concern over the work implications of the new contract by urging them to ditch NSF work which doesn't earn them money. Work outside the quality framework is `irrelevant', according to GPC...

Letter: No pay, no flu vaccinations for our under-65 patients.(Letter to the Editor)
September 1, 2003... It is beyond the pale to renege on what was a clear agreement to pay an item-of-service fee for under-65s flu vaccinations (news report, August 25). If it had really not been agreed, Mike Farrar, the NHS Confederation's lead negotiator, could...

Practice Q&As: How can we contact the patients who have moved?(Brief Article)
September 1, 2003... Q: We have a lot of students registered with our practice who frequently move without informing us of their new address. This is of particular concern if, for example, we have an abnormal result such as a cervical smear that needs follow-up....

Practice Q&As: Should GP be present when phlebotomist is working?(Brief Article)
September 1, 2003... Q: Could you advise me whether my phlebotomist should have a doctor on the premises while she is working? A: In an ideal world the doctor should probably be present. If the phlebotomist was unable to obtain a blood sample, or if there was a...

Is PMS a better alternative than GMS?
September 1, 2003... GPs' interest in PMS is said to be waning, but is it still a more acceptable alternative to GMS? Dr Bob Button considers the possibility PMS was originally developed an as an acceptable community-based face of fundholding. PMS was also...

Going for big gains in the diabetes quality markers.
September 1, 2003... Dr Lorna Gold continues our series on the quality framework There is considerable variation between GPs in their enthusiasm for, and expertise in, the management of diabetes and the new contract takes this into consideration in the quality...

Planning your pneumococcal campaign.
September 1, 2003... Now is the time to come up with an action plan to maximise your profits - Dr John Couch shows how It is not before time that the Department of Health has finally decided to pay GPs for immunising older patients with pneumococcal vaccine....

Family ignores warnings about asthma problems.
September 1, 2003... Three GPs discuss a tricky problem Case history The receptionist alerts you that one of your patients and her two children - aged nine and 12 - have gone through 42 inhalers in the six months since they joined the practice. They have...

Mammographic screening: the case for informed choice.(Editorial)
September 1, 2003... Professor Michael Baum defends his controversial assertion that women are coerced into having breast screening In certain circles I appear to have been branded a troublemaker and misogynist who wishes `to kill one in every 1,000 women' (an...

Breast screening: the enthusiast's view.
September 1, 2003... M00Lester Barr explains why he thinks screening is still the best weapon in the battle against breast cancer Despite new drugs and new treatments, breast cancer remains one of the big unsolved health problems of our time. It is the major...

MRCGP ESSENTIALS: Evidence versus narrative in the consultation.
September 1, 2003... Exam convenor Dr Peter Tate offers revision advice for some potential questions OVERVIEW There is an inherent conflict between practising evidence-based medicine and satisfying a patient's social and psychological needs. The...

ANSWER BACK: Are SEMG tests helpful for backache patients?(surface electromyography)(Brief Article)
September 1, 2003... Q: Patients complaining of backache bring with them computer-generated printouts obtained from chiropractors and osteopaths. These tests are known as computerised spinal examination through surface electromyography (SEMG). Are these tests...

ANSWER BACK: What is eczema and peanut allergy link?(Brief Article)
September 1, 2003... Q: What is the relationship between eczema and peanut allergy? A: Peanut is now the commonest food causing serious allergic reactions. The reasons for the increase are complex. Over the past 20 years there has been an enormous increase...

GPs furious at six-month wait for quality pay.
September 8, 2003... GPs have accused the NHS Confederation and ministers of `weaselling' after it emerged they may have to wait until March for a large chunk of their quality preparation pay. Practices are set to get just half of the cash they were promised...

Advanced access lets down elderly.(Brief Article)
September 8, 2003... The advanced access appointments system disadvantages elderly and chronically ill patients, a study has concluded. Research into the system at a north London practice also found some patients abused it by booking two slots in case they...

GPC's two-week trawl digs up evidence of flu pay deal.(Brief Article)
September 8, 2003... GP negotiators have managed to dredge up informal handwritten notes to back their desperate attempt to convince health minister John Hutton that GPs in England must be paid for vaccinating at-risk under-65s against flu. Mr Hutton returns...

Flu vaccination for healthy over-65s wastes GPs' time.
September 8, 2003... GPs' annual drive to vaccinate healthy over-65s against flu costs the NHS more than it saves, flagship Government research reveals. Immunising all patients aged 65 to 74 with no specific risk factors cuts GPs' workload by just three...

US GP forced to sit English test before she can work.(Brief Article)
September 8, 2003... American family doctor Dr Jane Crawford has been forced to sit an English language test before she can practise as a GP. Dr Crawford, who practised in North Carolina before moving to Lossiemouth, Morayshire, in April now faces two further...

Researchers claim quality pay system is `perverse and unfair'.
September 8, 2003... Leaders of a large study have launched a three-stranded attack on the quality framework. Researchers who assessed its likely impact in a study covering 67 practices claimed: * abandoning the Carr-Hill weighting of quality points means...

Local contract negotiations for Scots GPs?(Brief Article)
September 8, 2003... Draft legislation to enact the GMS contract in Scotland has left the door open for `local negotiation' of the deal. Explanatory notes to the Primary Medical Services (Scotland) Bill state contracts between practices and local health boards...

`Aberrant' reaction of GPs makes complaints worse.(Brief Article)
September 8, 2003... One in four complaints against GPs escalates because they are poorly handled by practices at the beginning, new research has found. A Medical Defence Union analysis of 202 complaints against its members found poor initial handling,...

Retired but I'm back.(Brief Article)
September 8, 2003... Dr Ranj Dambawinna has returned to his singlehanded practice after taking a one-month retirement holiday which enables him to claim his full pension. The Essex GP is the first to be allowed to carry on as a full-time singlehander and still...

GP occupational health schemes.(Brief Article)
September 8, 2003... PCTs that were `named and shamed' by the BMA for not having GP occupational health schemes have claimed they do offer the service. Dr Geoffrey Hayle, professional executive committee chair on Ellesmere Port and Neston PCT, cited as one of...

EU watchdog to scrutinise HRT.(Brief Article)
September 8, 2003... The European medicines watchdog has put HRT under scrutiny in the wake of the Million Women Study. An expert panel at the European Agency for the Evaluation of Medicinal Products - which can remove drugs from the EU market - will decide...

Scathing report raises doubts over NHS Direct taking GP calls.
September 8, 2003... Serious doubts have been cast over NHS Direct's ability to handle out- of-hours calls to GPs after a Commission for Health Improvement review condemned one of the nurse triage service's flagship sites. CHI attacked NHS Direct North East...

GP workload will rise with patient choice.(Brief Article)
September 8, 2003... The majority of GPs believe the Government's drive to give patients more choice on how they are treated will increase their workload, a survey has revealed. The Mori poll also found 28 per cent of GPs think the policy will lead to worse...

Trusts not fazed by contract.(Brief Article)
September 8, 2003... More than a third of primary care trusts do not see implementation of the new GMS contract as a `challenge', according to an NHS Alliance survey. A total of 64 per cent of PCTs saw implementation as one of their top five challenges for the...

Government to tackle GPs' `nihilistic' attitude to COPD.(chronic obstructive pulmonary disease )
September 8, 2003... The Government has flagged up better GP management of chronic obstructive pulmonary disease as one of its clinical priorities. Concerns that GPs have a `nihilistic' attitude to COPD will be addressed by a two-pronged strategy aimed at...

Manager won't have to repay GPs for fraud.(Brief Article)
September 8, 2003... A practice manager who topped up his salary by #13,200 by amending his pay slips will not have to repay the money, the appeal court has ruled. Judges quashed a compensation order against Malcolm Aitken, who was jailed for four months and...

Mystery millions cause a muddle over IT funds.(Brief Article)
September 8, 2003... The GPC is in disarray over how much cash PCTs will get from the Government to enable them to take over 100 per cent reimbursement of GPs' IT needs. GPC IT sub-committee chair Dr Paul Cundy said trusts will get #28 million `in the next few...

Non-principals seek to change outdated name.(Brief Article)
September 8, 2003... Non-principals want to change their name because it is out of date and implies they are second-rate GPs. The National Association of Non-Principals, which has proposed the move, said the title carried negative connotations. It is discussing...

Cardiologists row over GP risk charts.
September 8, 2003... Cardiologists are embroiled in a row over whether GPs should ditch the discredited Framingham coronary risk prediction charts in favour of a new model that is claimed to be more accurate. The Framingham charts - published in the BNF - are...

GPs stick to older hypertension drugs.(Brief Article)
September 8, 2003... UK GPs are far less likely to prescribe newer antihypertensives than their European counterparts. A World Heart Federation survey of 825 European GPs showed the UK had the highest prescribing rate of older drugs for hypertension. Of...

PSA-on-demand policy fuels huge rise in prostate cancer.(prostate-specific antigen)
September 8, 2003... The massive increase in the use of prostate-specific antigen testing has fuelled an explosion in diagnoses of prostate cancer, new figures from the Office of National Statistics reveal. Diagnosed cases rose 85 per cent in the decade to...

Dr Kelly's GP gives evidence.(Brief Article)
September 8, 2003... The GP of Dr David Kelly has told the Hutton inquiry he was not aware of anything of medical significance that could have contributed to the weapons expert's death. Dr Malcolm Warner, a GP in Faringdon, Oxfordshire, and Dr Kelly's GP for...

PCTs break pledge to help GPs meet childcare needs.(primary care trusts)
September 8, 2003... GPs' childcare needs are being ignored by PCTs despite Government promises to extend subsidised care to all primary care staff, BMA research has found. The survey of childcare provision in 122 PCTs in England found only four trusts had met...

GP loses tribunal case against authority.(Brief Article)
September 8, 2003... GPs' independent contractor status has been confirmed after an employment appeals tribunal ruled a former GP had no right to sue his health authority for constructive dismissal. The London appeals tribunal found that Dr C. David-John could...

GPs' hostility holding back progress of walk-in centres.
September 8, 2003... Antagonism towards walk-in centres from GPs and many primary care trusts is hampering the development of the initiative, Department of Health-funded research has concluded. The evaluation of one of the Government's key health reforms found...

Talking POINTS.
September 8, 2003... Dr Unnati Misra, a GP for 38 years, practises in Handsworth, Birmingham. Jo Carlowe spoke to her about hot topics in her practice. GP stress Are there good services to help stressed GPs in your area? Yes, we are fortunate in this...

Letter: Glucose test: we pick up pieces.(Letter to the Editor)
September 8, 2003... I was not surprised to hear GPs being blamed yet again for a problem they are not responsible for but I did not expect to see fellow GPs joining in the accusations (`GPs told: don't waste cash on home glucose testing', News report, August 25)....

Letter: My solution for diabetes care.(Letter to the Editor)
September 8, 2003... I refer to the news story headlined `GPs told: don't waste cash on home glucose testing' (August 25). Whether or not we are wasting cash on prescribing these expensive testing strips, I for one consider I waste a lot of time forever...

EDITORIAL COMMENT: GPs must not lose out over flu immunisation.(general practitioners)(Editorial)
September 8, 2003... Health minister John Hutton returns from holiday this week to sort out the mess over payment for immunising at-risk under-65s against flu. Through no fault of their own, GPs in England may have to stand and watch colleagues in Wales, Northern...

Letter: Why we have no alternative to antidepressants.(Letter to the Editor)
September 8, 2003... Further to the news report `GPs criticised for prescribing unnecessary antidepressants', we have a one-year waiting list for `psychotherapy' and no access to NHS-funded counselling. I know other areas have far better provision than this but...

Letter: Do not forget we help patients too.(Letter to the Editor)
September 8, 2003... I see we are in the doghouse again for prescribing antidepressants too freely (News, September 1). It is not very long ago that we were criticised for under-diagnosing and treating depression, and now we have gone the other way. What is...

Letter: Two-year wait to blame.(Letter to the Editor)
September 8, 2003... Re-`GPs criticised for prescribing unnecessary antidepressants', the approximately two-year (I jest not) wait to see a clinical psychologist round these parts means we have to dismiss cognitive behaviour therapy as a treatment. Dr Dave...

Letter: Why we reach for our Rx pads.(prescription)(Letter to the Editor)
September 8, 2003... You reported `GPs criticised for prescribing unnecessary antidepressants' (September 1). As Dr Alan Cohen, RCGP mental health spokesman, so succinctly puts it, GPs can't win. Has Professor Collier, editor of the Drugs and Therapeutics...

Letter: Can we make back claims for success?!(Letter to the Editor)
September 8, 2003... Re: the introduction of a pneumococcal immunisation programme for the over-80s. We introduced a flu/pneumonia programme in 1994, offering immunisation in accordance with the Green Book. Some 82 per cent of our over-80s have already been...

Letter: We don't need extra pay for flu vaccination.(Letter to the Editor)
September 8, 2003... It is often said the insane think everybody else is mad, and they are not. I am trying to decide if I'm a lone voice in the wilderness, or just deluded. I cannot understand the furore around `non-payment' for vaccinating at- risk under-65s...

Letter: We refused to chase access target.(Letter to the Editor)
September 8, 2003... You reported that the Government is considering action to stop GPs' so- called `access ploy' (August 25). Banning patients from making appointments more than 48 hours ahead was initially precisely what Telford and Wrekin PCT ordered us to do....

Letter: GPs will lose respect over out-of-hours.(Letter to the Editor)
September 8, 2003... Thanks to the new contract we are organising out-of-hours cover where doctors will never have to do a visit. We are organising days in which doctors never do a visit. We are going to go into partnership with NHS Direct, which has been proven to...

Letter: Diabetes criticism takes the biscuit.(Letter to the Editor)
September 8, 2003... I was distressed by the news report on the `diabetes timebomb' (September 1) in which Professor Sir George Alberti, president of the International Diabetes Foundation and former president of the Royal College of Physicians, implied that GPs are...

Shipman murders shattered my confidence.
September 8, 2003... Dr Raj Patel was one of six GPs criticised in the Shipman inquiry report for the way they signed form Cs - he explains what it is like practising in Hyde after Shipman and how the case affected his confidence In August 1998 the Manchester...

Gaining the full quality points for hypertension care.
September 8, 2003... Dr Lorna Gold concludes our series on maximising the opportunities in the new contract quality framework The identification and effective treatment of hypertension has a considerable volume of evidence to support its role as a health...

Fatal attraction of my `a bit special' partner.
September 8, 2003... The problem The socially inept female patient who falls in love with her GP may be a cliche but in my practice it is no joke. In 15 years of working together one of my partners has had many patients develop an inappropriate attachment to...

PracticeQ&As: Should I agree access to dead patient's records?
September 8, 2003... Q: The Practitioner and Patient Services Agency holds the records of a patient of mine who has died. I have been asked by the PPSA to agree to the contents of the medical records being copied for the next of kin under the Data Protection Act....

How do you help a carer whose health is failing?
September 8, 2003... Three GPs discuss a tricky problem Case history You know Marilyn well, although she does not often consult on her own behalf. She is 56 and the only entries in her records relate to her pregnancies. Two of her eight children are still...

Is #70m NHS childcare strategy creating a two-tier system?(UK National Health Service)
September 8, 2003... How the rhetoric fails to match the reality for most young GPs - Steve and Ann Toon report Dr Lucy Henshall has spent nearly #100,000 on childcare in the past nine years. As a part-time GP Dr Henshall calculates her disposable income is...

Case studies: female perspective - Dr Lucy Henshall.(Brief Article)
September 8, 2003... Ipswich GP Dr Lucy Henshall pays a full-time nanny #12,500 a year to help look after her three children, aged nine, seven and four. Dr Henshall works part-time, with a 35 per cent parity share, and says that after deducting professional...