Pulse articles from September 2004

Pulse archives from September 2004

GPs kick off fight against IT disruption.(General practitioners)(information technology)
September 6, 2004... GPs have begun a concerted campaign against the Government's National Programme for IT over a series of policies that threaten massive disruption to practices. The battle centres on the programme's plans, revealed by Pulse, to force most...

Shipman GP stunned by GMC charge.(General practitioners)(General Medical Council)(Brief Article)
September 6, 2004... Dr Rajesh Patel is `shocked and bewildered' after the GMC launched professional conduct proceedings against him and five other GPs who were criticised by the Shipman Inquiry. The inquiry censured the GPs for counter-signing 214 cremation...

PCOs get code on visits.(services of primary care organisations)(Brief Article)
September 6, 2004... The Government is to release a code of practice on quality framework visits to GPs in order to stave off breaches of patient confidentiality by primary care organisations. The move comes after widespread complaints by GPs over PCOs' plans...

Outcry as the GMC charges Shipman whistleblowers.(General Medical Council)(Brief Article)
September 6, 2004... GPs have condemned the GMC for bringing misconduct charges against six GPs who blew the whistle on Harold Shipman. GPC negotiators attacked the council for making `scapegoats' of the GPs, who were censured by the Shipman Inquiry last year...

GP's study predicts contract will hit morale.(General practitioners)(Brief Article)
September 6, 2004... GP morale will suffer under the new contract because it focuses on treating diseases not patients, Dr Karen Fairhurst's research concludes. Dr Fairhurst interviewed 19 GPs on what gave them most satisfaction about their consultations. She...

It's goodbye to the golden hello for GPs.(shortage of general practitioners-golden hello scheme )(Brief Article)
September 6, 2004... The Government is to replace the golden hello scheme from next April with an initiative designed to target deprived and under-doctored areas. The NHS Confederation and GPC are hammering out details of the new programme, which could allow...

GPs in plea over asylum seekers' team.(General practitioners)(care for refugees)(Brief Article)
September 6, 2004... GPs are calling on their PCT to maintain a GP-led team to treat asylum seekers after it closed the dedicated practice they had been based in. Central Derby PCT shut the Sai practice because it had become `financially unviable' after...

GPs `in no-man's land' over statin prescribing.(prescription by General Practitioners for coronary heart disease patients)
September 6, 2004... GPs are increasingly flouting the Government's `out-of-date' guidance on statins after being left in `no-man's land' by the decision to move simvastatin over the counter. The drug is available in pharmacies to patients over 55 with a...

NICE in talks over drug firm link-ups.(National Institute for Clinical Excellence)(Brief Article)
September 6, 2004... NICE is in discussions with the Association of the British Pharmaceutical Industry over ways of improving implementation of its guidance. The move follows the decision by the Scottish Intercollegiate Guidelines Network to formally...

GPs shun cox-2s amid data chaos.(General practitioners avoid usage of COX-2 inhibitors)
September 6, 2004... GPs and PCTs are questioning whether any marginal benefit of cox-2 inhibitors over non-selective NSAIDs is worth the added cost in the wake of further evidence casting doubt on their safety. Pulse has learned some PCTs are already advising...

GP saves a life with his biro.(General practitioners)(Brief Article)
September 6, 2004... Dr Guy Knights saved a man's life at a local country fayre after he performed an emergency cricothyroid puncture using a penknife and part of a biro. Dr Knights was forced to carry out the surgery after a Heimlich manoeuvre failed to free...

Thiomersal `cleared'.(effect of ethylmercury sodium salt in neurological development and its usage in vaccines)(Brief Article)
September 6, 2004... Thiomersal does not impair neurological development, according to two major UK studies published in the current edition of Pediatrics (September). GPs can now reassure parents over the current thiomersal-containing dTwP vaccine after...

GPs facing disputes over partners not pulling their weight on quality.(General practitioners)
September 6, 2004... `Slacking' partners could fuel contract rows between doctors - Nerys Hairon and Shirin Beheshti report The new contract is set to spark off a wave of practice disputes after half of GPs admitted they have had problems with partners not...

Act on partnership agreements now.(Brief Article)
September 6, 2004... More than three GPs in four have failed to update their partnership agreements to take account of the new contract. The lack of action is despite a series of GPC warnings that agreements need to be substantially altered to cater for the...

GPs facing GMC discipline over personal injury case tip-offs.(General practitioners)(Brief Article)
September 6, 2004... GPs could face GMC action if they take up `cash for referral' promotions being offered by personal injury law firms. Solicitors across the UK have written to GPs promising earnings of up to #10,000 a year if they regularly recommend them to...

Taped GP consultations may be `useful tool'.(General practitioners-tape of their consultation)(Brief Article)
September 6, 2004... Giving patients a tape of their consultation could help improve control of complex conditions such as diabetes, a GP researcher claims. A study published in this month's British Journal of General Practice found 64 per cent of patients who...

Scots GPs face IT hitch.(calculation of quality scores by general practitioners using information technology)(Brief Article)
September 6, 2004... GPs in Scotland will have to wait until December at the earliest before they can calculate their quality scores by computer. Practices face a delay getting the quality management and analysis system (QMAS) because it is not compatible with the...

Hidden diabetics.(analysis of cardiovascular disease patients)(Brief Article)
September 6, 2004... All patients at risk of cardiovascular disease should have their glycaemic status tested, say researchers, after finding one in five patients with CVD or risk factors has unrecognised type 2 diabetes. A randomised double-blind multinational...

ECG `does not rule out heart failure'.(analysis of electrocardiography-echocardiography)
September 6, 2004... Richard Hoey reports on key developments in GPs' diagnostic role at the European Society of Cardiology congress Electrocardiography cannot exclude the possibility of heart failure and should not be used as the sole means of diagnosing the...

Home care safe.(home-based and hospital-based cardiac rehabilitation)(Brief Article)
September 6, 2004... Home-based cardiac rehabilitation is as effective as hospital care for patients with coronary heart disease, research shows. Researchers at the University of Birmingham randomised 35 CHD patients to hospital-based rehabilitation and 37 to...

Syndrome risk.(coronary heart disease patients-metabolic syndrome)(Brief Article)
September 6, 2004... CHD patients with at least three signs of metabolic syndrome are twice as likely to die from a cardiovascular event. The EUROPA trial found 23.4 per cent of 8,397 CHD patients had at least three signs of the syndrome. After 4.2 years 11.1...

`Use family history to target CHD drugs'.(treatment of coronary heart disease)(Brief Article)
September 6, 2004... One in four healthy people with siblings who developed premature cardiovascular disease will themselves be at high risk and should be targeted for preventive treatment, a new study concludes. Taking greater account of family history would...

Statin renal boost.(Brief Article)
September 6, 2004... Statins significantly improve renal function in patients with CHD. A Greek study found 704 CHD patients with normal renal function who were not treated showed a decline in creatinine clearance of 5.2 per cent over three years. In contrast,...

Age no longer dyspepsia red flag.(endoscopy-analysis)(Brief Article)
September 6, 2004... GPs no longer need to consider age a red flag for dyspepsia in what has been described as a `significant change' to clinical practice. In its final guidance, NICE has ruled that GPs do not automatically need to refer patients with...

Warning is sounded on teratogenic drugs.
September 6, 2004... Rob Finch reports on controversial studies presented at a recent pharmaco-epidemiology conference in Bordeaux Defence bodies are urging GPs to gain informed consent before prescribing women teratogenic drugs after research revealed...

Epilepsy linked to fractures.(Brief Article)
September 6, 2004... People with epilepsy are at twice the risk of fractures of the population as a whole, according to a large-scale study of UK patients. Hip and femur fractures were almost three times as likely among patients with epilepsy, the conference...

SSRIs raise risk of pancreatitis.(Selective Serotonin Reuptake Inhibitor)(Brief Article)
September 6, 2004... SSRIs may increase the risk of acute pancreatitis. Swedish researchers identified 462 cases of the disease in a study population of 1.4 million and found patients were more than twice as likely as controls to have taken an SSRI at least once in...

More strokes with spondylitis.(complications of ankylosing spondylitis)(Brief Article)
September 6, 2004... Men with ankylosing spondylitis are at increased risk of heart attack or stroke, conference delegates heard. The authors said cardiovascular disease might be a previously unknown manifestation of the condition, which is associated with...

Insulin use has nearly doubled.(oral hypoglycaemic drugs-diabetes)(Brief Article)
September 6, 2004... The number of people switching from oral hypoglycaemic drugs to insulin has risen dramatically in recent years, a new study reveals. Since 1998's UKPDS study showed intensive treatment of type 2 diabetes could cut the risk of microvascular...

LMC scraps contract committee after PCT managers fail to turn up.(Lancaster and Morecambe College)(primary care trust)(Brief Article)
September 6, 2004... Nottinghamshire LMC has shelved a forum designed to improve communications with a local PCT because managers failed to take its role seriously. The breakdown in communications between the LMC and Nottingham City PCT comes amid growing...

Tsar takes chair at premises initiative.(Partnerships for Health-Local Improvement Finance Trust)(Brief Article)
September 6, 2004... Dr David Colin-Thome, the Government's primary care tsar, has taken over as chair of the company in charge of the LIFT premises improvement scheme. Dr Colin-Thome has joined the board of Partnerships for Health, a joint venture between the...

Government curbs overseas poaching.(restraining recruitment of doctors and nurses from developing countries)(Brief Article)
September 6, 2004... The Government has announced proposals to curb poaching of doctors and nurses from developing countries. The plans are designed to strengthen the code of practice on international recruitment, which prevents agencies from targeting...

Practice nurse shortage could hit drive to cut GPs' workload.(General practitioners)
September 6, 2004... Skill-mix drive faces training shortfall as tensions build over pay and accountability - by Pulse reporters The Government's drive to relieve workload pressures on GPs by increasing the skill mix in primary care could founder on an acute...

JOURNAL WATCH: Statins can delay insulin treatment.(Brief Article)
September 6, 2004... Using statins can delay the need to start insulin treatment in patients with type 2 diabetes, according to new research. Canadian researchers conducted a retrospective cohort study, including 10,996 diabetes patients who were newly taking...

JOURNAL WATCH: Women at higher risk of winter death.(Brief Article)
September 6, 2004... Elderly women are more likely than men to die from the effects of the cold during winter, but socioeconomic factors do not affect mortality, new research shows. The population cohort study analysed records from 119,389 people over the age...

JOURNAL WATCH: Falls and age are fracture risks.(elderly women-health)(Brief Article)
September 6, 2004... An elderly woman's risk of suffering a fracture increases with age and if she has suffered a fall or previous fracture, new research shows. The UK study assessed potential risk factors in 4,292 patients over the age of 70, following up...

JOURNAL WATCH: Headache linked to other illnesses.(Brief Article)
September 6, 2004... Patients who present to their GP with a headache are also more likely to suffer from digestive or respiratory disorders, according to a new study. Researchers in Staffordshire surveyed 4,885 patients and conducted prospective record...

JOURNAL WATCH: Co-prescribing ups warfarin events.(combined prescription-side effects)(Brief Article)
September 6, 2004... Use of medications concomitantly with warfarin may be driving an increase in adverse events associated with the drug, a US study suggests. Researchers analysed records from 300,000 patients admitted to hospital between 1995 and 2002 and...

JOURNAL WATCH: Bipolar risk peaks from age 10 to 14.(research of child mental health)(Brief Article)
September 6, 2004... Children aged from 10 to 14 are at particularly high risk of developing bipolar disorder when treated with antidepressants, a new study suggests. US researchers assessed records from 87,920 mentally-ill patients aged from five to 29, of...

GPs' workload set to soar as obesity doubles CVD.(cardiovascular disease)(General practitioners)
September 6, 2004... GPs face being swamped with workload as the obesity epidemic doubles rates of cardiovascular disease in the middle-aged within two decades, an alarming new study reveals. Cardiologists and GPs said the crisis would worsen unless the...

Gulf between patients' and GPs' expectations widens.(relations between General practitioners and patients )
September 6, 2004... After a recent survey found nine million GP appointments were missed last year and many GPs wanted to charge patients who did not turn up, radio and TV phone-ins were jammed with patients responding with complaints about their practices. ...

Letter: This `undemocratic' slur on the GPC is not borne out by facts.(Letter to the Editor)
September 6, 2004... Professional courtesy to a fellow council member at the BMA constrains me from making many of the comments that spring to mind on reading yet another intemperate letter from Dr David Roberts (August 23). Suffice to say that, once more, the...

EDITORIAL COMMENT: GPs must not be railroaded into computer change.(information technology-influence on general practitioners)(Brief Article)
September 6, 2004... The Government's #6 billion National Programme for IT has so far had only a tiny effect on GPs' lives. But it is becoming ever clearer just how disruptive it could be for practices. A recent policy document reveals plans to develop two new GP...

Letter: Why I am urging my GP husband to throw in towel.(Letter to the Editor)
September 6, 2004... I read the recent news story `GP faces GMC for smacking three-year-old' with great anger at a system that treats its professions with such little regard. As a wife of a GP I am well aware of the vulnerability of doctors and the tightrope...

Letter: PCTs must learn to behave more like customers.(Letter to the Editor)
September 6, 2004... The news story `PCTs don't have the savvy to win hospitals battle' (August 16) describes the Institute for Public Policy Research's concern that PCTs may not be well-equipped to negotiate with acute trusts. In our experience at the NHS National...

Letter: Don't let PCT near clinical servers!(Letter to the Editor)
September 6, 2004... GPs must not be bullied into taking on IT systems. This has been reaffirmed and endorsed by the Department of Health. I quote from the BMA website: `Our advice to GP practices, which is endorsed by the Department of Health and the National...

Letter: Have I somehow lost an entire year of PGEA payments?(Letter to the Editor)
September 6, 2004... I have a query on PGEA payments: my understanding is that in the past PGEA was paid quarterly in the year after the PGEA courses were done Personally, I earned PGEA from April 2002 to March 2003 and was paid quarterly through the year...

Letter: Vaccination scare stories make our lives so difficult.(Letter to the Editor)
September 6, 2004... Tabloid scare stories under headlines such as `Chaos over five-in-one baby jab' (Daily Mail) are totally irresponsible and over the top and have raised unnecessary doubts on the motives for introducing this vaccine. Now Michael Langman,...

Letter: Underage sex advice is just a sick joke.(Letter to the Editor)
September 6, 2004... GP Dr Martyn Walling and MDU medicolegal adviser Dr John Gilberthorpe emphasise that legally the consent of a child under age 16 to use contraception or have an abortion depends on the ability of the child to understand the nature, purpose and...

Letter: Your views sought over Ca referrals.(Letter to the Editor)
September 6, 2004... The NICE referral guidelines for suspected cancer, being developed by the National Collaborating Centre for Primary Care based at the RCGP, are at an early stage of development. As part of the development of the guidelines a full literature...

Letter: Act now over the plight of overseas doctors.(Letter to the Editor)
September 6, 2004... I am writing to expose the difficulties of young overseas doctors who have come to the UK for higher training and employment. Many of these young medical graduates, after completing basic medical education in their own countries, strive hard to...

Letter: Costing out heart failure test.(Letter to the Editor)
September 6, 2004... Your report `Study hits hopes for LVSD screening' (News, August 16) states BNP can exclude `only 40 per cent' of patients from further assessment - I for one would call that jolly useful! We are not screening a healthy population in general...

ME patient complains as you refuse to prescribe her thyroxine.
September 6, 2004... Case history Mrs Byrne was diagnosed with chronic fatigue syndrome following a viral infection last year. She seems to be bearing it bravely and says she `hopes to get back to work one day doctor'. As part of her investigation, you...

Employment law changes: don't be caught out.
September 6, 2004... GPs must take careful heed of the changes to employment law coming into force next month, says solicitor Daphne Robertson On October 1 new disciplinary and grievance procedures1 will come into force, constituting a fundamental change to UK...

How to produce the best possible practice leaflet.
September 6, 2004... Practice leaflets are crucial but are often very badly produced - Dr Rod Sheaff explains how to get things right Practice leaflets contribute to the quality of general practice, yet they are not always well-produced, properly thought out or...

September contract calendar.(Calendar)
September 6, 2004... Dr Bob Button advises practices on what they need to be doing this month SEPT 6 Check your finance statement from your primary care agency to see whether or not it has adjusted your global sum to take account of what it terms the...

How medication reviews make one-stop general practice work.
September 6, 2004... Patients can get the most out of a practice while giving you the contract data you need, says Dr Peter Stott The new GP contract is not only a new way of paying GPs, it is also a new way of working that forces primary care to perform...

Heart failure: putting research into practice.
September 6, 2004... Dr Strat Liddiard details the latest evidence on management of a condition that now affects nearly 2 per cent of the population Some 40 per cent of patients die within 12 months of being diagnosed with heart failure. Subsequent mortality is...

Managing wheezy infants and toddlers.
September 6, 2004... Dr Dominic Cochran advises how to treat under-twos with persistent symptoms that are not necessarily asthma A child under two with persistent lower respiratory tract symptoms is the single most common reason for a GP referral to a...

A structured approach to better diabetes care.
September 6, 2004... Dr Azhar Farooqi explains how a systematic approach to offering diabetes care can pay off for both practices and their patients One of the welcome aspects of the new contract is that general practice will, for the first time, be rewarded...

Case study: Blueprint from a `model' practice.
September 6, 2004... Diabetes tsar Dr Sue Roberts has praised Haslemere Health Centre in Surrey as a model of good practice for annual diabetes reviews - senior partner Dr Chris Taylor explains how the system works We have a relatively low prevalence of...

CLINICAL CASEBOOK: Stress at work.
September 6, 2004... Case history Colin has taken two months to recover from back pain. He has finally gone back to work as a baggage handler, but he is not sleeping well and feeling very anxious. Colleagues talk behind his back and his employer is being...

YOUR FIRST: Patient who offers you money or other gifts.
September 6, 2004... Accepting gifts is tricky, but so is refusing them - Dr Melanie Wynne- Jones advises Money is very rarely offered in general practice. Most patients feel strongly entitled to a free NHS, although of course a gift is not the same as paying...

Choosing a practice: I took great care and got it right.
September 6, 2004... Being a GP partner is a great career, but do your homework to get off to a flying start - Dr John Hughes shows how GP partnership is great. I was relatively late starting, having enjoyed a variety of specialties and, for one reason or...

ANSWER BACK: Does graded exercise help CFS patients?(Chronic Fatigue Syndrome )(Brief Article)
September 6, 2004... Q: A patient of mine with CFS says she was told by her consultant that graded exercise for her condition is no longer recommended. Why would that be so? A: I am at a loss to know why the consultant has said that graded exercise is no...

ANSWER BACK: When should I treat low haematinic levels?
September 6, 2004... Q: Should I treat a well, non-anaemic woman in her mid-20s who has a low vitamin B12 and folate but negative intrinsic factor (IF) and coeliac autoantibodies and a balanced diet? A: This depends on how low the levels are. Significantly low...

GPs face pay shock on BP quality target.(general practitioners find difficulty achieving quality targets for hypertension treatment)
September 13, 2004... GPs face an uphill battle to achieve lucrative quality pay for hypertension because the blood pressure target in the contract is far too optimistic, experts are warning. Practices will struggle to get even 50 per cent of patients to hit...

GP gives second opinion on referrals.(general practitioner Mabel Aghadiuno)(Brief Article)
September 13, 2004... Dr Mabel Aghadiuno is running a `rapid-access referral clinic', seeing patients who put pressure on GPs to refer them to hospital when it may not be clinically appropriate. Dr Aghadiuno, a salaried GP in Croydon, said she would be seeing...

Ayling blow to singlehanders.(singlehanded general practitioners)(Ayling Inquiry report )(Brief Article)
September 13, 2004... The Ayling Inquiry report has raised concerns over the working practices of singlehanded GPs. The report marks singlehanders out for special treatment due to their `professional isolation'. Disgraced former Kent GP Clifford Ayling, who...

Chaperones must all be trained, says report.(Ayling Inquiry report)(Brief Article)
September 13, 2004... The Ayling Inquiry report has called for tough measures to protect patients from sexual abuse by GPs, including training chaperones. The report, on how the NHS handled allegations against the disgraced former Kent GP Clifford Ayling, called...

Asylum seekers' art has message for surgery.(health care industry)(Brief Article)
September 13, 2004... Dr Paul Kelland has just installed a piece of artwork by asylum seekers and refugees in his waiting room. Dr Kelland hopes the high proportion of asylum seeker and refugee patients at his practice in Shoreditch, north London, will be...

Patient-centred consultations of little benefit, says GP study.(general practitioners)(Brief Article)
September 13, 2004... The touchy-feely approach to patient consultations is a waste of time and has only `meagre benefit', according to new GP research. Eliciting patients' concerns about treatment lengthened consultations by 10 per cent and had no effect on...

Pay threat to EMIS users.(European Medical Informatics Society)(Brief Article)
September 13, 2004... Practices could lose quality points and patient care could suffer if they are forced to change computer systems by the National Programme for IT, the EMIS National Users Group has warned. Dr Manpreet Pujara, chair of the EMIS National Users...

GPs boycott out-of-hours as PCTs offer paltry rates.(general practitioners)(primary care nursing)(Brief Article)
September 13, 2004... GPs are shunning out-of-hours work because of low hourly rates leaving many shift rotas unfilled, sparking fears over quality of patient care. As many PCTs prepare to take over cover next month, hundreds of shift slots still remain empty,...

Drug regulators under fire from safety experts.(Medicines and Health Care Products Regulatory Agency)(Brief Article)
September 13, 2004... The Medicines and Health Care Products Regulatory Agency is facing criticism from safety experts after admitting its drug regulatory role is entirely funded by pharmaceutical company levies. On the opening day of the Commons health select...

GPs driven to `scattergun' prescribing.(general practitioners)(preventive medicine)
September 13, 2004... The drive to make preventive medicine a key priority of primary care is forcing GPs into a `scattergun' approach to prescribing, a new study warns. GPs are under such pressure to meet targets they are prescribing `indiscriminately' to...

`Final word on the MMR/autism myth'.(Measles, Mumps, Rubella vaccine)(research report)(Brief Article)
September 13, 2004... The most comprehensive and robust study to date has confirmed there is no link between MMR and autism after analysing records from UK general practice. Immunisation experts hailed the research as the final word on the topic and said it...

GPs urged to run interaction checks.(general practitioners)(Royal College of General Practitioners )(Brief Article)
September 13, 2004... GPs should regularly run searches on their computer to check for patients who could be on potentially hazardous drug combinations, according to the latest RCGP safety bulletin. It advises GPs to focus initially on the big problem areas,...

Ministers dilute mental health plans.(patient compliance)(Brief Article)
September 13, 2004... The Government has watered down proposals to detain mental health patients who do not comply with their treatment. Its new draft Mental Health Bill has set stricter criteria for patients who can be detained and conceded that compulsory...

New NHS plan to overhaul efficiency.(National Health Service)(managing medical care quality)(Brief Article)
September 13, 2004... The NHS Modernisation Agency has identified 10 `high-impact' ways to overhaul NHS efficiency and quality of care. A new 100-page guide outlines measures such as reducing the number of queues, making greater use of day surgery and using...

U-turn on Choose and Book initiative.(patients to choose health care services)(Brief Article)
September 13, 2004... The Government has done a U-turn on its pledge in the Choose and Book initiative to offer all patients a choice of four to five providers at the point of referral by a GP. In a policy document released last month, the Department of Health...

Public still find GPs trustworthy.(general practice)(survey report)(Brief Article)
September 13, 2004... General practice is the most trusted profession in the UK, according to a Committee on Standards in Public Life survey on public attitudes. The survey found that 92 per cent of respondents trusted family doctors to tell the truth. In...

GP's hep B blitz in misusers.(general practitioner on hepatitis B vaccination program)(Brief Article)
September 13, 2004... Dr Nigel Hewett has drawn on his experience working with homeless patients to optimise uptake of hepatitis B vaccine in high-risk drug misusers. Dr Hewett, a GP in Leicester, conducted regular audits to refine his approach and has now...

Study reveals fears over Beta-blockers in COPD unfounded.(Chronic Obstructive Pulmonary Disease)
September 13, 2004... COPD patients can safely take Beta-blockers and have been missing out on the drugs because of near-universal `misconceptions', a new study claims. Over 98 per cent of patients treated with the drugs not only tolerated them but were able to...