Pulse articles from September 2005

Pulse archives from September 2005

Commissioning in crisis as GPs and PCTs snub scheme.
September 3, 2005... Practice-based commissioning is floundering because GPs do not believe it is worth the risk and PCTs are paralysed with anxiety about their future, a Pulse investigation has revealed. The problems mean the Government's 2006 deadline for all...

GP finds A&E drive `has the opposite effect'.(Brief Article)
September 3, 2005... GP research has cast new doubt on the Government's drive to cut emergency hospital admissions after finding current policy could have the `opposite effect'. The pilot study of active case management - the Department of Health's flagship...

SSRIs in pregnancy link to birth defects.(Selective serotonin reuptake inhibitors)
September 3, 2005... New questions over SSRIs emerged at the International Society for Pharmacoepidemiology confererence - Daniel Cressey reports Confidence in SSRIs is set to take a further pounding after two new studies presented at a major international...

`I don't want fly-by-night salaried GP'.(Brief Article)
September 3, 2005... Dr Stuart Findlay is refusing to follow the trend towards hiring salaried GPs as he seeks to replace one of his partners. Dr Findlay said he does not want any `fly-by-night' salaried doctors at his rural practice in Haddenham, near Ely,...

Fears are reignited over fluoxetine for children.(Brief Article)
September 3, 2005... The US drug regulator has reignited the controversy over use of fluoxetine (Prozac) in children after finding that it does increase the risk of suicidal thoughts or behaviour. The Food and Drug Administration analysed data from 20...

No point in big QOF changes.(quality and outcomes framework)(Brief Article)
September 3, 2005... Minister have given the go-ahead to GPC and NHS Employers plans to make only minor changes to the quality framework for 2006/7. Department of Health officials told Pulse they believed there was `no point' in making radical alterations to...

Practice's shock at death of out-of-hours pioneer.(Brief Article)
September 3, 2005... Colleagues of a well-known GP found dead at a Welsh beauty spot, having apparently taken his own life, have spoken of their shock and sadness at his death. The body of Dr Paul Goodson, a GP in Pembroke Dock, Pembrokeshire, was found at...

Management of failure to thrive `needs reassessing'.(Brief Article)
September 3, 2005... Child health experts are calling for aggressive management of failure to thrive to be `reassessed' after finding the condition has few long- term ill effects. The researchers warned current practice could be doing `more harm than good'....

#13m scheme will tackle GP shortage.(Brief Article)
September 3, 2005... The Government has announced a #13-million-a-year scheme to help recruit GPs to under-doctored areas. Under the Primary Care Development Scheme, cash has been allocated to strategic health authorities according to the severity of shortages...

NEWS IN BRIEF: Access to computerised CBT.(Brief Article)
September 3, 2005... NICE has confirmed it plans to oblige PCTs to provide GPs with access to some forms of computerised cognitive behaviour therapy. The institute's final draft appraisal recommends Beating the Blues in mild and moderate depression and...

NEWS IN BRIEF: `Homoeopathy is bunkum'.(Brief Article)
September 3, 2005... The evidence on homoeopathy does not suggest anything above a placebo effect, researchers claim. A Swiss study, published in The Lancet this week, compared 110 trials of homoeopathy with 110 of conventional medicine. In both groups the largest...

NEWS IN BRIEF: OOH contract move slammed.(Brief Article)
September 3, 2005... The Wales Audit Office has condemned Cardiff local health board's decision to hand an out-of-hours contract to a company that had no experience of delivering the service. It condemned the board for not conducting sufficient background...

NEWS IN BRIEF: NICE to review BP guidance.(National Institute for Clinical Excellence)(Brief Article)
September 3, 2005... NICE is formally to review its hypertension guidance only a year after it was first published in light of the forthcoming publication of results from the ASCOT study. It has been in talks with the British Hypertension Society, as previously...

NEWS IN BRIEF: Policy for practice e-mails.(Brief Article)
September 3, 2005... Practices would have to reveal internal e-mails if they received a Freedom of Information Act request, new GPC guidance states. The GPC said the position meant it was essential GPs adopted a clear policy on retaining and deleting e-mails....

GPs win battle for extra Choose and Book cash.
September 3, 2005... GPs are set to be paid for using Choose and Book. The Government has said it wants GPs to be `supported' for taking on the controversial booking scheme as well as other Connecting for Health programmes such as the National Care Record. The...

GP's script audit picks out gaps in pain control.(Brief Article)
September 3, 2005... Dr Blair Smith believes a prescribing audit of his patients can act as a template for improving pain control in general practice. Dr Smith made changes in treatment to 77 per cent of patients at his former practice in Banff, near Aberdeen,...

Paracetamol may raise high BP risk.(Brief Article)
September 3, 2005... Use of paracetamol raises a woman's risk of developing high blood pressure, a US Government-funded study warns. The researchers said their findings had `substantial public health implications' and that widespread analgesic use `may...

Fears grow on sick doctor disclosures.(Brief Article)
September 3, 2005... GPs are continuing to raise concerns about the GMC's plans for wider disclosure of information about sick doctors. With consultation on the plans due to end on September 12, one GP said his career could be ruined if details of doctors'...

Trouble in store for GP's new surgery.(Brief Article)
September 3, 2005... Dr Stuart Saunders has accused Sainsbury's of leaving his practice `high and dry' after it shelved plans to build a new surgery as part of a store development. Dr Saunders said the practice in Dronfield, Derbyshire, wasted four years...

`Investigate new fees that could hit GP jobs'.
September 3, 2005... The BMA is demanding the pay Review Body investigate new charges for GP certification because of fears they will impact on recruitment. Potential GPs could face fees totalling #2,000 or more from next month when the Postgraduate Medical...

Tests that push up GP workload.(Brief Article)
September 3, 2005... GP workload is being pushed up by a growing market for unregulated and potentially dangerous screening tests aimed at `worried well' patients, the BMA is warning. It said private providers were increasingly targeting patients for...

COMING YOUR WAY: `SSRIs trigger adult suicides'.(selective serotonin reuptake inhibitors)(Brief Article)
September 3, 2005... THE STORY SSRIs can trigger suicide attempts in adults as well as children, the Times, Guardian, Daily Mail, Independent and BBC News Online report. THE SOURCE A Norwegian team analysed 16 trials of paroxetine (Seroxat) and found...

Self-monitoring cuts BP and GPs' consultations.(Brief Article)
September 3, 2005... Self-monitoring in GP surgeries can improve blood pressure control and cut consultation rates, a study reveals. Researchers said self-monitoring was popular with patients and urged GPs to offer it in their practices. The study,...

COMING YOUR WAY: `5-in-1 vaccine side-effects'.(used to treat diphtheria, tetanus, pertussis (whooping cough) and the bacterial infection haemophilus influenzae type B (Hib))(Brief Article)
September 3, 2005... THE STORY The new five-in-one vaccine can cause serious side-effects for up to a week, the Guardian claims. THE SOURCE A journalist gives a first-person account complaining that, as a parent, she was not warned that side-effects...

COMING YOUR WAY: `Coffee is good for you'.(Brief Article)
September 3, 2005... THE STORY Coffee in moderation is good for you, the Daily Mail claims. THE SOURCE The British Coffee Association, which represents coffee manufacturers in the UK, launched a campaign to promote benefits of moderate coffee drinking...

COMING YOUR WAY: `Bird flu is inevitable in UK'.(Brief Article)
September 3, 2005... THE STORY Bird flu will inevitably reach Britain, a clutch of newspapers including The Independent, Times and Daily Mail warn. THE SOURCE The president of the British Veterinary Association warned that avian flu would be carried...

Charge for missed appointments and remove the culprits, say GPs.(Brief Article)
September 3, 2005... Patients should be charged for missing appointments and removed from practice lists if they make it a habit, two-thirds of GPs believe. Research into DNAs showed patients missed more than 10 million GP appointments last year, a rise of more...

GPs' top approval rating.(Brief Article)
September 3, 2005... Patients are overwhelmingly satisfied with GP services, even though most do not believe they can get an appointment within 48 hours, separate opinion polls have found. A YouGov poll for the Daily Telegraph found 76 per cent of patients...

JOURNAL WATCH: RSV bronchiolitis raises asthma risk.
September 3, 2005... Infants who are hospitalised with RSV bronchiolitis are at increased risk of subsequent wheeze and asthma, a new study finds. UK researchers analysed outcome data from 150 children who had been hospitalised with RSV bronchiolitis as infants...

JOURNAL WATCH: Probiotics improve atopic dermatitis.(Brief Article)
September 3, 2005... Probiotics can improve the extent and severity of atopic dermatitis, an Australian study shows. Researchers randomised 53 children aged six to 18 months to a twice- daily eight-week course of Lactobacillus fermentum or an equivalent...

JOURNAL WATCH: High-risk screening fails in ovarian Ca.(Brief Article)
September 3, 2005... Annual screening for ovarian cancer in women at increased familial risk is ineffective at detecting tumours early enough to improve prognosis, UK researchers report. Their cohort study examined the effect of annual screening with...

JOURNAL WATCH: Regular aspirin cuts colectoral Ca risk.(Brief Article)
September 3, 2005... Regular, long-term use of aspirin can reduce the risk of colorectal cancer, US researchers conclude. The prospective study analysed data on 82,911 women from the Nurse's Health Study to examine the effect of aspirin on colorectal cancer...

JOURNAL WATCH: Antipsychotics raise hip fracture risk.(Brief Article)
September 3, 2005... Antipsychotics increase the risk of hip or femur fractures, a new study reveals. Dutch researchers analysed data on 44,500 patients from the UK general practice research database to explore the effect of antipsychotic use. Current and...

Study prompts call to avoid NSAID use with heart failure.
September 3, 2005... The safety of NSAIDs has been thrown into doubt once again after an analysis of UK general practice found the drugs raised the risk of hospitalisation for heart failure. The researchers said their results were particularly worrying for the...

Cochrane warning over child asthma.(Brief Article)
September 3, 2005... Beta2-agonists are `widely used inappropriately' in children's respiratory disease, the authors of a new gold standard review conclude. The Cochrane review found no evidence for using the drugs to treat cough in the absence of additional...

Symptom diaries pick out asthma.(Brief Article)
September 3, 2005... Dr Chris Woodforde gives parents special symptom diaries to ensure diagnoses of childhood asthma are based on the fullest possible information. The diaries have sections for details of day and night symptoms, treatment, smoking and...

Second MIs plummet but GP prevention remains uneven.(Brief Article)
September 3, 2005... Hospitalisations for second myocardial infarction are falling twice as fast as for first MIs, a new study reveals. The researchers, who will present their data at this week's European Society of Cardiology annual congress in Stockholm, said...

Why practices favour recruiting salaried GPs.
September 3, 2005... Job adverts for salaried GPs are far outstripping those for principals, research by Pulse has revealed - Ian Cameron talks to four GPs who have advertised in our jobs pages about their practice's recruitment reasoning UNCERTAINTY ON...

Letters: Was the GMC blundering or brave?(Letter to the Editor)
September 3, 2005... While anyone who is subject to the attention of the gutter press has my sympathy, I feel the GMC cannot be accused of making a `colossal blunder' (News/Comment, August 20) by publishing full details of an interim order against a GP. GMC...

EDITORIAL COMMENT: It's no time to erect barriers to being a GP.(Brief Article)
September 3, 2005... The most quoted recent statistic about general practice has to be the BMA and RCGP assertion that 10,000 more GPs are needed in the UK. Since it was uttered five years ago, GP numbers are up by around 3,500. But it is an influx that has merely...

Letters: Decline in partnerships a sorry sign.(Letter to the Editor)
September 3, 2005... As someone who is looking for partnerships to apply for (`Partner jobs reduced to a trickle', News, August 20), I have noticed a decline in the number of adverts. A few years ago salaried posts were being presented as a `wonderful' option,...

For the record: Inaccurate information about flu vaccine supply.(Brief Article)
September 3, 2005... Sanofi Pasteur MSD has asked us to correct inaccurate information it gave us about its flu vaccine supply (News, August 20). The correct information is as follows: - Orders for Inflexal V only: on schedule, no delays - Orders for...

Letters: GPs have free will over signing termination forms.(Letter to the Editor)
September 3, 2005... I was dismayed by a quote by Dr Dennis Abadi (`Vatican drawn into inquiry over GP's surgery move', News, August 20): `We cannot breach our terms of service.' He added: `Terminations could be a problem for them but we are legally obliged to...

Letter: Movicol safe in palliative care.(Letter to the Editor)
September 3, 2005... The article `Management of constipation in patients receiving palliative care' (Clinical, July 16) contains the statement: `(Movicol) contains electrolytes that can lead to disordered blood biochemistry when given regularly.' This implies...

ANDY JONES: The summer of our discontent?
September 3, 2005... Who said it's the quiet season? Andy Jones hears the distant sound of autumn's war drums In the summer it can often be a struggle for columnists to find something to write about. Not this year. The NHS finances seem to be in a right old...

Will pension review mean end of the good times?
September 3, 2005... NHS pensions are the gold standard but soaring deficits make reform inevitable - Dr John Couch looks at how tough the review might prove With the demise of most final salary company pension schemes, public sector pensions are now the gold...

Ill-health retirement.(Brief Article)
September 3, 2005... Your pension and lump sum are enhanced if you retire through ill-health before retirement. The amount of increase depends on how long you have already served and can only be increased to give a maximum 40 years' service. You can also have an...

Making the most of job planning for employed GPs.
September 3, 2005... Non-partners, whether they are salaried GPs, retainers or returners, need to know exactly what the extent of their duties are and a job plan is essential - Dr Paula Wright offers some timely advice All practices should have a clear job plan...

What's new in Paediatrics.
September 3, 2005... Dr Stephen Brearey and Professor Rosalind Smyth outline the latest research and breakthroughs relating to children 1 The changing nature of paediatrics Paediatrics is evolving with the changing health care needs of children in the 21st...

Journal shortcuts: gastroenterology.
September 3, 2005... Tired of wading through endless journals? Overwhelmed by too much evidence? In this series a GPwSI cuts to the bottom line on papers from recent months that will change the way they practise. This month, Dr Mark Follows looks at papers on...

GP's role in the health needs of refugees.
September 3, 2005... Patients who have fled torture in their home countries will be carrying many problems - Dr Peter Le Feuvre outlines what GPs can do to help The arriving asylum seeker may well have priorities other than health care, and may not address...

Advice for a consultation with an asylum seeker.(Brief Article)
September 3, 2005... FIND OUT how you are going to communicate and contact an interpreter if necessary. LISTEN as much as you can. The patient may be desperate to share his/her story - it may be the first opportunity he/she has had to do this. SPEAK...

ANSWER BACK: How long is malaria immunity retained?
September 3, 2005... Q: Our practice nurse says patients have immunity to malaria for two years after leaving their country but then lose it. Is this true? A: People who live and remain in malarious areas develop immunity against the disease after repeated...

ANSWER BACK: How long does Monospot stay positive?
September 3, 2005... Q: How long does the Monospot remain positive after glandular fever? A: The Monospot test (a quick version of the Paul Bunnell test) is not strictly a diagnostic test for glandular fever as it actually detects antibodies directed against...

Honey for ulcers and burns?
September 3, 2005... It can be hard to find effective treatments for ulcers, but Bandolier editors Dr Andrew Moore and Professor Henry McQuay look at recent studies that show honey might be worth a try There is logic to using honey to treat infected wounds and...

YOUR FIRST: Trip to see how district nurse works.
September 3, 2005... You may not get the full lowdown on her work, but there will be useful insights, says Dr Melanie Wynne-Jones Your trainer will probably arrange for you to spend some time with the district nurse (DN) as part of your induction in general...

CLINICAL CASEBOOK: Management of foot pain.
September 3, 2005... Case history Julie is a 34-year-old waitress in a busy restaurant. She is 5'5" tall and weighs 12 stone. She has been trying to lose weight by exercising for several months. She jogs twice a week and has lost about 4lb in the last month....

CAREERS: Don't leave your terms and conditions to chance.
September 3, 2005... In the second part of his series on locum work, Dr Robbie Coull looks at the business and practical aspects of the job It is advisable to send the practice a written confirmation or quote for the work that you plan to do, along with terms...

MPs/GPs CAMPAIGN UPDATE: GP tackles MP on access.(Brief Article)
September 3, 2005... As part of our campaign, Labour MP Sandra Osborne visited GP Dr David Stevenson's practice in Ayr The key message that Sandra Osborne took away when she became the first Labour MP to take part in the Pulse MP/GP visits campaign was the...

GPs set to face new checks on access.(Brief Article)
September 10, 2005... The Department of Health is to introduce a series of new checks on practices to force them to allow patients to book appointments more than two days ahead. Monitoring of 48-hour access is also to be tightened as part of a renewed clampdown...

ASCOT throws GPs into turmoil on hypertension.
September 10, 2005... GPs' treatment of hypertension is set to be revolutionised with this week's publication of the landmark ASCOT trial. The formal release of the data on The Lancet website has sparked intense debate over the future of o-blockers and diuretics...

The Anglo-Scandinavian Cardiac Outcomes Trial.(Brief Article)
September 10, 2005... Amlodipine/perindopril compared with atenolol/bendroflumethiazide in 19,257 hypertensive patients with at least three additional CVD risk factors. Patients in the amlodipine/perindopril arm had: * 16 per cent fewer cardiovascular...

Second study backs diabetes benefits of ACE inhibitors.(angiotensin converting enzyme inhibitors)(Brief Article)
September 10, 2005... Pressure is growing for new guidance on use of ACE inhibitors in patients at risk of diabetes after a second study joined ASCOT in pushing for wider use. Extended follow-up of the HOPE trial, published in Circulation, found long-term use...

GPs beat all predictions to score 959 QOF points.(quality of framework)
September 10, 2005... QOF figures for England released last week showed fantastic performances by GPs but also the difficulties faced by practices in deprived areas - Daile Pepper reports GPs exceeded all predictions by scoring an average of 959 points in the...

Case study: League tables are so misleading.(Brief Article)
September 10, 2005... Dr John Sullivan's practice is a perfect illustration of why GP league tables based on QOF results are misleading. According to the official statistics, his practice in North Bradford - supposedly the worst-performing PCT - scor-ed just...

Low scorers say figures are wrong.(Brief Article)
September 10, 2005... Two of the three PCTs with the lowest average QOF scores have hit out at the publication of the results. The official figures show North Bradford PCT averaged just 64.1 per cent of the total QOF points, far below the next lowest scoring...

Toughest targets are COPD and epilepsy.(Chronic obstructive lung disease)(Brief Article)
September 10, 2005... GPs found COPD, epilepsy and mental health the hardest clinical QOF targets to hit. In contrast, hypothyroid-ism, with performance close to 100 per cent on average, and coronary heart disease were easiest. Dr Mike Thomas, General...

GPs better at clinical than organisational.(Brief Article)
September 10, 2005... GPs performed better on the clinical section of the quality framework than on the organisational indicators, the QOF results show. Practices scored an average of 87.3 per cent of the 184 points on offer in the organisational section. This...

Wide gap between the leafy suburbs and inner-cities.
September 10, 2005... The quality and outcomes framework results for England clearly illustrate the contrast between general practice in affluent suburbs and rural areas, and deprived inner-cities. Rural and suburban PCTs dominated the highest-scoring regions....

News in brief: New bid to cut admissions.(Brief Article)
September 10, 2005... A new computer program released by the King's Fund can provide GPs with `early warning' lists of patients at highest risk of hospital admission. The software - made available to the NHS earlier in the month - allows PCTs to identify...

News in brief: BMA subscriptions increased.(British Medical Association)(Brief Article)
September 10, 2005... The BMA has increased its subscription rates for members by between 2 and 3 per cent. For the year from October 1, 2005, principals will pay #369, up 2.5 per cent on last year. Rates for doctors in the first year after qualification...

News in brief: Warning over PCT mergers.(primary care trusts)(Brief Article)
September 10, 2005... Frontline clinicians are at risk of being sidelined as a result of wholesale PCT mergers, the NHS Alliance is warning. Larger PCTs should have a clinical committee, on an equal footing with executive managers, to ensure GPs' and nurses'...

News in brief: Global sums fiasco lingers.(Brief Article)
September 10, 2005... GPs could have to wait months for corrections to their global sums after NHS IT experts botched their first attempt to clear up the mess. Practices have been underpaid or overpaid by thousands of pounds in some cases because of errors in...

News in brief: Chickenpox risk warning.
September 10, 2005... The Drug and Therapeutics Bulletin is calling for doctors to be alert to the risks of chickenpox in pregnancy. It warned that pregnant women who have not had chickenpox should avoid all exposure to those with chickenpox or shingles. It...

News in brief: Child respiratory deaths fall.(Brief Article)
September 10, 2005... Child deaths from respiratory illnesses have fallen faster than the overall decline in child mortality over the past three decades. In 1968 respiratory illness was responsible for 30.8 per cent of all deaths in children 28 days to 16 years...

Cholesterol target poised to fall to 4 in new guidance.
September 10, 2005... GPs face much tougher total cholesterol targets for secondary prevention of CHD under new draft guidelines. The Scottish Intercollegiate Guidelines Network has provisionally recommended a target of 4mmol/l for all adults with clinical...

Debate over drugs for heart failure.
September 10, 2005... A new trial has provoked fierce debate over which drugs should be used first in heart failure after directly `challenging' current practice. The Cardiac Insufficiency Bisoprolol Study III found initiating treatment with a o-blocker was at...

Three GPs on jury service proves trial for practice.(Brief Article)
September 10, 2005... Jury service call-ups for three partners already this year have played havoc with Dr Bill Tamkin's practice. Dr Tamkin, a GP in Withington, Manchester, said he had no objections to GPs being called up for jury service, but provision for...

55,000 follow-ups dumped on GPs.(Brief Article)
September 10, 2005... GPs in Surrey and Sussex are being forced to take on 55,000 follow-up outpatient appointments after an NHS trust cancelled them to save money. The change is part of a #17 million cost-cutting exercise by debt- ridden Surrey and Sussex NHS...

Coming your way: `Bug causing cot deaths'.(Brief Article)
September 10, 2005... The story A bug in mattresses may cause up to 50 per cent of cot deaths, the Daily Mail claims. The source A study to be published in the Journal of Applied Microbiology found Staphylococcus aureus could survive for long periods...

Counselling service for GPs deluged since new contract.(Brief Article)
September 10, 2005... A counselling service for GPs is under threat because it does not have the resources to cope with a massive increase in demand for its services. The PCT-funded service in Cornwall has run up a #28,000 deficit after being deluged with calls...

Coming your way: `Take olive oil for pain relief'.(Brief Article)
September 10, 2005... The Story Extra virgin olive oil works as well for pain relief as aspirin or ibuprofen, the Daily Telegraph and Daily Mail claim. The Source Scientists at the University of Pennsylvania found the main compound in olive oil -...

Coming your way: `Words can trigger asthma'.(Brief Article)
September 10, 2005... The Story Emotive words can trigger asthma attacks, the Guardian, Daily Mail and BBC News Online report. The source A US study, published in Proceedings of the National Academy of Sciences, found reading asthma-related words to...

Drug regulator reform `a missed opportunity'.(Brief Article)
September 10, 2005... GPs have joined a chorus of protest after the Government `shirked' its responsibilities and rejected proposals by MPs for wholesale reform of the drug regulatory system. The RCGP condemned the Department of Health's response to a report...