GP articles from April 2004

GP archives from April 2004

Call for uniform LES standards.(local enhanced services)
April 26, 2004... LMCs will demand that the GPC sets blanket UK standards for local enhanced services (LESs) at the LMCs conference in June. A motion from North Essex LMC reflects widely held concern over inconsistencies in how primary care organisations...

GP fights back.(self-defence training for health professionals)(Brief Article)
April 26, 2004... Northern Ireland GP Dr Sandra Elliott (right), who was attacked by thugs armed with baseball bats last year, is taking self-defence lessons funded by her primary care organisation. All staff at Dr Elliott's Omagh practice will take part in a...

GMS gains right to commission.(General Medical Services)(Brief Article)
April 26, 2004... GMS GPs as well as PMS GPs will have the option of commissioning services for patients, according to a source close to negotiations. Originally it was thought that practice-led commissioning would be available only to PMS GPs, but last...

Community pay fiasco is 'constructive dismissal'.(health care industry)
April 26, 2004... The GPC is considering whether the DoH's failure to discuss pay rises for GPs working for as little as pounds 3.50 an hour in community hospitals amounts to constructive dismissal. Repeated attempts by doctors' leaders to open UK-wide...

GPs make pharmacist partner.(Wallingbrook Health Centre)(Brief Article)
April 26, 2004... A PMS dispensing practice in Devon has taken on a pharmacist as a partner in what is believed to be the first agreement of its kind. Pharmacist Karen Acott, who has become a partner at the Wallingbrook Health Centre, in Chulmleigh, Devon,...

One GP in five could be hit by IT dispute.(general practitioners)(Brief Article)
April 26, 2004... One fifth of GPs in England could be cut off from the National Programme for IT (NPfIT) unless two of the government's regional IT contractors reach an accord with clinical systems supplier EMIS. Two of the NPfIT's five local service...

DoH is 'double counting' GPs.(Department of Health)(general practitioners)
April 26, 2004... Evidence of inaccurate supplementary lists and lack of cross-checking between PCTs is fuelling claims that double counting of GPs is artificially inflating DoH workforce figures. Primary care czar Dr David Colin-Thome claimed the DoH...

Runs in the family.(National Kidney Research Fund marathon)(Brief Article)
April 26, 2004... Dr Phil Yates, a Bristol GP, and seven of his siblings ran the London marathon to raise pounds 30,000 for the National Kidney Research Fund. Dr Yates, who completed the course in four hours and 38 minutes, said he wanted to support the...

Ovarian cancer linked to insulin growth factor.
April 26, 2004... High levels of a circulating insulin-like growth factor (IGF-I) could identify premenopausal women at high risk of ovarian cancer, Swedish research has suggested. The results showed that women with the highest levels of IGF-I had an...

Clinical image of the week.
April 26, 2004... Needle injections, as shown in close-up above, could soon be a thing of the past. Using the Star Trek approach, US researchers have developed a less painful gas injection. A stream of gas containing crystals of inert aluminium oxide is fired...

Research brief: Socioeconomics impact on heart failure.(Brief Article)
April 26, 2004... Researchers investigating socioeconomic status and treatment of 2,186 heart failure patients in Scotland found that prescribed treatment did not differ across the socioeconomic gradient. However, compared with affluent patients, those who...

Research brief: Pregnancy and future risk of metabolic syndrome.(Brief Article)
April 26, 2004... Women who suffer pre-eclampsia or hypertension during pregnancy are at increased risk of developing metabolic syndrome, according to Finnish research. The research showed that women who had been hospitalised for these conditions subsequently...

Research brief: Drop in antibiotic prescribing among children.(Brief Article)
April 26, 2004... Prescribing of amoxycillin, erythromycin and phenoxymethylpenicillin fell by 42, 62 and 47 per cent respectively, between 1993 and 2002. According to the data, presented at the Royal College of Paediatrics and Child Health annual meeting in...

Research brief: Knit your way to a trauma-free life.(tapping or knitting immediately following a traumatic event may help reducing trauma occurance )(Brief Article)
April 26, 2004... Clinical psychologists found that people who tapped out a sequence on a keypad while watching disturbing film scenes suffered fewer flashbacks than those who did nothing. The researchers, who presented the study at this month's British...

Inhaled steroids for milder asthma.
April 26, 2004... Inhaled steroids should be prescribed to people with milder asthma, according to recommendations from the British Thoracic Society (BTS). The updated guidelines, developed by the BTS in collaboration with the Scottish Inter- collegiate...

LMCs force crisis talks on out-of-hours.(Local Medical Committees)
April 26, 2004... Northern Ireland LMCS Conference - Concerns over out-of-hours arrangements and global sums LMCs in Northern Ireland held crisis talks last week with the region's director of primary care over fears that out-of-hours services will...

Enhanced funding will not stretch to LESs.(Brief Article)
April 26, 2004... GPs in Northern Ireland believe there will be no money for local enhanced services (LESs) in the region. The four health and social services boards are expected to commission three national enhanced services (NESs) on top of the six...

Calls for review of N Ireland funds formula.(demand to reduce wide variations in the level of funding per patient received by practices in Northern Ireland )(Brief Article)
April 26, 2004... GPs in Northern Ireland are demanding a revision of the region's allocation formula to reduce wide variations in the level of funding per patient received by practices. Some practices are believed to be earning more than double per...

Poor PCT planning puts enhanced funds at risk.(Primary Care Trust)
April 26, 2004... GPs fear funding for enhanced services is at risk after an Audit Commission report revealed that two thirds of PCT financial plans were unsound. The report, 'Achieving first-class financial management in the NHS', published last week,...

News Brief: Magazine offers allergy relief.
April 26, 2004... Allergy sufferers can now find relief through a magazine entitled 'A'. Allergy UK, Europe's biggest allergy charity, and London magazine publisher Electric INK have produced the magazine, which gives specialist advice on how to manage...

News Brief: Audit tool monitors glucocorticoid prescribing.
April 26, 2004... An electronic audit tool has been derived from the Royal College of Physicians (RCP) guidelines on oral steroid-induced osteoporosis. The GIOSCOPE aims to help doctors reduce the risk of osteoporosis and fractures in older people taking these...

News Brief: Practice accreditation document.
April 26, 2004... The RCGP Scotland and NHS Quality Improvement Scotland have published an updated version of Practice Accreditation. The document, 'Practice Accreditation 1A', aims to reflect the standards included in the new GMS quality framework. The advice...

News Brief: Guide to repeat prescribing.
April 26, 2004... The National Prescribing Centre has produced a guide for GPs that examines repeat prescribing and suggests how GPs can review the process. The guide, endorsed by the RCGP and the GPC prescribing subcommittee, also offers pointers to better...

News Brief: Examination simulator for prostate cancer.
April 26, 2004... Doctors are being pointed in the right direction in relation to prostate examination. Pfizer has created a model with four interchangeable prostate inserts that represent normal, enlarged, suspicious and cancerous prostates. It is hoped that...

Pledge to stamp out elder abuse.
April 26, 2004... The Healthcare Commission has pledged to stamp out abuse of the elderly, including over-sedation, following publication of a damning health select committee report. The 'Elder Abuse' report, published last week, documents widespread...

Pounds 850 appraisal fee per GP 'not enough'.
April 26, 2004... The GPC has warned that the DoH's planned pounds 850 per GP for appraisals is not enough. The DoH will provide pounds 17 million for GMS GP appraisals and pounds 13 million for PMS appraisals from July. GMS global sums will receive a...

GPs at centre of training reforms.(general practitioners)
April 26, 2004... Limited resources could hit plans to expose all trainee doctors to general practice, writes Asha Goveas Doctors in training are to have more opportunity to experience general practice first hand before choosing between hospital medicine...

Falls prevention pilot rolled out in England.(Healthy Communities Collaborative, care of the elderly)
April 26, 2004... A pilot scheme that reduced falls among the elderly by a third is being rolled out across England. Pilot schemes in Gateshead, Easington and Northampton offered a range of interventions targeting the over-65s. The schemes were...

Value of agency disputed.(National Health Service Professionals)(Brief Article)
April 26, 2004... A government agency designed to cut staffing costs in the NHS has cost more than pounds 50 million since its inception in 2000, but there is no evidence it has saved any money. NHS Professionals (NHSP) was set up to help cut the expense...

Warning on changes to death certification.
April 26, 2004... Changes to the death certification system will be undermined by a lack of willing and qualified GPs to do the work, the GPC has warned. Under government proposals unveiled last month, GPs and hospital doctors will be recruited as 'medical...

Timetable for learning from GMS mistakes.(General medical Services)(Brief Article)
April 26, 2004... The review of the GMS contract negotiations will come under scrutiny at this year's LMCs conference in June. The GPC has published a timetable for its response to the review, led by Dr Julian Neal, chairman of the GPC's primary care and...

Opinion: The bureaucracy freedom day.(health care industry)
April 26, 2004... A convenient - if unofficial - measure of our tax burden is the day in each year on which the average citizen stops working for the government and instead starts working for themselves. This 'tax freedom day' currently falls on 30 May. A...

Opinion: Death by a thousand requests.
April 26, 2004... 'Am I alright to go on holidays, doctor?' he asked. 'Yeah, you're fine,' I said, without looking up from my newspaper. 'Go, enjoy.' 'But you don't understand, doctor,' he said anxiously, 'I'm going to... Spain.' He spoke the last...

Opinion: Leader - GPs must not be blamed for the failings of others.(general practitioners)
April 26, 2004... Over the past couple of years GPs, and we in the GP press, have managed to pick plenty of holes in the new GMS contract. And in due course the GPC, the NHS Confederation, the DoH or some combination of all three have rushed to plug the gap...

Opinion: Leader - Training reforms promise too much.(Brief Article)
April 26, 2004... That all postgraduate medics should experience general practice as part of their training is one of those ideas it is hard to disagree with. Unfortunately it is also one of those good ideas that is almost impossible to deliver unless you...

GP Business: In Practice with... Dr Rebecca Torry, south London.(Interview)
April 26, 2004... Every week we profile GPs and their practices. This week Debbie Andalo travels to Bermondsey How did you start in general practice? I have wanted to be a doctor since I was about four, although I don't come from a medical family. As...

GP Business: How minor injuries NES will hit rural GPs.(national enhanced service)(general practitioners)
April 26, 2004... As part of our occasional series on enhanced services, Lucie Benson looks at the NES for minor injuries Under the new GMS contract treating minor injuries is now a national enhanced service (NES). The NES aims to enable GPs to take on...

GP Business: Understand the rules on when someone is self-employed.
April 26, 2004... Ask The Experts - GPs should be aware of the differences between being employed and self-employed, says Jenny Stone There are many reasons why the Inland Revenue would argue that individuals are employed as opposed to self-employed and...

GP Business: The merits of GP-led research.(general practitioners)
April 26, 2004... Research can play an important role in primary care, writes Dr Shahid Ali More and more GPs are becoming involved in research. While this is often because of a personal interest, the incentive-driven quality agenda has also highlighted...

GP Business: The new GMS contract and practice premises funds.(General Medical Services)
April 26, 2004... New GMS brings changes to how premises can be funded and developed, says Chris Acton Accompanying the new GMS contract there are significant changes to the way in which new premises can be developed and funded. The most important...

GP Business: Volunteers help reduce GP workload.
April 26, 2004... A service that aims to solve social problems benefits patients and GPs, writes Debbie Andalo Two Doncaster practices have seen consultation rates drop by 30 per cent after they recruited a team of volunteers to help patients find...

GP Business: Improving access for minority groups.
April 26, 2004... An interpreting service for ethnic minorities has led to a wide-ranging support system, finds Carol Davis When a Salford GP began pushing for funding to help the large number of local people from ethnic minorities who speak little...

GP Registrar: On different wavelengths.
April 26, 2004... You can improve consultations by changing the way you talk to patients, says Dr Jo Nicholl Have you ever had a consultation where everything seemed to go wrong? Where you and the patient seemed to be on different wavelengths? One...

GP Registrar: Guidelines - Part one.
April 26, 2004... Clinical guidelines are defined as 'systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances'. Guidelines should be practical, realistic and based on...

GP Registrar: What They Forgot to Tell You... McMurray's Test.(Brief Article)
April 26, 2004... The anatomical diagram illustrates the position of the menisci in relation to the tibial plateau and the femoral condyles. To perform McMurray's test for meniscal injury, the patient lies supine. The knee and hip are flexed to 45deg. One...

GP Net: Free Staff Intranet - No one misses out on messages.
April 26, 2004... As his intranet template is offered free to other practices, Dr Peter Crouch explains the thinking behind its development The staff and partners at my Taw Hill practice use IT extensively. We are a fairly computer literate bunch with a...

GP Net: Tip of the week 1 - Budget airlines - European cheap flight check for quick getaways.(Brief Article)
April 26, 2004... If you are planning on taking a short break in Europe, why not try travelling on a cheap flight? Enter your destination in the website at www.applefares.com and it will search a number of budget airlines for you saving you time and...

GP Net: Tip of the week 2 - Free firewall - Protect your PCs from outside interference.(Brief Article)
April 26, 2004... Mentioned in top tips some time ago, but still worth recommending, ZoneAlarm is apparently one of the most downloaded free software programs on the internet. It is easy to understand why - it provides your computer with a firewall, a...

GP Net: Learning more on colorectal cancer.
April 26, 2004... Dr Keith Barnard recommends websites relating to the Clinical Review (page 53). Visit gponline.com for live links to these pages. THE COMPLETE COLORECTAL CANCER - www.emedicine.com/med/topic413.htm Although I could find some UK...

GP Net: Unified diabetes care.
April 26, 2004... The benefits of joined-up diabetes care are clear, says Dr John Parry Diabetes patients are a group who find themselves moving between primary and secondary care, which can make tracking their records difficult. This is particularly...

GP Life: Food - Beef platter with an Italian edge.
April 26, 2004... Never mind the antipasti, beef was the biggest hit at Dr Chris Duckham's Italian evening I always find it interesting when guests are confronted by a large choice of dishes served as a buffet, as we recently did when we had friends round...

GP Life: Drink - Too many wines, not enough time.
April 26, 2004... With spring come wine tasting events, much to the delight of Dr Idango Adoki The arrival of tulips and daffodils proclaims that spring is here, although with the weather we get in this country it is sometimes hard to believe. However,...

GP Life: Working as a volunteer in western Nepal.
April 26, 2004... Volunteering in a gynaecology camp in Nepal was a rewarding experience, writes Dr Claire Stevens I arrived in Musikot, a small remote village in Western Nepal, last October to spend 12 days working in a gynaecology camp, which was...

GP Life: Swim for triathlon glory.
April 26, 2004... GP entrants in the London Triathlon can save 30% on specialist swimming training The swim leg of a triathlon is technically the most demanding. If you can lower your resistance as you swim, you will not only be faster but you will swim...

Plain Tales From The Surgery.(Brief Article)
April 26, 2004... Up in smoke Mindful of fulfilling my GMS contract clinical updates, I was asking every patient in a surgery about to their smoking habits. 'Do you smoke, sir'? I asked. 'Why, yes I do; would you like one?' he replied. ...

Black cohosh or dong quai.(menopause)(health care industry)
April 26, 2004... Mrs Flush, who had to be fitted in because she made a fuss at reception, comes to see me waving a fan and making a very big thing out of not having visited the surgery for almost a century. I take this as a subtle request for extra time...

GP Clinical: Behind The Headlines - Can oestrogen help breast cancer?(general practitioners)
April 26, 2004... The idea that oestrogen-only HRT may benefit breast cancer sounds too good to be true, writes Emma Baines What is the story? Earlier this month the national press reported that hundreds of thousands of women in the UK may have...

GP Clinical: Tackle type-2 diabetes more aggressively.(Irbesartan microalbuminuria type-2 diabetes mellitus in hypertensive patients)(National Service Framework )
April 26, 2004... Treating type-2 diabetes needs to focus on tackling cardiovascular risk factors, finds Dr Azhar Farooqi The close and common association between type-2 diabetes and hypertension produces severe problems for the cardiovascular system....

GP Clinical: Heel ultrasound and osteoporosis.(general practitioners)
April 26, 2004... Viewpoint - Heel ultrasound is a possible alternative to DEXA scanning for osteoporosis, writes Dr Jean Hodson Osteoporotic fractures are a source of considerable mortality, morbidity and cost. The need to identify individuals at high...

GP Clinical: Part 15 - foreign bodies in eyes.(general practitioners)
April 26, 2004... 1. Examination Use a good light The eye should always be examined carefully with a bright light. One with a good magnifying lens will prove to be an asset. Most foreign bodies will either lodge under the upper eyelid or in the...

GP Clinical: At a Glance - Systemic sclerosis or scleroderma.(general practitioners)(Brief Article)
April 26, 2004... Definition - A chronic disease of an unknown cause. - Main characteristics are diffuse fibrosis, degenerative changes and systemic vascular damage of the skin (scleroderma) and internal organs. Epidemiology - Forty per cent...

GP Clinical: The Good Old Days - Trephining the skull.(general practitioners)(Brief Article)
April 26, 2004... When trephining the skull, if there is sufficient time to prepare, a day or two beforehand the area of the scalp to be drilled should be shaved and repeatedly washed with hot soap and water. It should then be rendered aseptic by scrubbing...

GP Clinical: Injecting knees, fungal toes and HPV.(general practitioners)(Human Papilloma Virus )
April 26, 2004... Journals Watch - No time to check up on research? Allow Dr Honor Merriman to summarise Do knee injections work? - BMJ 2004; 328: 869 I tend to avoid giving patients intra-articular steroid injections, partly because I am not sure how...

GP Clinical: An introduction to Kawasaki disease.(general practitioners)
April 26, 2004... The Basics - Kawasaki disease, an acute febrile illness, may be on the rise in the UK, writes Dr Roo Tindall Kawasaki disease is an acute febrile illness that is unresponsive to antibiotics and usually occurs in infants and children under...

Gap between GMS and PMS income narrows.(General Medical Services)(Brief Article)
April 19, 2004... The gap between GMS and PMS earnings has narrowed by almost 20 per cent in the past year, according to a survey by specialist medical accountants. GMS practices earned an average of pounds 85,037 per partner, compared with pounds 97,197...

GP vacancies on display in Jobcentres.(Brief Article)
April 19, 2004... GPs hoping to move up a rung on the career ladder can now peruse vacancies at their local Jobcentre. Advertisements for salaried and out-of-hours posts paying up to pounds 110,000 are appearing in Jobcentres across England. NHS...

Opted-out GPs lose on goodwill change.
April 19, 2004... GPs who opted out of 24-hour responsibility unaware of potential earnings from the sale of goodwill may be able to reverse their decision or claim compensation, solicitors believe. As many as 4,000 GPs may have opted out from 1 April....

GP on his hobby horse.(charity work)(Brief Article)
April 19, 2004... Middlesbrough GP Dr John Blakey has found an unusual way of raising money for his local hospital: crafting a rocking horse to be raffled for the benefit of the James Cook University Hospital. 'It took longer than anticipated - 18 months...

Members to decide on new structure for BMA.(British Medical Association)
April 19, 2004... The BMA has launched a consultation paper asking its members to choose between three possible new organisational structures for the professional body. The paper, drawn up by Dr John Canning, chairman of the governance committee, and Dr...

Practice pays for own computer system.(Brief Article)
April 19, 2004... Dr Malcolm Willis's practice in Norwich, Norfolk, recently paid pounds 10,000 for a new computer system because it had no confidence in its PCT to upgrade the practice to the level required for the new GMS contract. Dr Willis told GP: 'Our...

NICE eczema advice criticised.
April 19, 2004... Clinicians and patient groups have criticised NICE for advising against the use of the topical immunomodulator pimecrolimus (Elidel) in the treatment of atopic eczema. Pimecrolimus is licensed for first-line treatment of mild-to-moderate...

Primary care focus for postgraduates.(physicians)(Brief Article)
April 19, 2004... Plans to increase all doctors' experience of general practice before registration have been welcomed but there are fears the scheme may fail due to a lack of training capacity. Doctors in training will be able to choose placements in...

Nine on default contracts.(physicians)(Brief Article)
April 19, 2004... Only nine GMS practices in England are on default contracts because they failed to sign the new GMS contract by 1 April, the DoH has revealed. The DoH's primary care czar Dr David Colin-Thome said that he expected these practices to sign...

GPC stands by its partnership model decision.(General Practitioners committee)(Brief Article)
April 19, 2004... The GPC has defended its decision to issue a detailed checklist rather than a model for partnership agreements as instructed by the 2002 LMCs conference. In a statement, the GPC said: 'Our lawyers have informed us that this would be...

PCTs have ignored NSF for diabetes.
April 19, 2004... The 'soft-touch' approach of the diabetes NSF means some PCTs are still not prioritising the disease one year after the standards document was published. The DoH report, 'NSF for Diabetes - one year on', published earlier this month,...

UVA rays 'more harmful' than UVB.
April 19, 2004... Exposure to UVA radiation may be more likely to promote the development of skin cancer than exposure to UVB, according to an international study. The researchers found that cancer-causing DNA mutations in stem cells in the deepest layers...

Clinical image of the week.(bowel cancer)(Brief Article)
April 19, 2004... Patients need to become more aware of the symptoms of bowel cancer, according to Colon Cancer Concern. Results from the charity's patient survey showed that fewer than a third of bowel cancer patients acted on their symptoms within a month,...

Research brief: Non-invasive bowel cancer test.(Brief Article)
April 19, 2004... Austrian researchers have developed a test for colorectal cancer that detects a particular genetic alteration in stool samples. The test correctly identified patients who had colorectal cancer with a sensitivity of 77 to 90 per cent, and a...

Research brief: Measuring BP in under-35s could lead to misdiagnosis.(Brief Article)
April 19, 2004... UK research has revealed that measuring blood pressure in men aged 16 to 34 years only had a 31 per cent positive predictive value. The author suggests that routine measurement of blood pressure in under-35s is more likely to lead to...

Research brief: Gout risk and alcohol consumption.(Brief Article)
April 19, 2004... US researchers examined alcohol consumption and development of gout prospectively in 47,000 men over 12 years. They found that drinking up to 15g of alcohol a day increased gout risk by 30 per cent, rising to 250 per cent for those drinking...

Research brief: Risks and benefits of oestrogen-only HRT.(Brief Article)
April 19, 2004... Latest data from the Women's Health Initiative shows that women taking conjugated equine oestrogen 0.625mg daily had a 39 per cent increased risk of stroke and a 34 per cent increased risk of pulmonary embolism after 6.8 years follow-up....

Research brief: IVF success subject to seasonal variation.
April 19, 2004... Only 16 per cent of IVF treatments resulted in a successful pregnancy during winter compared to 20 per cent between May and September, according to research presented to the British Fertility Society conference in Cheltenham last month. In...

DoH to meet 2,000 extra GPs target.(Department of Health)(Brief Article)
April 19, 2004... The DoH has achieved its NHS Plan target of 2,000 extra GPs by this month, according to the government's primary care czar. Headcount figures included in the DoH primary care progress report, A responsive and high-quality local NHS,...

Regions divided on GP hospital pay.
April 19, 2004... GPs in Wales, Scotland and Northern Ireland will split from UK-wide negotiations over community hospital pay. GPs are beginning to quit working at community hospitals altogether, following the failure to reach any agreement during the new...