GP articles from April 2012

GP archives from April 2012

Clinical: Journals Watch - Stroke, BP and antidepressants.(briefs)(Report)
April 25, 2012... Too busy to read the journals? Let Dr Tillmann Jacobi bring you up to date with the latest research. - Predicting haemorrhagic stroke with the SICH score Stroke 2012 doi: 10.1161/STROKEAHA.111.644815 IV thrombolysis for the treatment of...

Clinical: The basics - Herpes simplex virus.(Report)
April 25, 2012... The diagnosis can be made clinically when typical lesions are present, says Dr Harry Brown. Herpes simplex virus (HSV) types 1 and 2 cause infections of the skin and mucous membranes and can affect several organs, resulting in a variety of...

MedEconomics: GMS Regulations - Know the patient removal rules.(General Medical Services)
April 25, 2012... When it is right and wrong for practices to eject patients from their registered list. Removing patients from the practice list is a problem most GPs have to grapple with during their career. Doing it right can make the difference between...

MedEconomics: Care Quality Commission - Start preparing for CQC registration.(Care Quality Commission)
April 25, 2012... With the first stage in CQC registration three months away, how prepared are you? The time is fast approaching for providers of NHS general practice and primary medical services in England to register with the Care Quality Commission (CQC)....

Commissioning: Data - How Data Can Transform Care
April 25, 2012... How Bexley Care Trust uses data to improve patient care. Bexley Care Trust is part of the NHS South East London cluster and commissions health and social care to around 220,000 patients in the London borough of Bexley. The trust is widely...

Opinion: The Gift That Lingers in the Handshake
April 25, 2012... All actions are ultimately self referential, observed Spinoza, and though he wasn't a GP, he knew what he was talking about. We like to think that gifts from our patients are a symbol of generosity and gratitude, a sign that our relationship...

Opinion: A bump in the night unites everyone.
April 25, 2012... It is late, and I am alone. The Commando, upon whom one might usually call in such circumstances, is away in a pirate-infested swamp rescuing small children from crocodiles. My immediate neighbours are long since deceased, as we're in a...

Clinical Review: Turner syndrome.
April 25, 2012... Contributed by Dr Raja Padidela, paediatric endocrinologist, Royal Manchester Children's Hospital, and Professor Peter Clayton, professor of child health and paediatric endocrinology, University of Manchester. Section 1: Epidemiology and...

Clinical: Questions on osteoporosis.
April 25, 2012... Our clinical review on osteoporosis (GP, 7 March) led GP Dr Rajiv Ghurye to ask these questions. Dr Mark Cooper, the author of the review, has the answers. Q: There is an increased risk of atypical femoral fractures after five years of...

GPs can use CCG role to cut health inequalities.
April 25, 2012... Improving public health and tackling health inequality will be key to meeting QIPP challenge. GP commissioners 'cannot afford' to ignore health inequalities as the NHS battles budget cuts and must take the chance to improve public health,...

GP Diary.
April 25, 2012... - GLASS HALF FULL If you're feeling down because of yet more NHS restructuring, a five-year freeze in GP pay, gloomy weather and the price of stamps about to rocket, then prepare for more bad news. People with a pessimistic view of life have...

CCG finance system deal triggers GP concerns.
April 25, 2012... DH signs deal worth pounds 15m a year that will impose finance system on commissioning groups. GPs could face more missed payments following a pounds 15.38m per year deal that will force clinical commissioning groups (CCGs) to outsource their...

GPs predict more financial pressure.
April 25, 2012... More than 90% of GPs believe financial pressures will increase in the next five years, a survey has revealed. Of 167 GPs surveyed between October 2011 and January 2012, 91% expected financial pressures to increase. A total of 73% of the...

Latest Clinical Research: Physical activity may stave off dementia, study finds.
April 25, 2012... Staying physically active may protect against dementia and general cognitive decline, a US study suggests. Adults who remained active halved their risk of developing cognitive decline and Alzheimer's disease, researchers found. They believe...

Research brief.
April 25, 2012... The spice of life The curry spice turmeric may help prevent MI after bypass surgery, according to a study of 100 patients. Researchers believe the antioxidant and anti-inflammatory effects of curcumins, the yellow pigment in turmeric, may...

Public health reforms may disrupt vaccinations.
April 25, 2012... Advisers warn government may be unable to identify and tackle problems with immunisation. Government advisers have warned that public health reforms could disrupt vaccination plans in England. Experts raised concerns about the transition...

DH advice to cut cancer delays.
April 25, 2012... The DH has published guidance to help GPs decide which patients to send to direct access cancer scans with the aim of cutting delays in diagnosis. The advice from the DH's Cancer Diagnostics Advisory Board sets out when GPs should consider...

GPs 'must always consider cancer', says RCGP expert.
April 25, 2012... Professor Greg Rubin will lead the drive to bring cancer care to the forefront in primary healthcare. Detecting cancers earlier remains one of the toughest goals for general practice. So when the RCGP asked Durham University's Professor...

Editorial: DH must explain how telecare saves pounds 1.2bn.(Editorial)
April 25, 2012... Last month, care services minister Paul Burstow said telecare and telehealth 'could save the NHS up to pounds 1.2bn over five years'. It would seem common sense that the ability to deploy the latest technology in the NHS would result in both...

Opinion: It's time to rethink the cost of OTC prescriptions on the NHS.
April 25, 2012... Although the NHS is supposed to be free there are many areas where this principle is ignored. Prescription charges apply in England; the exemption strategy is complicated and unfair, and patients acquiring OTC drugs have to pay in full, even...

Opinion: Tales from the black tower.
April 25, 2012... The bit that made me laugh is that everybody is concerned that some GPs will commission services from companies in which they have an interest. Lo and behold - the NHS Commissioning Board has given the support gig to a company that it part...

Opinion: Money talks.(value of surgery partnership)
April 25, 2012... I heard from a client who has just retired from his partnership. He is expecting the surgery to be valued at pounds 900,000, giving him a modest gain, enough to cover the outstanding loan on the property. The valuation, from a respected firm...

Opinion: From the editors.
April 25, 2012... Do we need the Health Act? It may be a question for a different blog but I ask because there's no doubting the coalition government wants to build on the best of the NHS and improve what it is: a national health service of which we can be...

Plain Tales from the Surgery.(Brief article)
April 25, 2012... - Dorothy has the answer A 38-year-old man with Down's syndrome was brought to surgery by his worried mother who said that he thought he might die due to his heart. He repeated after her 'might die' and added: 'Might have a broken heart.'...

Exclusive: GPs demand telecare savings evidence.
April 25, 2012... Fears telecare may increase work as DH refuses to explain pounds 1.2bn saving claim. Investing millions in telehealth could add to GP workload without benefiting patients, the GPC has warned, after the DH refused to explain its claim that the...

RCGP hails 'momentous' move to four-year GP training.
April 25, 2012... The RCGP hailed a 'momentous day' after Medical Education England (MEE) backed its call to extend GP training to four years. The college called for the extra year as part of a training programme with 'extra focus on the key clinical,...

GPs face huge expansion of flu jab campaign.
April 25, 2012... DH advisers consider plan to add millions more patients to annual flu immunisation scheme. GPs face having to immunise millions more people against flu as DH advisers consider plans to extend the annual flu programme and boost uptake among...

Out-of-hours care improving, report finds.(Brief article)
April 25, 2012... Variation in the cost of out-of-hours services is falling and standards are on the rise, a groundbreaking report shows. The Primary Care Foundation report was published last week along with an online benchmarking tool comparing cost, quality,...

Terminally ill doctor turns author.(Kate Granger)(Brief article)
April 25, 2012... A third-year elderly medicine registrar with terminal cancer has urged GPs to read a book she wrote about her experiences on the receiving end of healthcare. Dr Kate Granger, a 30-year-old Wakefield doctor, has been diagnosed with a terminal...

GP language checks to be duty of responsible officer.
April 25, 2012... GPs back DH plan to extend responsible officer role but warn that extra support will be required. GP leaders have backed plans to extend the role of responsible officers (ROs) to cover checking overseas doctors' language skills but warned...

GMC campaign to contact GPs.
April 25, 2012... The GMC has launched a campaign to contact the remaining 54,000 UK doctors who have still not confirmed their 'designated body' for revalidation. For GPs this means the primary care organisation which manages the performers list they are on:...

QOF should link to patient benefits not GP workload.
April 25, 2012... GPC defends targets after study by member of NICE QOF team criticises failure to link pay to health benefits. Primary care could be made more efficient if QOF points were linked to patient benefits rather than GP workload, research by a...

GPonline's new blog for CCGs.
April 25, 2012... The days of practices' 'peripheral involvement' with management are long gone, according to National Association of Primary Care chairman Dr Charles Alessi. Launching GPonline.com's Inside Commissioning blog, Dr Alessi writes: 'Clinical...

Opinion: Let's get naked to save the NHS money.(national health service)
April 18, 2012... One of the unwritten rules of general practice runs thus; the longer it takes for a patient to disrobe, the less likely there is to be any significant clinical finding. There is obviously a huge cost implication for the NHS here. Instead of...

Opinion: Frozen out by my dramatic conviction.(Column)
April 18, 2012... A trip to Camden one chilly day finds us queuing for ice cream. This is no ordinary ice cream. It is made instantly, in a bowl, via the liberal application of liquid nitrogen to custard. People, blue with cold, are queuing to pay. The...

The Basics: The management of vertigo.
April 18, 2012... Ask the patient to describe their experience and duration of sensation. Vertigo or dizziness is a very common complaint and affects many individuals at least temporarily at some point during their lifetime. Patients and healthcare...

Clinical: RA and smoking - a joint problem.
April 18, 2012... Dr Helen Harris conducted a survey investigating awareness of the link between RA and smoking. We are all familiar with the association between smoking and heart disease and lung cancer. However, the impact smoking has on the development of...

MedEconomics: How to ... Ask questions about research.
April 18, 2012... Professor Rodger Charlton explains how research can be undertaken by GPs in everyday practice. We talk a lot about evidence-based medicine and guidelines as if they were set in tablets of stone and unchangeable. But we should remember they...

Commissioning: What CCGs should know about social enterprises.(clinical commissioning groups)
April 18, 2012... In the new health and social care landscape, the social enterprise sector could be taking on a significant role in the provision of services. The passing of the Health and Social Care Act - the largest upheaval to our health system in recent...

Commissioning: Viewpoint - CCGs need to stand up to the NCB.(clinical commissioning groups)(national commissioning board)(Column)
April 18, 2012... Paul Corrigan on what happens next with commissioning now the Health Act has become law. The Bill is now an Act and the struggle over its passage will now become a struggle over its implementation. Now the Bill is an Act, the important...

Clinical: Journals Watch - Breast cancer and migraines.
April 18, 2012... Not had time to read all of the journals? Let Dr Louise Newson bring you up to date on the research. - No definitive evidence that HRT causes breast cancer J Fam Plann Reprod Health Care 2012; 38: 102-9 Many women and healthcare...

Clinical: Clinical Review - Pneumonia.(Brief article)
April 18, 2012... Contributed by Dr Simon Barry, consultant chest physician, University Hospital Llandough. Section 1: Epidemiology and aetiology This review considers community-acquired pneumonia (CAP), which does not include chronic bronchitis, infective...

MedEconomics: What GPs should know about leases.(general practitioners)
April 18, 2012... There are several pitfalls regarding leases that GPs need to be aware of, explains Angela Hardman. A lease is a binding contract and, once concluded, cannot be altered without the landlord's consent, so it is important to ensure the terms...

Plain Tales from the Surgery.
April 18, 2012... - The two sides of stress A 22-year-old student came to see me, worried about her two-week history of back pain. This had appeared following many arduous hours at her desk working on a dissertation. Acknowledging her despair I probed...

Rapid steroid dose cuts admissions for asthma.
April 18, 2012... Study shows that corticosteroid within 75 minutes of asthma attack cuts hospital admissions by 16%. Hospital admissions for asthma can be reduced by providing systemic corticosteroid treatment within 75 minutes of attack onset, research in...

Release of risk register is still essential, GP leaders believe.
April 18, 2012... DH blocking release of risk register despite damning tribunal report as GPs demand openness. Forcing the DH to publish the NHS risk register is crucial because changes can still be made to the 'contradictory' Health Act, GP leaders have...

Choice of cancer test can boost compliance.
April 18, 2012... Study finds patients 45% less likely to adhere to screening when they are offered colonoscopy alone. Failing to offer a choice of faecal occult blood (FOB) testing alongside colonoscopy may deter patients from completing bowel cancer...

Mobile team aids stroke treatment.
April 18, 2012... Mobile stroke teams could speed up access to life-saving treatment by assessing patients at the scene of a suspected stroke, research suggests. Specialised ambulance teams halved the time between the patient sounding the initial alarm and a...

Latest Clinical Research: ECG readings would improve cardiovascular risk scores.
April 18, 2012... ECG readings can provide better predictions of CHD risk than traditional risk factors and should be added to profiling tools, researchers believe. AF, left ventricular hypertrophy and other ECG abnormalities double CHD risk among elderly...

Flu patches may replace jabs to allow self delivery.
April 18, 2012... Patches covered in tiny needles could replace current methods for delivering flu vaccines, and allow self-delivery of flu jabs, US scientists believe. Dr Ioanna Skountzou and colleagues from Emory University in Atlanta, Georgia, found that...

Research briefs: Diabetes and shift patterns.
April 18, 2012... Shift patterns should change monthly, rather than every few days, as disruptions to individuals' body clock increase the risk of diabetes, US researchers have argued (Science Translational Medicine Online 2012). -------------------- Did...

Research briefs: Intelligence and sick leave link.
April 18, 2012... There is a link between low intellectual ability and long-term work absence, with intelligent people taking less sick leave, a UK study involving more than 23,000 people suggests (BMJ Open Online 2012). -------------------- Did you find...

Technology drives expansion in GP-led research.
April 18, 2012... Simple tool driven by Read codes in patient records simplifies gathering of data within GP practices. Electronic tools driven by codes in patient records could trigger an expansion in GP-led research, a UK study suggests. Researchers...

Diabetes patients missing BP targets.
April 18, 2012... Half of people with diabetes are not meeting BP treatment targets, analysis by Diabetes UK has shown. Diabetes UK analysed data from the National Diabetes Audit to show that just 50.7% of people with diabetes met their BP target. The...

Fears growing over the freedom of CCGs.(clinical commissioning groups)
April 18, 2012... Details of reforms emerging, but gaps remain. With the authorisation process for clinical commissioning groups (CCGs) due to start this summer, GP leaders remain concerned that the groups will be denied genuine freedom to make their own...

RCGP in talks about UK-wide NHS plan.
April 18, 2012... RCGP wants all four UK governments to adopt 10 core values for the NHS. RCGP leaders will press the four UK governments to adopt a shared vision for the NHS at meetings over the next year. College chairwoman Dr Clare Gerada and her...

Opinion: Ballot box.
April 18, 2012... Take part in our daily polls at GPonline.com. Results from recent polls include: Should GP training be extended to four years? No 39% Yes 61% Source: GP -------------------- Did you find this article useful? Why not subscribe...

Letters: GPs cannot stop some patients going to A&E.(Letter to the editor)
April 18, 2012... Well, here we are, relaxing for a day after the March madness to befriend all our diabetic and gasping patients for every priced or prized item of information. Moving on, I see that this year we now have 47.5 QOF points for reviewing and...

Letters: Lansley's boundary idea is virtually unworkable.(Letter to the editor)
April 18, 2012... I write in response to 'GPs slam 'pathetic' boundary funding' (GP, 11 April). Regardless of how Andrew Lansley dresses this up, it is virtually unworkable and designed only to remove the monopoly of general practice. This, in turn, will turn...

Letters: We GPs must make the most of commissioning.(Letter to the editor)
April 18, 2012... In response to 'Why commissioners need legislation' by Dr Stewart Findlay (GP, 21 March) - at last somebody whose views I completely agree with. No doubt the future is going to be tough but if the GP community rises to this challenge it can...

Editorial: National approach to public health is needed.(Editorial)
April 18, 2012... The debate about whether a national flu advertising campaign is necessary has divided doctors. There is little evidence to suggest national campaigns increase vaccine uptake among at-risk groups However, a recent review of England's response to...

Opinion: Prescription charges ruin the 'from cradle to grave' ethos.
April 18, 2012... Although I'm a firm believer in the free market, I'm definitely a socialist as far as the NHS is concerned. I have always supported the welfare state as being 'from cradle to grave', consistently objecting whenever this principle is in danger....

Opinion: Tales from the Black Tower.
April 18, 2012... There is a lot riding on the NHS Commissioning Board. The good news is, it has great experience in running the NHS, good pace setting, and is already running the NHS. The same team which fired the starting pistol and most of the PCT staff with...

Opinion: Money Talks.
April 18, 2012... You can learn a lot from the accounts, looking at the movements in the net current assets can point towards a potential acute shortage of cash, and also highlight an underlying trend towards a chronic problem. -------------------- Did you...

Opinion: From The Editors.
April 18, 2012... I remembered a conversation with former health secretary John Reid about his frustration with a media which concentrated on the one in a million p+/-+/-roblems with the NHS, at the expense of the everyday stories of professionalism and...

Exclusive: Public health reforms 'put lives at risk'.
April 18, 2012... Warning as report links policy changes to rise in flu deaths after pandemic. Poor health emergency plans are putting lives at risk, experts have warned after a report found DH failures in the last flu season may have caused hundreds of...

Exclusive: GPs face five-figure losses over unpaid LES work.
April 18, 2012... Partners forced to stop drawing income as PCT clustering leaves practices thousands out of pocket. Practices may be unable to recoup thousands of pounds in unpaid enhanced services fees because of PCT reorganisations, accountants have warned....

Boundary pilots could force service cuts.
April 18, 2012... PCTs could be forced to cut services or bust their budgets due to cost pressures caused by DH practice boundary pilots, LMCs have warned. The warning came as a poll of 2,000 patients suggested 19% would move practice if they could and 10%...

Hospital discharge hits GP workloads.
April 18, 2012... Patients must be discharged from hospital with a wrap-around care package that does not rely on a GP home visit the next day, GPs have warned. The warning came after a study found that thousands of patients were discharged in the middle of...

Exclusive: Call for GP-led NHS 111 to be linked to out-of-hours.
April 18, 2012... DH urged to consider national roll-out of Derbyshire model of joined up out-of-hours and NHS 111. Ministers should consider the national roll-out of a combined NHS 111 and out-of-hours service led by local GPs in England, LMC leaders believe....

RCGP to boost GP cancer diagnosis.
April 18, 2012... GPs will be helped to improve early cancer diagnosis by a five-year programme launched this week by the RCGP and Cancer Research UK. The joint project, part of the college's new 'enduring priorities' programme, will focus on plans to improve...

GP wins North Pole Marathon.
April 18, 2012... A GP braved -26degC temperatures to win a North Pole marathon, becoming the first Scottish winner of the event. Aberdeen GP Dr Andrew Murray, who ran from John O'Groats to the Sahara Desert in 2010 to raise money for the Yamaa Trust, beat 41...

Exclusive: LMCs demand GP power to sack CCG boards.
April 18, 2012... Pensions, CCGs, workforce and revalidation among issues set to dominate 2012 LMC conference. GPs should have the power to sack clinical commissioning group (CCG) boards if they underperform, GP leaders will argue at this year's UK LMC...

GP Diary.
April 18, 2012... LEAD ON, LANSLEY Troubled by Andrew Lansley's effect on the NHS? It may be for reasons other than his reforms. According to Norwegian scholar Professor Jan Ketil Arnulf, 'there are few things more dangerous than leadership'. His book What Is...

Opinion: Negotiating the GP minefield can be very tricky.
April 11, 2012... War gets a bad rap, but there's a bright side; the poetry, the feature films, meeting babes at anti-war marches and the wisdom gained from young men dying like flies can help us navigate the minefield of family practice. Hold your friends...

Opinion: Superstition can be useful as well as useless.(Column)
April 11, 2012... Superstitions can be useful. I can't omit my statin, says Mrs Lucky who has been vomiting and has now therefore taken six and needs some more. She believes a day without might be the final straw, because it would be just her luck. And I realise...

MedEconomics: How to ... Manage staff absenteeism.
April 11, 2012... It is wise for practices to have policies to mitigate the impact of staff absence, writes Fiona Dalziel. Practices tend to be small businesses and staff absences can have considerable impact. Absences tend to group into one of the...

Clinical: Miner's knee.
April 11, 2012... Dr Emma Lackey and Mr Ron Sutton explain how patients can access industrial injuries disablement benefit. Miner's knee is an osteoarthritis (OA) of the knee, which became a prescribed disease in July 2009. Prescribed diseases are occupational...

Clinical: The basics - The management of rosacea.(Disease/Disorder overview)
April 11, 2012... Identifying and avoiding triggers for rosacea should reduce its severity, writes Dr Nigel Stollery. Acne rosacea is a common chronic skin condition which presents as facial flushing and erythema and is exacerbated by triggers such as alcohol,...

Clinical: Journals Watch - Incontinence and sinusitis.(briefs)
April 11, 2012... Not had the time to read all of the journals? Let Dr Gwen Lewis update you on the latest research. - Prevalence of urinary incontinence after labour BJOG 2012; doi.10.111/j1471-0528.2012.03301.X Urinary incontinence is a common...

Clinical: Clinical Review - Pancreatic cancer.
April 11, 2012... By Dr Shanthini Crusz, senior house officer, Dr Louise Lim, specialist registrar, Dr Thorsten Hagemann, consultant medical oncologist, and Dr Sarah Slater, consultant medical oncologist, St Bartholomew's Hospital, London. Section 1:...

Plain Tales from the Surgery.
April 11, 2012... - WD-40 for the joints I was asked recently by a patient how the steroid joint injection worked. After a long explanation of the steroid's anti-inflammatory effect on the articular surface, the patient concluded: 'So it's WD-40 for the...

Clinical: Moles.
April 11, 2012... Benign compound naevus This is a common pigmented lesion that is frequently responsible for patient concern. Although most patients are aware that moles represent a significant risk, they often also associate itching with the possibility of...

GPs slam 'pathetic' boundary funding.
April 11, 2012... Practice boundary abolition pilots to earn just pounds 12.93 per consultation fee. GP leaders have accused the DH of 'trying to get GPs on the cheap' by offering just pounds 12.93 per consultation for practices taking part in its delayed...