GP articles from August 2008

GP archives from August 2008

Opinion: How sea birds taught me a lesson about life.
August 22, 2008... I'm on the southern coast of Ireland trying to chill out, and it's been a magical day. Early this morning I was whale watching. Our skipper had that sea-weathered, ruddy-faced worthiness that makes deskbound people like me feel totally...

Opinion: Suffolk general practice reminds me of Kenya.
August 22, 2008... A great deal is said about leopards and spots, and in Kenya there are plenty of leopards. There are wooden leopards, painted leopards, leopards on cushions. There are leopard masks, key rings and necklaces, bowls and tablecloths. ...

Education: RCGP curriculum - Introducing the GP curriculum.(Royal College of General Practitioners)
August 22, 2008... Dr Ben Riley and Dr Jayne Haynes explain what the curriculum is and why it is necessary. The RCGP curriculum, for the first time, presents the official view of the fundamental knowledge, skills, attitudes and expertise that a doctor in...

MedEconomics: How to ... Manage underperforming employees.
August 22, 2008... Staff members failing to do their work well need help to improve performance, writes Claire Brook. It is never pleasant to tell a staff member, including a poorly performing salaried GP, that they are not pulling their weight. So how...

MedEconomics: Ask the experts - Integrated care and rent variations.
August 22, 2008... Q: Integrated care pilots My partners and I have heard of integrated care pilots and wonder whether these are a development in which our practice could become involved. Can you advise? Integrated care pilots come from health minister...

Plain tales from the surgery.
August 22, 2008... Check your Blackberry I was working for the local out-of-hours service one evening last week. The first call I triaged on the phone coincidentally happened to be a friend of mine, calling about his eight-year-old son Thomas. Thomas...

Clinical: Clinical Review - Altitude-related illness.(Disease/Disorder overview)
August 22, 2008... Contributed by Dr Matthew Litchfield, GP, Nottingham and Dr James Milledge, retired consultant respiratory physician, Northwick Park Hospital, Harrow. Section 1: Epidemiology and aetiology Millions of people holiday at high altitudes...

Education: NMRCGP exam update - Evidence for aspirin use.
August 22, 2008... Current situation. - Many healthy people over the age of 50 years in the UK take regular aspirin. - Many patients at high risk of cardiovascular disease are still not taking aspirin. - Aspirin remains the most cost effective and...

Education: Pictorial case study.(Case study)(Brief article)
August 22, 2008... The case For the past seven years this 26-year-old woman had repeatedly attended the surgery with recurrent painful 'boils' in the groin and perineum Numerous courses of antibiotics had failed to control the recurrences. Many times...

MedEconomics: Simple IT solutions speed diagnosis.
August 22, 2008... Voice software and NHSmail have transformed our local ultrasound service, writes Dr John Havard. We receive the results of ultrasound abdominal scans from our cottage hospital while the jelly is still wet on the patient's tummy. ...

Practice manager pay up just 1.5%.(Survey on General practitioners bonuse)(Survey)
August 22, 2008... GPs are finding bonuses for practice managers despite practice income freezes, writes Tom Ireland. After three years of successive income freezes, GPs are having to cut rewards for the work their staff do to improve patient care. A...

Behind the headlines: Could osteoporosis drug treat breast cancer?
August 22, 2008... A drug used to treat osteoporosis could halt the growth of breast cancer when combined with chemotherapy, media reports suggest. UK researchers found that treatment with the chemotherapy agent doxorubicin followed with the bisphosphonate...

Clinical: Journals Watch - Diverticulitis, diabetes and Wii.(Clinical report)
August 22, 2008... Too busy to catch up on the latest research? Let Dr Suzanne Hunter update you on recent papers. Perforated diverticulitis Br J Surg 2008; 95: 876-81 Diverticulosis is a very common condition in the west and is viewed frequently...

Clinical: Providing travel services.
August 22, 2008... Dr Michael Ingram reviews a new competency framework for nurses working in travel health. If there is one area of clinical practice that is almost entirely delegated to practice nurses, it is travel health services. For the majority...

Clinical: Women's health - Sexual dysfunction and the menopause.(Case study)
August 22, 2008... An open, non-judgmental attitude helps patients discuss sexual dysfunction. Mrs Jones, a 55-year-old teacher, has been married for 30 years. She says she attends the practice because she feels tired and has gone off sex. She is...

Clinical: The basics - Asthma in adults.
August 22, 2008... Recently updated guidelines clarify how to manage asthma in adults, explains Dr David Morris. Asthma is a chronic inflammatory condition leading to obstruction of the small airways that is characteristically reversible. Smooth muscle...

Medeconomics: Incapacity certification changes.
August 22, 2008... The new Employment and Support Allowance will not mean extra work for GPs, says Dr Nerys Williams. GPs frequently fill in forms about patients' eligibility for incapacity benefit. On 27 October the new Employment and Support...

Scottish practices face being asked to work public holidays.(out-of-hours health care services)(Brief article)
August 22, 2008... The Scottish Health Department is considering asking GP surgeries to open on public holidays. The plans were suggested by Scotland's out-of-hours helpline, NHS24, to reduce the number of calls it receives over Easter and Christmas. ...

News in brief.(risk of epilepsy)(risk of renal disease)(Haroon Siddique wins bid)(Brief article)
August 22, 2008... Drowning risk in epilepsy Patients with epilepsy have an 18-fold increased risk of drowning over the general population, an analysis of international data has shown Researchers compared 51 cohorts of patients with epilepsy worldwide with...

Patient uproar delays phone support service.
August 22, 2008... A PCT in Merseyside has postponed the introduction of a telephone support service after an outcry at plans to transfer patient records to a private company. Patients at practices who sign up to the 'Wirral Keep Well' scheme will be able...

'Clumsy' children at higher risk of being obese adults.
August 22, 2008... Poor physical control and coordination in childhood could increase the risk of developing obesity in later life, joint Swedish and UK research suggests. Previous studies have suggested that poor cognitive function in childhood could be...

Northern Ireland trainee GPs force U-turn over planned pounds 7,000 pay cut.
August 22, 2008... GP trainees in Northern Ireland have overturned a plan to cut their income by up to pounds 7,000 a year, according to the BMA. The Northern Ireland Medical and Dental Training Agency (NIMDTA) recently said trainee GPs in Northern Ireland...

DoH 'claws back' pounds 2,400 on pensions.
August 22, 2008... Retiring GPs to lose pounds 1,800 from lump sum and pounds 600 a year as DoH 'adjusts' dynamisation. GP pensions will not be uprated to take account of increases in average incomes between 2006 and 2008, the BMA has revealed. In...

Jab could cure RA within five years.
August 22, 2008... Rheumatoid arthritis (RA) could be cured by a single jab within five years, say UK researchers. The research team from the University of Newcastle is developing the jab, which involves taking cells from the RA patient, altering them and...

Opinion: Ballot box.
August 22, 2008... Percentage of GPs who believe that presumed consent for organ donation should be introduced: 50%. Source: healthcarerepublic.com

Opinion: Your say online ... community.healthcarerepublic.com.
August 22, 2008... What GPs are saying online about working for private firms - If we look at the job ads, more and more practices are opting for salaried GPs. This gives new GPs the message that if salaried practice is the future then what is the...

Editorial: Foolish plans will not win back electorate.(Editorial)
August 22, 2008... This time last year, Gordon Brown was still riding high in the opinion polls after a successful start as prime minister. His speech at last year's Labour party conference was hailed a resounding success and he seemed certain to win if he...

Opinion: Halt the mass murder of doctors' motivation.
August 22, 2008... Motivation is central to human behaviour. Yet although doctors and nurses begin as some of the most motivated people in the country, the NHS seems hell-bent on annihilating this drive. How many colleagues can't wait to retire? It is sad...

Clinical: Viewpoint - Vitamin D deficiency.
August 22, 2008... There is a strong case for prescribing higher dosages of vitamin D in elderly patients, says Dr Geoff Venning. Vitamin D deficiency in adults can only be diagnosed by laboratory measurement of plasma level of calcidiol. This test has...

Dispensing: Travel dispensing in all practices.
August 22, 2008... Non-dispensing practices can boost income with travel medicines, explains Dr Jeremy Phipps. With more and more patients holidaying in exotic destinations, the time needed to give appropriate individual medical advice can be extensive....

Practices to lose a quarter of patients.(United Kingdom. National Health Service. Primary Care Trusts launch APMS Darzi practices)(Alternative Provider Medical Services)
August 22, 2008... Exclusive - PCTs to launch APMS Darzi practices in areas that are not 'under doctored'. New APMS Darzi practices could strip existing practices of up to a quarter of their patients in some areas, GP can reveal. Local sources say some...

Limits of stem-cell therapies.
August 22, 2008... The effectiveness of human therapies derived from embryonic stem cells could be limited, according to US research. The researchers found that injecting human embryonic stem cells into mice triggered the immune system to attack the stem...

Avoid fruit juice with beta-blockers and antibiotics.
August 22, 2008... Fruit juice should be avoided by patients taking some beta-blockers and antibiotics, because it reduces efficacy by more than half, researchers have warned. The warning comes as GPs are being told to prescribe beta-blockers to patients...

Dementia risk is revealed by test.
August 22, 2008... Elderly patients with inconsistent scores across different neuropsychological tests are at increased risk of dementia, according to a US study. It suggests that erratic performance on cognitive tests may be a more useful marker of...

Anti-psychotic scrips rise by 10%.
August 22, 2008... Exclusive - GP investigation reveals two-year rise in number of controversial scrips. The number of prescriptions by GPs for anti-psychotic drugs is on the increase and is set to top 2.7 million by the end of the year, GP can reveal. ...

'Don't force patients to register at Darzi centres'.
August 22, 2008... The DoH has warned PCTs against adopting a controversial 'three strikes' policy of forcing regular attenders of GP-led health centres to register there. According to GPs including National Association of Primary Care chairman Dr James...

Practices now bid to extend hours to offer diagnostics.
August 22, 2008... GP DoH adviser spearheads scheme to open at nights and weekends. A group of 16 practices in London is embracing Lord Darzi's extended services agenda and plans to offer patients secondary care services into the night and at weekends. ...

NICE hits out at pharma profits.(Financial report)
August 22, 2008... The drug industry is overpricing new medicines to boost profits, the chairman of NICE has warned. Speaking to The Observer last week, Professor Sir Michael Rawlins accused drug companies of using 'perverse incentives' like linking the...

Otitis media ups later obesity risk.
August 22, 2008... Chronic otitis media in childhood increases the risk of obesity, US research presented last week at the American Psychological Association's annual convention in Boston shows. Data from 6,584 adults aged between 16 and 92 years from a...

Boys more likely to grow out of asthma.
August 22, 2008... Boys' airway responsiveness starts to drop after 11 years but it remains the same in girls. Boys are more likely to grow out of childhood asthma during puberty than girls, according to the results of a US study. It showed that the...

Research Briefs.
August 22, 2008... Arsenic linked to diabetes Exposure to arsenic increases the risk of type-2 diabetes, a US government health survey has found. Arsenic levels in the urine of 788 adults were measured. Those in the top quintile of arsenic exposure were...

DoH orders blanket income freeze for PMS practices.
August 22, 2008... GPC condemns local contract 'mockery' as DoH imposes freeze. The DoH has instructed SHAs and PCTs not to give PMS practices an uplift this year. A letter this month from Ben Dyson, the DoH's director of primary care commissioning,...

Elderly receive 'better' care for QOF conditions.
August 22, 2008... Quality of care for older patients is poor when treatment is not in the quality framework, according to research in the BMJ. Researchers from the University of East Anglia found that the recommended care for patients over 50 is received...

Consult vow on contract change.
August 22, 2008... The GPC has warned the DoH that it will ask for the profession's opinion again if negotiations for 2009/10 involve major changes to the contract. GPC chairman Dr Laurence Buckman wrote in a letter to GPs last week: 'If there are to be...

Opinion: We can learn a lot from Homer Simpson.(Character overview)
August 8, 2008... There is much we can learn from The Simpsons, and particularly from Homer, who possesses a wisdom borne of having to survive in the real world; that is, if at first you don't succeed, pretend you're sick. In one episode a travelling...

Opinion: A Shakespearean attitude to general practice.
August 8, 2008... Into the great Tennis Match of Evening Surgery pop Spoiled and Dreadfully, like 12-year-old mushrooms. Private School sent them home injured, declares Mrs Dramatic, so it's urgent. Apparently Spoiled socked Dreadfully with Macbeth...

Clinical: Journals Watch - Dyspepsia, asthma and pregnancy.
August 8, 2008... Too busy to catch up on the latest research? Let Dr Lizzie Croton update you on recent papers. - Functional dyspepsia Gut 2008. doi:10.1136/gut.2008.158162 Gastric sensorimotor dysfunction, psychosocial factors and somatisation...

Clinical: Sports Medicine - Therapeutic use exemption.
August 8, 2008... Dr Chris Jarvis explains the therapeutic use exemption for athletes taking prohibited substances. Athletes found to have used a prohibited substance or method outlined by the World Anti- doping Agency (WADA) prohibited list face a...

Clinical: Equipment review - Digital spirometer.(Product/service evaluation)
August 8, 2008... Dr Raj Thakkar reviews a hand-held digital spirometer. If you don't have time to read the whole of this review, I can summarise it in two words: 'buy it!' For those with a little more time, shut your surgery door, take the phone off...

Clinical: Clinical dilemma - A patient dying of lung cancer.
August 8, 2008... The Dilemma A 70-year-old woman who is dying of lung cancer belongs to a neighbouring practice where I do some Saturday mornings. I am asked to visit because she is in pain. I arrive to see her peacefully asleep in bed surrounded by six...

Education: Alcohol problems in young people.(Drug abuse counseling)(Clinical report)
August 8, 2008... Greater awareness of drinking problems is needed, say Professor Eileen Kaner and Ruth McGovern. Approximately 90 per cent of people in the UK drink alcohol, and most of the time the majority have no difficulties. Alcohol can be an...

MedEconomics: Ask the experts - Capital gains tax and NHS pensions uprating.
August 8, 2008... Q: CAPITAL GAINS TAX I am retiring completely in November although I will still own a half share in the surgery premises. I am keen to know before then, what in terms of the value of my investment in the practice finances (for example,...

MedEconomics: Tips to prevent burn-out.
August 8, 2008... Dr Emma Lackey finds advice on the internet that might be helpful to GPs who are feeling stressed out. Burn-out is a syndrome of emotional exhaustion, de-personalisation, low productivity and feelings of low achievement. While burn-out is...

Dream job awaited trainee GP killed on honeymoon.
August 8, 2008... The young doctor shot dead in Antigua last week was due to start her dream job as a GP registrar next month. The two GP trainers at the Tabernacle Street Surgery in Skewen, South Wales, were said to have been shocked by the news and have...

Win a Panasonic HD camcorder worth pounds 650.
August 8, 2008... The new Panasonic HS9EB-S camcorder is compact but powerful. Having full HD video quality linked to a healthy video storage capacity, this camcorder offers exceptional image details, while digital cinema colour produces natural, lifelike...

Behind the Headlines: Can Alzheimer's drug halt progress?
August 8, 2008... A new drug can slow Alzheimer's disease progression by up to 80 per cent, according to reports. Experimental drug Rember, the first of its kind to target tau protein tangles, will offer hope to the UK's 400,000 Alzheimer's disease...

'Promote partnerships or lose loyalty'.(Negotiation between Beth McCarron-Nash and Jonn Elledge )
August 8, 2008... New GPC negotiator Dr Beth McCarron-Nash speaks to Jonn Elledge about priorities for the future. In the centre of a sunny courtyard at BMA House, Dr Beth McCarron-Nash is grinning broadly. 'This is a turn up for the books, isn't it?' ...

Editorial: Next generation needs partnership opportunities.(Editorial)
August 8, 2008... Practices have been affected by a raft of reforms and restructures that successive governments have sought to impress on the NHS. But, it is recent policies that threaten to bring the biggest change to general practice. APMS, polyclinics...

Opinion: The government must admit to its mistakes.
August 8, 2008... Why won't this government admit its mistakes? MPIG is a classic example. MPIG came about because the government's attempt to reward GPs according to workload fell flat on its face. First they produced a thoroughly inaccurate measure of...

Clinical: Clinical Review - Subfertility in women.(Disease/Disorder overview)
August 8, 2008... Section 1: Epidemiology and aetiology Infertility is defined as failure to conceive after regular unprotected sexual intercourse for two years, in the absence of known reproductive pathology. One in seven couples will have fertility...

MedEconomics: GP contract - Quality scheme compliance checks.(post-payment verification visit )
August 8, 2008... Dr Jeremy Phipps explains what to expect if a post-payment verification team pays your practice a visit. Being informed by your primary care organisation (PCO) that your practice is to have a quality and outcomes framework 'post-payment...

MedEconomics: Bidding for a GP-led health centre.(contracts between general practitioners for build a health centre)
August 8, 2008... Will our joint bid with another local practice reach the official tender stage? I am a GP in Southend where South East Essex PCT is planning to build a 'mini-Darzi centre' comprising a healthy living centre with attached GP-led service...

Dispensing: Reducing medication errors.
August 8, 2008... Dispensing practices must draw up coherent communication policies, writes Annette Arthur. It is a sad fact that in a large number of dispensing units there is little communication between the dispensing team and the practice GPs. ...

Flu jabs for under-twos may reduce influenza A by 21%.
August 8, 2008... Flu jabs for children remain under review pending work on impact. Vaccinating children against flu could protect the whole population, research by the Health Protection Agency (HPA) suggests. The overall incidence of flu could be...

GP satisfaction scores on the rise.
August 8, 2008... Patients in England are more satisfied with GP care than three years ago, but almost a quarter felt that they should have been seen sooner. The survey of 69,000 patients was co-ordinated for the Healthcare Commission by Picker Institute...

News in brief.
August 8, 2008... Learning difficulties highlighted An inquiry has concluded that the DoH should develop annual health checks for all adults with learning disabilities. The DoH should develop a directed enhanced service (DES) for GP practices to provide...

Ruling casts doubt over the legality of patient database.
August 8, 2008... GP calls on government to ditch plans for a single NHS database. The NHS could be forced to completely rethink its pounds 6 billion patient database, because it is unlawful under the European Convention of Human Rights, it has been...

Two-thirds of patients 'failed' by the Choose and Book programme.(Report)(Brief article)
August 8, 2008... Two-thirds of patients re-ferred under Choose and Book are not being given a choice of appointment date or time, say researchers at University College London. Their report, 'Does Choose and Book fail to deliver the expected choice to...

London practices win contract for services for addicted doctors.
August 8, 2008... A new government-funded occupational health scheme for doctors is to be run by a group of London practices. The contract for the 'Practitioner Health Programme', which opens in the autumn for physical, mental or addiction problems, has...

Calls to scrap second abortion signature.
August 8, 2008... Proposals to scrap the need for two doctors' signatures to give permission for an abortion have been welcomed by women's health experts Amendments to the Abortion Act of 1967 have been tabled for debate in the Commons this autumn. The...

Opinion: Ballot box.
August 8, 2008... GPs who think they should not disclose their personal beliefs to their patients: 68% Source: healthcarerepublic.com

Opinion: Your say online ... community.healthcarerepublic.com.
August 8, 2008... What GPs are saying about the cut in correction factors from 1 October - Junior doctors are demoralised, consultants too, and now all GPs. Time for a general election. - I can hardly credit that the GPC agreed to have the MPIG...

Plain tales from the surgery.
August 8, 2008... A family affair I dictated a letter on behalf of a patient who had missed a hospital outpatient appointment. On checking the letter I noticed that the reason for not attending was an 'exasperation' of family problems. I had intended the...

GPs-to-be back work for private firms.
August 8, 2008... Exclusive - Shortage of partnerships forces dramatic change of heart for future GPs. More than half of future GPs would work for practices run by private providers, a GP snapshot poll has found. An even higher proportion said that...

'Greedy GPs' slurs fail to put off 80 per cent of young GPs.
August 8, 2008... Young doctors are still flocking to general practice, despite the barrage of negative press coverage. Four fifths (79 per cent) of those GP surveyed at the BMA's 'GPs-to-Be' conference said that their colleagues had not been put off...

First polyclinic in London 'to close'.
August 8, 2008... A health centre once feted as London's first polyclinic is to close because the PCT cannot afford to keep it open. The Finsbury Health Centre in Islington, north London houses two GP practices, as well as dental services, podiatry,...

Strike-off threat to 'competitive' GPs.
August 8, 2008... Exclusive - DoH on collision course with profession over 'fair competition' definition. GP leaders are on a collision course with ministers after GPC and RCGP joint guidance suggested that GPs could be struck off if they actively...

CMO referred to GMC on 'disrepute' claim.(Chief Medical Officers)(General Medical Council)(Brief article)
August 8, 2008... England's CMO, Sir Liam Donaldson, is being referred to the GMC by junior doctors' pressure group Remedy UK. Following the Modernising Medical Careers (MMC) debacle, the complaint claims Sir Liam fell below the standard expected of...

GPs under pressure on scrips.
August 8, 2008... SHAs aim to save pounds 68 million a year by pushing generic prescribing. SHAs are aiming to save pounds 68 million a year by pushing GPs to match the highest rates of generic statin prescribing. But GPs have warned that the targets...

Correction factors cut from October.(Correction notice)
August 8, 2008... Correction factors will be cut from 1 October, the GPC has announced. GPC negotiators say the DoH has acknowledged that the Doctors' and Dentists' Review Body's (DDRB) recommendation to cut correction factors is illegal, so is now...

Warfarin could prevent liver failure in hepatitis C patients.(Clinical report)
August 8, 2008... UK study reveals that blood-thinning drug cuts liver fibrosis. Warfarin could be used to prevent liver failure in thousands of patients with hepatitis C, a study suggests. UK researchers found that warfarin significantly reduced the...

Anxiety and depression may lower blood pressure.
August 8, 2008... Anxiety and depression may reduce BP in the long term, a major population-based study has found. Norwegian researchers looked at data on 36,520 adults over an 11-year period and found baseline anxiety and depression was associated with...

Research Briefs.(Smoking ban )(Brief article)
August 8, 2008... Smoking ban cuts heart risk Hospital admissions for acute coronary syndromes fell by 17 per cent in Scotland in the 10 months following the smoking ban (N Eng J Med 2008; 359: 482-91). Race divide on stroke prevention Despite...

DoH says extended hours LESs 'unacceptable'.
August 8, 2008... PCTs could be forced to unpick local extended hours deals after the DoH warned that they were unacceptable, say LMC leaders. The DoH has said some local enhanced services (LESs) will not count towards PCTs' target of 50 per cent of...