GP articles from August 2009

GP archives from August 2009

Independent Nurse: Nurses warn that swine flu jabs will be a serious challenge.
August 24, 2009... Providing swine flu and seasonal jabs together will pose a serious challenge for practices, nurse leaders warn, after the DoH revealed priority groups for swine flu vaccination. People aged six months to 65 years in seasonal flu risk groups...

Independent Nurse: Practices are not paid for nurses' extended hours.
August 24, 2009... More than a fifth of GP practices (21 per cent) employ practice nurses in extended hours, but just 8 per cent receive funds to pay for it. A poll by Independent Nurse's sister magazine GP found practices are losing up to pounds 30,000 a year...

Independent Nurse: News in brief.
August 24, 2009... VACANCIES: The number of unfilled nursing posts in the English NHS has risen for the first time in five years, NHS Information Centre data show. The proportion of unfilled posts rose from 2.5 per cent in 2008 to 3.1 per cent in 2009. Health...

Independent Nurse: Unite urges DoH to set up a fast track into health visiting.
August 24, 2009... The DoH should set up a fast track into health visiting to halt the plunge in the profession's numbers, the union Unite has said. The call comes as an NHS vacancies survey found unfilled health visitor posts rose two-thirds in a year (see...

Independent Nurse: Provider split delay leaves nurses in limbo.
August 24, 2009... Community nursing teams are facing yet more uncertainty about their future, after the DoH scrapped its deadline for PCTs to decide future plans for the provider arms. PCTs were originally told to come up with plans for how to spin off their...

Independent Nurse: Call for healthcare assistant framework.
August 24, 2009... A national framework detailing minimum competencies for healthcare assistants should be drawn up to help nurses delegate work with confidence, NHS Employers has said. In a response to the prime minister's commission on the future of nursing...

Independent Nurse: Nine QOF indicators face the axe.
August 24, 2009... Nine indicators worth 46 points could be axed from the 2010/11 QOF and replaced by new targets for diabetes, epilepsy and Down's syndrome, under plans set out by NICE. Half of the indicators selected for removal relate to diabetes, and the...

Independent Nurse: Vital Statistics - Alcohol and sleep.
August 24, 2009... - 58% of drinkers do not realise alcohol can cause sleep problems - 45% of people admit to feeling tired the day after drinking more than the recommended daily limit - 10 million adults in England regularly exceed the recommended daily...

Independent Nurse: Journals Watch.
August 24, 2009... - Nanoparticle lung risk Effective measures are needed to protect industrial workers from the dangers of inhaling nanoparticles, researchers have suggested. They found that nanoparticles can damage human lungs and cause inflammation and...

Independent Nurse: Health boost could save NHS millions.
August 24, 2009... Improving the health and wellbeing of 1.4 million NHS staff could potentially save over half a billion pounds a year and improve patient care, according to the NHS health and wellbeing review. Occupational health expert Dr Steve Boorman, who...

Independent Nurse: Number of practice nurses falls again.
August 24, 2009... The number of NHS managers rose by over 10 per cent in 2008, as the number of practice nurses fell for the second year running, NHS Information Centre data show. The NHS now has 39,913 managers and senior managers, 3,414 more than in 2007....

Independent Nurse: World Outbreak Information - Week beginning 24 August.
August 24, 2009... Taiwan, Philippines, China Severe flooding caused by Typhoon Morakot has affected many areas this month. There is likely to be an increased risk of food and water illness, and mosquito-borne diseases. Travellers should avoid bites, boil or...

Independent Nurse: Dual approach cuts vascular risk.
August 24, 2009... The importance of tackling blood pressure and glucose control in tandem has been demonstrated in a study of over 11,000 people with diabetes. New findings from the ADVANCE study showed that lowering blood pressure and improving glucose...

Independent Nurse: Pharmacists demand parity with nurses.
August 24, 2009... The Royal Pharmaceutical Society of Great Britain (RPSGB) has called on the prime minister to introduce parity between nurses and pharmacists in the prescribing of controlled drugs. Currently, nurses can prescribe controlled drugs in certain...

Independent Nurse: DoH ponders ban on herbal medicines.
August 24, 2009... The government is considering measures that would effectively outlaw herbal medicine. Such a move is likely to be welcomed by groups who campaign for evidence-based medicine. But others warned that prohibition could make it harder to regulate...

Independent Nurse: Drug lowers diabetes risk during Ramadan.
August 24, 2009... People with type-2 diabetes who fast during Ramadan may be at lower risk of hypoglycaemia if they are treated with a DPP-4 inhibitor instead of a sulphonylurea, research suggests. Dr Devasenan Devendra of Central Middlesex Hospital followed...

Independent Nurse: Clarification on hypertension.(Correction notice)
August 24, 2009... Independent Nurse would like to clarify that, in relation to the hypertension treatment algorithm included in the last issue (IN, 20 July 20), beta-blockers are not a preferred initial therapy for hypertension but can be used instead of an ACE...

Independent Nurse: News Focus - Where next for advanced nurse regulation?(Nursing and Midwifery Council)
August 24, 2009... After years of waiting, regulation could still be a long way off Tom Ireland reports. The news that the NMC will not even begin to look at regulation of advanced nursing until at least 2010 will disappoint many in the profession. It was...

Independent Nurse: Opinion - Online.
August 24, 2009... A think tank has called for a pounds 20 fee for GP appointments: do we really want to step back 60 years? Rich and poor are entitled to treatment that is 'free at the point of use' not 'fair at the point of use'. Deciding that everyone should...

Independent Nurse: Editorial - The DoH must act on health visiting now.(Editorial)
August 24, 2009... It is no secret that health visiting is a profession in crisis Over the past four and a half years, Independent Nurse has frequently reported on the shortage of health visitors and the impact this has had. Last week, health union Unite said...

Independent Nurse: Opinion - Support workers need regulating first.
August 24, 2009... The news of further delay to the regulation of advanced practice has disappointed many nurses. This work, which has been under way in various forms for at least 15 years, and talked about for longer, is now awaiting the completion of work on the...

Independent Nurse: In my view - Specialist training is key in dementia care.
August 24, 2009... For years, there has been a lack of awareness and understanding about dementia. It is incorrectly associated with mental illness, rendering it taboo. This is despite the fact that more than 700,000 people in the UK are currently living with...

Independent Nurse: Clinical - Tailoring antidepressant treatment.
August 24, 2009... Antidepressant dose and duration of treatment are important factors, writes Melanie Rogers. The prognosis of many depressive disorders is poor, and rates of relapse and recurrence are high. It is crucial that the care provided in primary care...

Independent Nurse: Clinical - Recognising and managing infected eczema.
August 24, 2009... Prompt recognition and treatment of infection in eczema is essential to reduce exacerbations, says Julie Van Onselen. Eczema and dermatitis are synonymous terms, with several types and presentations affecting all age groups, including atopic...

Independent Nurse: Clinical - Bacterial and fungal rashes in children.(Infectious skin diseases in children)
August 24, 2009... In the last of her articles on childhood rashes, Dr Terrina Dickson covers bacterial and fungal causes. A variety of bacterial and fungal pathogens can cause a rash in childhood (see box). Careful examination of the rash and a thorough...

Independent Nurse: Clinical - Undertaking immunisation.
August 24, 2009... Various practical issues need to be addressed before, during and after vaccine administration. Gina Robinson explains. The aim of immunisation is to help the body to fight off certain diseases. Immunisation works by allowing the body to...

Independent Nurse: Clinical focus - Pulmonary tuberculosis.
August 24, 2009... OVERALL KEY POINTS - Only 5-10 per cent of those infected with M tuberculosis will develop active TB in their lifetime. - A high index of suspicion in people from at-risk groups is the key to effective diagnosis. - A normal chest...

Independent Nurse: Clinical - Reviewing concordance - Case study.
August 24, 2009... A supportive approach can help concordance, writes Amber Cornforth. Mr X is a 48-year-old window cleaner with no dependants. He was diagnosed with essential hypertension in January, after he had come forward for help with smoking cessation....

Independent Nurse: Clinical - New drugs for type-2 diabetes.
August 24, 2009... NICE has outlined when to prescribe newer drugs for type-2 diabetes, writes Dr David Morris. The most recent NICE guideline for type-2 diabetes, published in May, has refined the use of blood glucose lowering treatments in light of the...

Independent Nurse: Professional - Protecting vulnerable children.
August 24, 2009... Reviews into child deaths are looking at how health visitors can be supported to safeguard children, writes Joe Lepper. Health visiting's reputation for safeguarding children has been tarnished this year with the publication of a raft of...

Independent Nurse: Professional - Self-care and community nursing.
August 24, 2009... Community nurses must know how to facilitate patient self-care, writes Jane Colling. Patients may maintain their personal health by engaging in a diverse number of self-care tasks, from taking exercise to monitoring their own symptoms (see...

Independent Nurse: Professional - Resources - Worth a look.
August 24, 2009... - Professional know-how initiative Educational tools A set of interactive 'know-how' videos has been developed by SMA Nutrition, to help health visitors and midwives educate new parents These cover breastfeeding; making up a bottle;...

Independent Nurse: Professional - Resources - In numbers Swine flu.
August 24, 2009... A poll of 246 GPs conducted by Independent Nurse's sister publication GP newspaper showed that 65 per cent think a swine flu vaccination campaign should go ahead, but only 27 per cent said their practices had the resources to deliver this. In...

Independent Nurse: Professional - Resources - Recommended patient resource.
August 24, 2009... What is this? A portable diet and exercise plan, designed on playing cards for added fun and motivation. The cards have been developed by DL Diet and Fitness, a health and wellbeing company that was started up by a personal trainer and an...

Independent Nurse: Professional - Resources - Policy digest.
August 24, 2009... Prevention Package for Older People What is this? Launched on 22 July (having initially been announced in 2008), this 'package' puts a focus on prevention as a means of ensuring good health, wellbeing and independence in later life, by...

Independent Nurse: Professional Workplace - Career profile, Tracy Whittle, Brighton, East Sussex.
August 24, 2009... - Why did you become a nurse? During an interview for art college I was asked what I wanted to do and I said 'help people'. It was suggested I look at nursing as a career rather than art and the rest is history - How has your career...

Independent Nurse: Professional Workplace - Practical prescribing.
August 24, 2009... Molly Courtenay helps resolve everyday issues for nurse prescribers Q: I have worked in general practice for 20 years and see many patients with diabetes and asthma. The doctors in the practice insist that they sign prescriptions for black...

Behind the headlines: Is alcohol to blame for rising oral cancer rates?
August 21, 2009... Rates of cancers of the mouth, tongue and lip among people in their forties have risen rapidly over the past decade, media reports have claimed. Diagnoses have increased by 28 per cent in men and by 24 per cent in women since the mid-1990s,...

Call to use PBC to commission acupuncture.
August 21, 2009... Regulatory body urges practices to take the lead on making savings after PCT efforts stall. GPs should develop acupuncture schemes through practice-based commissioning (PBC) to help implement NICE's recent back pain recommendations, the...

Opinion: Artifice, the best expression of human genius.(Column)
August 21, 2009... My aunties Josie and Mary had lived together for generations in amicably combative spinsterhood. Auntie Mary was lively and jolly, Auntie Josie was a whiny old torture. Of course, life not being fair, Auntie Mary died first. The funeral was...

Opinion: Breaking the language barrier at Heathrow.
August 21, 2009... In the consultation, language is everything. Yesterday I tried explaining to a group of French teenagers in Grenouille, (a bastardised form of schoolboy French unique to Selby Towers but strangely understandable for all that) that if...

Clinical: Journals Watch - Pneumonia and prostate cancer.
August 21, 2009... Too busy to read all the journals? Let Dr Katrina Ford keep you up to date with the latest research. Length of hospital stay for patients with pneumonia Thorax 2009; 64: 709-12 This retrospective study based in Nottingham City Hospital...

Clinical: Viewpoint - The impact of swine flu on a large school.(Clinical report)
August 21, 2009... Dr Jonathan Holliday describes how his school coped with an outbreak. Eton College is a school of 1,300 boys, all of whom are boarders. The boys live in 25 houses of roughly 50 each. All houses have boys from all ages, which is important in...

Clinical: Clinical Review - Psoriasis.(Clinical report)
August 21, 2009... Contributed by Dr Anthony Bewley, consultant dermatologist at Whipps Cross University Hospital and The Royal London Hospitals NHS Trust. Section 1: Impact on patients Patients with mild-to-moderate cutaneous psoriasis are mostly (and...

Clinical: Practice dilemma - A colleague confides he has hepatitis C.
August 21, 2009... The Dilemma: The GP registrar at your practice has just been diagnosed with hepatitis C infection. He did some blood tests as he was feeling more tired than usual. These showed abnormal LFTs so he then arranged hepatitis serology testing. He...

Clinical: Paediatric medicine - Gastroenteritis in children.(United Kingdom. National Institute for Clinical Excellence)
August 21, 2009... Dr Alastair Hay and Dr Veronica Cox summarise the recent NICE guidelines on diarrhoea and vomiting in children under five. Case study You are a GP doing morning telephone triage and you have been telephoned by a mother about her...

Clinical: At a Glance - Myxoid cyst vs rheumatoid nodule.(Disease/Disorder overview)(Brief article)
August 21, 2009... MYXOID CYST. Clinical features - Benign ganglion cyst of the finger. Often involves mucoid degeneration. - Usually associated with osteoarthritis of the underlying joint. - More common in women. - May present at any age but...

Education: Preparing for revalidation as a locum.
August 21, 2009... Dr Linda Miller offers some tips on how to collate evidence for revalidation as a freelance GP. When revalidation begins, evidence from the ePortfolio will be used in your annual appraisal, in particular how the goals outlined in the personal...

Education: Medico-Legal - Troublesome telephone calls.
August 21, 2009... MDU medico-legal adviser Dr Emma Cuzner explains how to avoid some common pitfalls. Many problems in general practice can have seemingly innocuous origins. From repeat prescriptions to home visits, activities that GPs may have done many...

MedEconomics: How to ... Treat your patients as consumers.
August 21, 2009... Ratna Singh says structured participation groups are a good way to effectively engage with patients. Big companies selling consumer products and services are adept at involving consumers in product design, often using structured sessions with...

MedEconomics: Our practice intranet is robust.
August 21, 2009... Kathie Applebee describes the internal electronic communication systems at a large Cornish practice. As well as face-to-face consultations, practices have to deal with patients' queries and requests, test and investigation results and...

MedEconomics: Texting patients saves us money.
August 21, 2009... We reduced missed appointments and slashed recall costs by sending free texts via NHS Mail, says Andy Button. Swallowfield Medical Practice's pioneering attitude means we are always keen to volunteer to try out new IT solutions. The GPs and...

Dispensing: Pharmaceutical needs assessments.
August 21, 2009... Dispensing practices are potential providers of pharmaceutical services, writes Dr Lisa Silver. Last month, NHS Employers published further guidance on pharmaceutical needs assessments (PNAs). This amounts to 62 pages (if you include the 20...

Plain Tales from the Surgery.
August 21, 2009... - Down the tubes I recently visited an elderly man who was complaining of diarrhoea, malaise and fever. He told me he had had a severe bout of diarrhoea the previous Saturday. When I asked him what had happened to the diarrhoea since then, he...

Foundation trust to run GP practice.
August 21, 2009... Integration Watchdog backs takeover, but GP leader expresses sadness and 'huge concerns'. A practice in Sunderland is to be swallowed up by its local foundation trust, after the Co-operation and Competition Panel (CCP) gave the go-ahead for a...

BMA backs NHS Twitter campaign.(British Medical Association)(United Kingdom. National Health Service)(Brief article)
August 21, 2009... BMA chairman Dr Hamish Meldrum has called on Labour and the Conservatives to abandon pro-market policies and block the use of management consultants in the NHS. Entering the Twitter-based 'We love the NHS' campaign, sparked by US criticism of...

Swine flu czar in death-in-service plea.
August 21, 2009... PCTs should look to hire locum GPs on continuous contracts of at least three months to ensure they receive death in service cover, England's director for flu resilience has said. In a letter to PCTs this month, Ian Dalton called for the...

GP protection is boosted by ruling.
August 21, 2009... GPs may be able to demand legal representation if their PCT seeks to remove them from the performers' list. A ruling by the Court of Appeal found that, under the Human Rights Act, hospital doctors employed by the NHS have the right to legal...

Side-effect risks overestimated.(Brief article)
August 21, 2009... Patients overestimate the risk of drug side-effects by 50 per cent because of the way their chances of occurring are described, research suggests. Peter Knapp and colleagues from the University of Leeds asked 285 people to estimate the risk...

Hypertension targets 'should be reduced' for all.
August 21, 2009... A study of non-diabetic patients found 130mmHg target reduced cardiovascular events. Systolic BP targets for patients with any risk factors for heart failure should be lowered to 130 mmHg, research published in The Lancet suggests. Studies...

Research briefs.
August 21, 2009... - Occupational health Effective measures are needed to protect industrial workers from the risks of inhaling nanoparticles, researchers have said. They found that nanoparticles can cause inflammation and pulmonary fibrosis (European Respiratory...

Skin patients 'may need psychological therapy'.
August 21, 2009... Women with skin conditions such as acne and psoriasis should be offered psychological treatment as part of their management of skin problems, Australian researchers say. The research team found that symptoms of depression and stress occurred...

Age cuts risks of antidepressants.
August 21, 2009... Antidepressants appear to reduce risks of suicidal thinking in older people, but to increase risks in younger adults, researchers have found. Data from 372 studies involving over 99,000 patients were analysed by Dr Marc Stone from the US Food...

Herbal medicine 'could be outlawed'.
August 21, 2009... Herbalism - DoH consultation revives debate over regulation of alternative practitioners. The government is considering measures that would effectively outlaw herbal medicine. Such a move is likely to be welcomed by groups who campaign for...

Swine flu may up telemedicine use.
August 21, 2009... Use of the internet and call centres to deal with swine flu could trigger rapid growth in remote diagnosis and prescribing, according to a think tank. Judith Kleine Holthaus, lead author of a report by the Future Foundation, said: 'Despite...

DoH drops October deadline for PCT provider arm plans.
August 21, 2009... PCTs are no longer facing an October deadline to decide what to do with their provider arms, a DoH letter reveals. The move represents a softening of the DoH line on the need to separate PCTs' provider and commissioning functions. But it...

LIFT 'fails to offer value for money'.(Local Improvement Finance Trust)(Brief article)
August 21, 2009... PCTs could have saved thousands of pounds if they had managed Local Improvement Finance Trust (LIFT) partnerships with the private sector properly, say researchers. The NHS-funded study, by the University of York's Management School, found...

Tories to scrap central NHS database.
August 21, 2009... Report by GP IT expert sets out possible path for reforming NHS IT programme. A Conservative government would scrap the centralised NHS database and replace it with smaller, local systems. Shadow health minister Stephen O'Brien accepted...

Pay blamed as empty GP posts in Wales quadruple.
August 21, 2009... Vacant GP posts in Wales have quadrupled over the past year, figures from the NHS Information Centre have revealed. The figures show that while vacancies in England's NHS as a whole have risen for the first time in years, the long-term...

Football's coming home.
August 21, 2009... The British Medical Football team has been crowned world champions after winning the annual World Medical Football Federation tournament in Seoul, South Korea. The team turned on the style, comprehensively beating Lithuania, hosts Korea and...

Is extended hours working?
August 21, 2009... After intense DoH pressure, most GPs now offer extended hours. Tom Ireland looks at the legacy of option A. Last February, GPC chairman Dr Laurence Buckman accused prime minister Gordon Brown of holding a gun to the profession's head over...

Ballot box.
August 21, 2009... 53% of GPs think that assisted suicide should be legalised Source: Healthcare Republic -------------------- Did you find this article useful? Why not subscribe to the magazine? Please call 08451 55 73 55 for more information or visit...

Your say online: www.healthcarerepublic.com/forums.
August 21, 2009... Daily Mail GP-bashing under investigation - Typical of the media... unless Michael Jackson dies or there is a plane crash it will always revert to GP bashing. It's a wonder that we are still the most trusted profession! - All practice...

Editorial: Extended hours should not be forced on GPs.(Editorial)
August 21, 2009... The government would have us believe that extended hours is a roaring success. The DoH trumpets the figures proudly - 77 per cent of practices are now open for longer. Meanwhile, Gordon Brown has said patients have a 'right' to see their GP in...

Opinion: DoH should overhaul pay for committee work.
August 21, 2009... The furore about MPs' expenses vividly demonstrates so much of what is wrong in government today. Putting aside the overtly fraudulent claims, it wasn't just MPs' fault that they were claiming for bath plugs or TVs but the system itself. The...

Exclusive - Extended hours costs GPs pounds 30,000.
August 21, 2009... GP survey shows patchy use of appointments and heavy costs for practices. Practices are losing up to pounds 30,000 a year because extended hours funding does not cover the cost of providing the service, a GP survey reveals. Only a quarter...

Exclusive - Practices may be forced to open on weekends to give swine flu jabs.
August 21, 2009... RCGP warns that practices lack the fridge space for swine flu and seasonal jabs. Practices will have to open at weekends and run vaccination clinics in extended hours to vaccinate all priority group patients against swine flu by the end of...

PCT scraps LES funding.
August 21, 2009... A PCT in London has decided to freeze all its local enhanced services due to cash shortages, a letter sent to GP practices this month reveals. The letter, from NHS Haringey, said that 2009/10 is a 'difficult year financially'. It goes on to...

Practices urged to sue if PCTs reject patient survey appeals.
August 21, 2009... Practices should sue their PCT if their patient survey appeals are rejected, a senior member of the GPC has said. 'Significant numbers' of practices appealed against the results of this year's survey, according to the GPC. But the early...

NICE suggests axing nine indicators from 2010.(United Kingdom. National Institute for Clinical Excellence)
August 21, 2009... QOF change 46 points up for grabs as talks start on altering diabetes, stroke and hypothyroidism pay. Nine indicators worth 46 points face being axed from the 2010/11 QOF and replaced by new targets for diabetes, epilepsy and Down's syndrome,...

Charities split on indicator proposals.
August 21, 2009... Epilepsy and Down's syndrome charities have welcomed new proposed indicators for QOF, but Diabetes UK has raised concerns about the proposed changes. Healthcare for adults with Down's syndrome is patchy at present, Carol Boys, chief executive...

Indicator pilots progressing well.
August 21, 2009... NICE's process for evaluating potential indicators needs to be improved, but indicator pilots are progressing well, those involved with the new evaluation scheme have said. After its first meeting, NICE's QOF committee said: 'There is a need...

GPs urged to publish their incomes.
August 21, 2009... GP profits NHS Alliance backs contractual requirement to publish GP income. Practices should fight back against 'fat cat GP' stories by publishing full details of profits, the NHS Alliance has said. The Daily Mail recently published a...

GP Diary.
August 21, 2009... WE LOVE THE NHS Britain normally reserves moments of national unity for sporting events and world wars. How heart-warming, then, to watch the recent outpouring of love towards the NHS. The US, you see, has been using the horrors of the...