GP articles from December 2006

GP archives from December 2006

Your practice 2010: Exclusive survey - 80% of GPs see end to UK-wide contract.(general practitioners)
December 8, 2006... Four GPs in five expect an end to the national contract before the end of the decade, according to an exclusive GP survey. The survey also found that more than a quarter expected to alter their opening hours and just 16 per cent felt...

Painkillers can reduce vaccine effectiveness.(cytological research)(Brief article)
December 8, 2006... Vaccinations could have reduced effectiveness if patients are taking NSAIDs, say US researchers. NSAIDs inhibit COX-2, which is produced by B cells. As well as easing pain, blocking COX-2 hinders B-cell production of neutralising...

PM wants GPs to promote NHS changes.(prime minister Tony Blair, general practitioners, United Kingdom National Health Service)(Brief article)
December 8, 2006... GPs should make the case for changes to NHS services that may anger patients, according to prime minister Tony Blair. Speaking at the launch of the NHS Confederation's PCT network in London this week, he said that the key to selling...

Glaucoma damage reduced by rheumatoid arthritis drugs.(Brief article)
December 8, 2006... TNF-alpha blockers could be a novel way of reducing ocular pressure in glaucoma, US researchers have found. The drugs, commonly used to treat rheumatoid arthritis, could be an alternative to surgery or beta-blocker eye drops currently...

Progesterone block prevents breast cancer.(Brief article)
December 8, 2006... Blocking progesterone may prevent or halt the development of breast and ovarian cancers in women with mutations of the BRCA1 gene, findings of a study suggest. The study of mice lacking BRCA1 and the gene p53 showed that mammary tumours...

Research brief: Miscarriages more likely in thin women.(Brief article)
December 8, 2006... Underweight women are 72 per cent more likely to suffer a miscarriage in the first three months of pregnancy than women with a normal BMI, according to UK research. The study was based on a diet and lifestyle survey of 603 women aged 18-55...

Research brief: Immune levels fail to be restored.(Brief article)
December 8, 2006... Antiretroviral therapy fails to restore depleted immune levels in HIV-positive patients, say US researchers. Intestinal biopsies were performed on 54 volunteers who started HIV treatment. After seven years of treatment, 70 per cent of...

Research brief: Predicting severity of RA.(rheumatoid arthritis)(Brief article)
December 8, 2006... Arthritis of the large joints at first presentation predicts the severity of rheumatoid arthritis (RA), say Dutch researchers. The association between the distribution of inflamed joints and the level of destruction of the joints of hands and...

Research brief: TV eases the pain.(venipuncture treatment research)(Brief article)
December 8, 2006... Watching TV is a more potent analgesic than active distraction for children during venipuncture, Italian research has shown. For the study, 69 children aged 7-12 undergoing venipuncture were assigned to TV watching, distraction by mother or a...

DoH demands a pay freeze for GPs.(Department of Health, general practitioners, general medical service)
December 8, 2006... The DoH is once again seeking a zero per cent pay rise in return for more work in negotiations for GMS contracts in 2007/8. NHS Employers, the negotiating arm of the DoH, submitted evidence to the Review Body requesting a general...

DoH figures wrong on pounds 100,000 GP earnings.(Department of Health)(Brief article)
December 8, 2006... Data showing that GP earnings rose 30 per cent to pounds 106,404 on average in 2004/5 may be artificially high, accountants say. Official NHS figures published last week appear to confirm predictions in GP that earnings for 2004/5 would...

Stem cell answer to back pain.(Brief article)
December 8, 2006... Stem cells from bone marrow could be used to cure lower back pain, say UK researchers. They have developed a procedure to generate intervertebral disc cells, which typically degenerate and cause lower back pain. Although still to be tested in...

Sigmoidoscopy is best for bowel screens.(Brief article)
December 8, 2006... Flexible sigmoidoscopy is the most cost-effective bowel cancer screening strategy and should be included in the national bowel cancer-screening programme, say UK researchers. Current bowel screening pilot schemes that target individuals...

NICE must end CKD confusion.(chronic kidney diseases)
December 8, 2006... Confusion over the diagnosis and management of chronic kidney disease (CKD) in primary care could be cleared up in a new NICE clinical guideline. GPs currently refer to the Renal Association guidelines and CKD targets in the quality...

Nebulisers ruled out for bronchiolitis in children.(Brief article)
December 8, 2006... GPs should use nebulisers in the treatment of bronchiolitis in children, according to guidance from SIGN. This is the first clinical guidance of its kind in the UK. It was issued in preparation for the winter months where there is a peak...

Exclusive: Quality score no guarantee of best care.(medical practice)(Brief article)
December 8, 2006... The quality framework does not guarantee a high standard of primary care and allows 'wide differences' between practices scoring similar points. Ordinary GPs believe the quality framework is not a 'sufficient measure of quality' and do...

News in brief: Concerns over national care record database.(chief medical officer Liam Donaldson)(Brief article)
December 8, 2006... GPs have accused CMO Sir Liam Donaldson of a 'complete disdain for privacy and patients' views' after he dismissed concerns about the national care record database. In a standard letter to patients who asked to opt out of the system because...

News in brief: Choice may result in inequality.
December 8, 2006... Government policies on choice and competition may actually result in 'deterioration in the quality and cost-effectiveness of services,' according to the DoH's own research. The NHS Service and Delivery Organisation, working on behalf of the...

News in brief: Charity Christmas stars.(Brief article)
December 8, 2006... The Multiple Sclerosis Society is urging practices to support its Christmas Appeal by selling decorations for it. If you would like to dispense stars (pictured) at a cost of pounds 1 each, call 0870 760 5606 or log on to...

News in brief: Advance appointments are available.(Brief article)
December 8, 2006... Most GP practices operating advanced access schemes still have appointments available for booking in advance, according to research in the British Journal of General Practice. The research says that the advanced access slogan, 'doing today's...

News in brief: Patients challenge APMS plan.(a primary care trust issues alternative provider medical service contract tender)(Brief article)
December 8, 2006... A PCT planning to offer only alternative provider medical service (APMS) contracts to run two PCT-run practices in Staplehurst, Kent, has opened up the tendering process to GMS and PMS bidders following opposition from residents. Residents...

News in brief: A new study facility in Dumfries and Galloway.(Brief article)
December 8, 2006... An Leabharlann (Gaelic for library) is the name for a new study facility at the Newton Stewart Health Centre, Dumfries and Galloway. NHS Education paid to equip the room for the visiting students on GP training placements.

Behind the headlines: Would a male contraceptive pill work?
December 8, 2006... A sperm-blocking contraceptive could be available for men in five years. Sanjay Tanday reports. What is the story? A contraceptive pill for men is to be tested in human studies and could become available on the market in five years'...

Your Practice 2010: Private firms are number one concern.
December 8, 2006... GPs are expressing concerns about private providers and the loss of professional status, reports Edward Davies. Over recent months GP has carried a debate on the challenges and rewards of primary care in 2010 and beyond. This week...

Opinion: Baiting the snake oil sharks.(cures for common cold)
December 8, 2006... Spinoza considered belief to be an emotional state, not liable to any rational persuasion, and another study this week shows homoeopathy to be useless, but its supporters still refuse to accept the evidence. I suppose it's understandable;...

Opinion: Why I'm meeting a seasonal need.(general practitioners joining choral groups)(Viewpoint essay)
December 8, 2006... Christmas is even busier for church organists than for GPs. Actually, organ playing is an allegory of general practice. You need both hands and feet to do it properly so you use your nose or your teeth to turn pages or just wing it;...

Editorial: Is it the end of the 'national' health service?(Survey)(Brief article)
December 8, 2006... Are we facing the greatest postcode prescribing lottery ever seen in the UK? Is the fundamental principle of the National Health Service at risk? Possibly so, if the results of a GP survey are to be believed. Some four fifths of those of...

Opinion: Chris Lancelot on ... Squandering NHS funds.(United Kingdom. National Health Service)
December 8, 2006... We may have reached a watershed in the history of the NHS. Not only has Channel 4 just screened a hard-hitting documentary on the postcode lottery, but it has also produced a detailed website to go with it (www.channel4.com/dispatches)....

Clinical: Journals Watch - Colorectal cancer and HIV prevention.(cancer screening)
December 8, 2006... If you have little or no spare time to read the journals, allow Dr Raj Thakkar to give you a brief account. CHRONIC ILLNESS, COLORECTAL CANCER AND LIFE EXPECTANCY Ann Intern Med 2006; 145: 646-53 This US retrospective study...

Clinical: Anticoagulation therapy.(warfarin)(heparin)(Drug overview)
December 8, 2006... 1. WARFARIN AND HEPARIN Anticoagulation therapy is commonly used for primary and secondary prevention of venous thromboembolism, prevention of systemic embolism in patients with AF or mechanical heart valves, and for treatment of acute...

Clinical: The 'common cold' has a more serious cause.(diagnosis of acute gastroenteritis)
December 8, 2006... Untreated acute gastroenteritis can be extremely serious. Dr Louise Newson explains. CASE STUDY A five-month-old baby presented to the surgery with a cough, runny nose, lethargy, high fever and was off his food. He was still drinking...

Clinical: Websites on anticoagulation therapy.
December 8, 2006... Websites relating to anticoagulation recommended by Dr Keith Barnard. HOW LONG TO TREAT? Many patients are put on warfarin for six months after a thromboembolic episode. This, however, must be working on the 'just in case'...

Clinical: Diagnosing annular skin lesions.
December 8, 2006... SCHAMBERG'S DISEASE The cause of Schamberg's disease is unknown but it is thought to be a form of capillaritis, possibly related to increased venous pressure or eczema. It is similar to drug-induced eruptions such as those associated...

Clinical: Managing irritable bowel syndrome.(Disease/Disorder overview)
December 8, 2006... THE BASICS Though it is common, irritable bowel syndrome can be a debilitating condition, says Dr Nicolette Price. Irritable bowel syndrome (IBS) is a common condition, with reported UK prevalence rates varying from 5 to 22 per cent....

Clinical: At a glance - Impetigo versus eczema herpeticum.(Brief article)
December 8, 2006... IMPETIGO Discriminatory signs - Caused by bacteria Streptococcus pyogenes and/or Staphylococcus aureus. - Usually affects children. - Contagious. - Often occurs on exposed areas such as the hands and face. -...

Clinical: Long-term prescription of aspirin for CHD.(coronary heart disease)
December 8, 2006... CLINICAL Q&A Aspirin and high BP can be a risky combination, says Dr Andrew Clark. Should a patient with known CHD continue to take aspirin despite a BP of 216/94mmHg? I am aware that the joint SIGN guidelines suggest continuation...

Clinical: Equipment Review - A bag designed to hold everything.(Elite doctor's bag from Williams Medical Supplies )
December 8, 2006... The Elite doctor's bag holds flat and bulky objects with ease, says Dr Stefan Cembrowicz. Over the past 30 years I have often pondered how to design a better doctor's bag. I've carried a Victorian leather obstetrician's bag - a...

Registrar: A Problem Shared - Mother asks for weekly home visits.(Discussion)
December 8, 2006... A mother of three children regularly requests home visits that you do not believe are necessary. What should you do? THE PROBLEM A mother of three small children requests a home visit at least once a week for herself or for one of...

Registrar: MRCGP Exam Update - Prescribing COX-2 inhibitors.(Member of the Royal College of General Practitioners)
December 8, 2006... Current situation - Prescribing of celecoxib has fallen dramatically in the UK since the withdrawal of rofecoxib from the market. - There has been recent concern about the cardiovascular safety of COX-2 inhibitors. What is the...

Registrar: Pictorial Case Study.(Brief article)
December 8, 2006... THE CASE A 35-year-old foreman presented with a painful right eye. He admitted the eye was sensitive to light but denied any discharge. He always wore goggles at work to protect his eyes from dust and took regular painkillers for back...

MedEconomics: GP Finance - How to ... remove 'difficult' patients from the list.
December 8, 2006... Beware the pitfalls when the doctor-patient relationship fails, warns the MDU's Emma Cuzner. Removing patients from the practice list when a relationship has irretrievably broken down or when a patient has been violent in the surgery can...

MedEconomics: GPs pilot Met Office cold weather calls.(Chronic obstructive lung disease patients)
December 8, 2006... Cold weather will trigger automated phone calls to COPD patients. Patrick Sachon reports. This winter, nine GP surgeries in Cornwall will pilot an innovative alert system for people with COPD. An interactive automated voice call...

MedEconomics: Start saving for your child's future.
December 8, 2006... Start investing early to give young adults a worthwhile nest egg, says Liz Willis. GPs' children or grandchildren would no doubt like lavish gifts this Christmas, but spending less on presents and putting money aside for their future...

MedEconomics: Throwbacks to the Soviet era remain.(medical practice under the soviet regime)
December 8, 2006... Primary care in Europe. GPs from the Baltic states are slowly gaining professional independence, reports Dr Gerald Michael. After leaving Poland we drove to Vilnius, Riga and Tallinn, the capitals of Lithuania, Latvia and Estonia, where I...

MedEconomics: Housing development offers new home to surgeries.(construction of apartments)
December 8, 2006... A developer building flats for key workers found room for two surgeries. Peter Downey reports. Moving to leased premises is increasingly the solution for GPs in outdated accommodation who are reluctant to shoulder the financial burden of...

MedEconomics: Capital gains tax and the GMS contract.
December 8, 2006... CAPITAL GAINS TAX I do some work from home and each year my accountant claims an amount for me for the use of my home. If I sell my home will I have to pay capital gains tax? Usually if the claim reflects that you use one room for...

GP Life: It was the best summer imaginable.(round britain sailing trip of Dr Sarah Fagg)
December 8, 2006... Three months off, a lifelong ambition and a failed GPS in a fog all added to Dr Sarah Fagg's round-Britain sail. We were halfway through our trip as we cast off at midnight from Stromness, Orkney, and headed into an ominously starless...

GP Life: GP gadget ... digital photo frames.(NuVue NV-561 digital photo frame )
December 8, 2006... Model: NuVue NV-561 digital photo frame Price: pounds 99.95 Available: www.iwantoneofthose.com If you haven't got seriously into Christmas shopping yet, you may not have noticed this year's must-have gadget but, trust us, the...

GP Life: Win a pounds 2,000 flatscreen television.
December 8, 2006... Wouldn't you like to curl up on the sofa this winter and watch the movies of your choice on a fabulously clear, mesmerisingly sharp, larger-than-average flatscreen television? Superlative picture quality is what you will get with the Sony...

GP Life: Three reasons why I use ... www.royalmail.com.(Brief article)
December 8, 2006... Confused by the new pricing structure for parcels? Need a postcode or last delivery date for Christmas? This website has it all, and if it helps to avoid the queue at the post office, it has to be a good thing. 1. Finding the right...

GP Life: A perfect prize weekend in Malta.(Valletta G-House, self catering house)(a weekend trip to Malta)
December 8, 2006... It wasn't actually me who won last year's competition in GP for a holiday for two in the amazing Valletta G-House on Malta. And I'm a nurse, not a GP. But my son is both a GP and the winner and he very kindly gifted his parents with the...

GP Life: 40% off at a luxury lakeside spa in Wales.(Lake Country House Hotel and Spa)
December 8, 2006... Set beside a lake in 50 acres of tranquil parkland close to the Brecon Beacons in Wales, the elegant Lake Country House Hotel and Spa makes the perfect relaxing and romantic retreat. And with this GP offer, you can save 40 per cent on a...

GP Life: Exclusive mortgage rates for GP readers.(Savills Private Finance)(general practitioners)(Brief article)
December 8, 2006... GP is linking up with Savills Private Finance (SPF), one of the UK's leading independent mortgage brokers, to offer readers access to exclusive mortgage deals. This is the latest in a series of partnerships that GP has launched with...

Plain tales from the surgery.
December 8, 2006... DIVERTED APPENDIX I recently received a letter from a consultant in general surgery, about a patient who had been admitted for lower abdominal pain, and had been diagnosed as having appendicitis. The letter read: 'He had open...

Independent Nurse: Community and practice nurse teams should share premises.(Brief article)
December 8, 2006... Co-location or having the same employer would improve the integration of practice and community nursing teams according to leading nurses. The idea was raised at a nursing workshop at the NHS Alliance conference in Bournemouth last...

Independent Nurse: RCN concerned by plan to cap nurses' pensions.(Royal College of Nursing)(Brief article)
December 8, 2006... The RCN is worried by government proposals to indefinitely cap employer contributions to NHS nurses' pensions at 14 per cent. The concern was raised in the college's response to NHS Employer's consultation on the review of the NHS Pension...

Independent Nurse: Merry Christmas.
December 8, 2006... This is the last issue of Independent Nurse for 2006. Our next issue will be published on Monday 8 January 2007. We would like to wish all of our readers a very merry Christmas and a happy new year. Throughout December all the latest news can...

Independent Nurse: Community FTs set to go ahead.(Community foundation trusts )(Brief article)
December 8, 2006... Community foundation trusts (FTs) have been given the go-ahead by the government and Monitor, the independent regulator of NHS foundation trusts. It means PCTs looking to rid themselves of their provider arms will be able to set them up...

Independent Nurse: PBR will stop services going to primary care.(payment by results tariff)(Brief article)
December 8, 2006... The government has admitted there is a perverse incentive in the current payment by results (PBR) tariff that encourages hospitals to prevent services shifting into the community. The admission by health secretary Patricia Hewitt came...

Independent Nurse: Hewitt: School nurses not my responsibility.(primary care trust)(Brief article)
December 8, 2006... Health secretary Patricia Hewitt has said she is powerless to ease the current school nurse shortage. At the recent NHS Alliance annual conference in Bournemouth, she said that, despite the government target for a school nurse in every...

Independent Nurse: Advertising.(health services promotion)(Brief article)
December 8, 2006... Private companies wanting to supply NHS health services will be able to directly compare themselves to current providers, according to a draft DoH code of practice for promoting NHS services. The consulation document proposes no cap on...

Independent Nurse: James Bond.(smoking cessation campaign)(Brief article)
December 8, 2006... Asthma UK has welcomed Casino Royale as the first no-smoking James Bond film. Asthma UK chief executive Donna Covey said it was ironic that the villain, Le Chiffre, who in the past might have been seen smoking, is in the latest film using an...

Independent Nurse: Self Care.
December 8, 2006... All European countries should build on the role of community nurse practitioners to encourage self-care according to a paper produced by the NHS Alliance for the European Forum of Primary Care. One of the authors, Dr Ruth Chambers, said the...

Independent Nurse: Health Visitors.(Brief article)
December 8, 2006... The government has said health visitors should help appropriate families with young children to apply for new free vouchers for milk, fresh fruit and vegetables and vitamin supplements. The vouchers can be spent at supermarkets and chemists...

Independent Nurse: Regulation.(Mental Health Act)(Brief article)
December 8, 2006... The government has launched a consultation on the merits of merging the regulators for health, social care and the Mental Health Act. Joint regulation and pricing should ensure a level playing field for providers.

Independent Nurse: PCTs urged to set indicative budgets for community care.(Primary Care Trust)(Brief article)
December 8, 2006... PCTs should set indicative budgets for community services under new guidance on practice-based commissioning from the DoH. The guidance says PCTs should calculate the budgets, even if only on a whole time equivalent or per capita...

Independent Nurse: Vital statistics - Drinking.(Office of National Statistics report)(Brief article)
December 8, 2006... 69% of adults in Great Britain are aware of consumption guidelines 35% of men are exceeding daily alcohol consumption guidelines 20% of women are exceeding daily alcohol consumption guidelines The Office of National Statistics...

Independent Nurse: GPs failing to reinvest pay rise into practices.(General practitioners)(Brief article)
December 8, 2006... GPs came under intense fire from the national media last week after the government released tax return figures showing GP partners increased their take-home pay in the first year of the new contract by 30 per cent. The average GMS GP...

Independent Nurse: Individuals could be given own budgets.(Brief article)
December 8, 2006... The new chief executive of the NHS David Nicholson wants to further investigate the idea of individual budgets for patients. At a recent NHS Alliance conference in Bournemouth, he acknowledged that achieving proper patient involvement in...

Independent Nurse: Journals Watch - Folic acid protects against stroke.(analysis of homocysteine levels in folic acid)(Brief article)
December 8, 2006... UK researchers conducted a meta- analysis of 16 cohort studies and 80 genetic studies and found lowering homocysteine levels had a protective effect against MI and stroke. Seven randomised trials of folic acid supplementation were too small...

Independent Nurse: Journals Watch - Flu jabs for care home staff.(treatment for flu )(Brief article)
December 8, 2006... A study of 44 UK care homes found those where staff, as well as residents, were vaccinated against flu had significantly lower levels of illness, death, GP consultations and admissions. Staff were encouraged to have the jab, with just under...

Independent Nurse: Journals Watch - Gastric hormones and H pylori.(Helicobacter pylori )(Brief article)
December 8, 2006... Researchers from the University of Nottingham exposed a number of strains of Helicobacter pylori to gastric hormones and monitored their behaviour. They showed adrenaline and noradrenaline enhanced H pylori in a dose-dependent manner. This...

Independent Nurse: Journals Watch - Many friends help sleep.
December 8, 2006... Analysis of four databases on the working populations of northern Sweden looked at stress in the workplace and sleep quality. It showed the risk of difficult sleep is tripled in men if they have few friends to confide in. Among women with few...

Independent Nurse: World Outbreak Information - Week beginning 4 Dec.(epidemics)(Brief article)
December 8, 2006... INDONESIA The WHO confirmed 74 human cases of avian influenza (56 deaths) up to November. Travellers are advised to avoid visiting live animal markets and to wash their hands regularly. COSTA RICA An increase in falciparum...

Independent Nurse: Prescribing CDs under review.(Brief article)
December 8, 2006... The RCN has met with the DoH and the Home Office to ask for nurse prescribing rights to be extended to all controlled drugs. If the Advisory Council on the Misuse of Drugs, which is in charge of drug legislation for the Home Office, and...

Independent Nurse: Nurses may lose PEC places under review.(professional executive committees)(Brief article)
December 8, 2006... An official review of professional executive committees (PECs) has recommended members no longer represent groups but be appointed on the basis of specific skills. The move could mean nurses no longer automatically become part of PECs....

Independent Nurse: Scottish IT system is ready for scrap heap.(General Practice Administration System for Scotland)(Brief article)
December 8, 2006... An independent review of GPASS, Scotland's practice IT system, has recommended it be scrapped in favour of a commercially available system. The review recommended testing available products that can store patient information centrally...

Independent Nurse: News focus - Nurse anger at DoH plans.(professional regulation proposals for recruitment of nurses )
December 8, 2006... Do professional regulation proposals undermine a 'no blame' culture? Judy Sands reports. Many of the government's proposals to overhaul the regulation of healthcare professionals have been condemned by nurses. The first is the...

Independent Nurse: News focus - Review of the year - A year of ups and downs.
December 8, 2006... Judy Sands reviews 2006 and speculates on which issues will continue to dominate 2007. The year kicked off with a bang as the government's long-awaited White Paper on health outside of hospitals was published. It outlined an ambitious...

Independent Nurse: Editorial - Nurses must see benefit of GP pay rise.(General Medical Services contract)(Editorial)
December 8, 2006... News that GP partners earned on average pounds 106,000 in the first year of the new GMS contract (2004/5) will come as no surprise to most primary care nurses. However, what many may not realise is that this represents a whopping 30 per cent...

Independent Nurse: Opinion - We are here to provide high-quality care.(Viewpoint essay)
December 8, 2006... There is a lot of talk about changes in the NHS and job losses. However, we must not forget why we are really here - to provide high-quality nursing care and to look after patients to the best of our ability. I have recently been...

Independent Nurse: Opinion - Improving our children's mental health.
December 8, 2006... All those who work with children must ensure mental health is considered in new initiatives, says Ros Godson. Anyone who works with school-aged children will know that there is concern about the numbers of quite young children who have...

Independent Nurse: The Big Question - Is the community matron role still a good idea?(Discussion)
December 8, 2006... A recent evaluation of the UK's Evercare pilots suggested community matrons do not necessarily prevent hospital admissions. However, the study's author has said there is evidence that they do improve patient care. Is this role a good use of...

Independent Nurse: Clinical - Preserving renal function in diabetes.
December 8, 2006... Renal disease is a common complication of diabetes. Professor Mike Kirby outlines its diagnosis and management. About 1.4 million people in the UK are currently diagnosed with diabetes; but as many as one in four of those with the...