GP articles from December 2007

GP archives from December 2007

Nurses working beyond competence.
December 14, 2007... More than one in six nurses performing work related to the GMS quality framework has been asked to carry out tasks they felt were beyond their competence, according to a survey by GP's sister magazine Independent Nurse. Thirty per cent...

Relicensing roll-out to be based on PCOs.(primary care organisations)(Brief article)
December 14, 2007... Relicensing will be rolled out first in primary care organisations (PCOs) that have the most information on their clinicians, the GMC has announced. GMC president Professor Sir Graeme Catto revealed that the scheme would be introduced in...

Signature requirements do not delay abortions.
December 14, 2007... The requirement for two doctors' signatures is not delaying terminations of pregnancies, says the government. Data for 2006 show that 68 per cent of terminations take place at less than 10 weeks and 89 per cent at less than 13 weeks,...

Private firms 'play no part in practice franchise plan'.
December 14, 2007... A PCT has ruled out private-sector involvement in its controversial plans to group GP services into a number of 'franchises'. Heart of Birmingham PCT is looking to replace 76 small prac-tices in the area with 24 larger franchised units...

Improvement grants to upgrade GP premises.
December 14, 2007... A PCT has pledged a raft of improvements to practices in its area, bucking a national trend to hold off funding premises upgrades. Portsmouth City Teaching PCT is releasing non-recurrent funding due to run out for a series of improvement...

GMC fee rises by 34%.(General Medical Council)(Brief article)
December 14, 2007... The GMC's annual registration fee will rise by over a third next year. The fee has remained the same for six years, but will rise by pounds 100 to pounds 390 in April 2008. The GMC is raising the fee to cut the deficit forecast for its...

DoH stroke plan queried by cardiovascular GPs.
December 14, 2007... DoH proposals to help reduce the number of strokes in England have been criticised by leading cardiovascular GPs. The DoH recommends that statin therapy should be given to all patients at risk of a stroke and that warfarin should be given...

Flu jabs a 'must' for CHD patients.
December 14, 2007... Patients with CHD have been urged to come forward for flu jabs this winter, after research revealed that flu can double the risk of having a heart attack or stroke. Latest research has shown that the risk of suffering a heart attack or...

GPC rules out GPs charging to give flu jabs.
December 14, 2007... The GPC has ruled out supporting plans to allow GPs to charge to offer flu jabs to patients not eligible for a free jab. Currently, influenza vaccination is offered for free to all patients over the age of 65 and for those in at-risk...

Behind the headlines: Do burnt chips raise risk of cancer?
December 14, 2007... Sanjay Tanday investigates whether women are at higher risk of cancer if they eat overcooked foods. What is the story? Women who eat overcooked fried, roasted or toasted foods may be at an increased risk of developing cancer, media...

New RCGP chairman on the fight ahead for GPs.(Royal College of General Practitioners)
December 14, 2007... Professor Steve Field wants GPs to be leaders, writes Prisca Middlemiss. Professor Steve Field has taken over as chairman of the RCGP as the profession increasingly feels under attack from private providers, the media and the DoH. He...

Letter: QOF score 'disgrace' of PCT-run practices.
December 14, 2007... Dear Editor Your front-page article is an eye opener (GP, 30 November). It is a disgrace to learn that PCT-run practices are failing to achieve national average quality scores, despite higher running costs in comparison with GMS and...

Letter: GP Ballot box.
December 14, 2007... 55% of GPs think the NHS does not need GPSIs This week's question: Should pregnancies be terminated in GP surgeries? Vote now on healthcarerepublic.com

Opinion: Your say online.(Brief article)
December 14, 2007... What Healthcare Republic users have to say on the DoH denying asylum seekers GP treatment: What about contraception then? Surely the same people don't want these sorts breeding and leaving untidy children about the country do they? Or...

Opinion: The growing pains of a GP.
December 14, 2007... Kids, don't you just love the little darlings, I could hug them till their tongues turn blue. I flatter myself that I have an excellent relationship with my young patients. I think they consider me a kind of father figure. Not the cuddly...

Opinion: This year, I'm covering for Santa.(Brief article)
December 14, 2007... It was Christmas Eve. He had been squeezed in as an urgent extra. There was little in his notes, just a consultation after a fight with an elf and some story about being stuck in a chimney. I had suspected too much sherry, but he'd said...

Editorial: What a difference one year can make.(Editorial)
December 14, 2007... This is GP's last issue of the year which means the team has been thinking about the past 12 months and what we might expect from the next. About a year ago we were expecting a fair amount of change. There were concerns over the future...

Opinion: Chris Lancelot on ... Funding healthcare.
December 14, 2007... The nationwide delivery of healthcare is not easy. Our much-vaunted NHS has serious defects. Private insurance schemes are a failure: look at the dreadful situation in the US where large swathes of the population are neither able to...

Clinical: Cystic fibrosis, acne and tattoos.
December 14, 2007... Too busy to catch up on the research? Let Dr Simon Hunter update you on recent papers. Lung transplantation in cystic fibrosis N Engl J Med 2007; 357: 2,143-52 Lung disease causes about 80 per cent of deaths in cystic fibrosis,...

Clinical: Advising patients on cosmetic surgery.
December 14, 2007... GPs have a key role in advising patients on the consequences of cosmetic surgery, says Professor Simon Kay. GPs can help patients considering cosmetic surgery in a number of ways, including determining whether a patient is suitable for...

Clinical: Diagnosis and management of epilepsy basics.
December 14, 2007... Most patients with epilepsy can be helped to live a normal, fit-free life, says Dr Alison Glenesk. Epilepsy is one of the most common neurological conditions, particularly in young people, with over 70 per cent of those who develop...

Clinical: Web resources for pancreatic cancer.
December 14, 2007... Dr Keith Barnard recommends websites relating to this week's Clinical Review. Treatment guidelines This page gives you the option to look up the guidelines for treatment of pancreatic cancer. We don't see that many cases, so...

Clinical Review: Pancreatic cancer.
December 14, 2007... Contributed by Mr Sherif Awad, specialist registrar, and Mr Ian Beckingham, consultant general surgeon at the Wolfson Digestive Diseases Centre, Queen's Medical Centre, Nottingham. 1. Aetiology and epidemiology Pancreatic cancer...

Clinical: Equipment review - Urisys 1100 gives accurate results.
December 14, 2007... A gadget that replaces the dip stick urine test proves effective, reports Dr Jane Barnard. Being old-fashioned in the way I practice, it was going to take something special to persuade me to change my ways with regard to urine testing....

Clinical: Viewpoint - Nurse involvement in CPR decisions.(Cardiopulmonary Resuscitation )
December 14, 2007... New guidelines on involving nurses' views in decisions over who should receive CPR will benefit doctors and patients, says Dr Simon Kenwright. New CPR guidelines issued by the BMA, the Royal College of Nursing and the Resuscitation...

Registrar: Personal development - Recognising and coping with stress.
December 14, 2007... Be aware of the signs of stress and seek help early, advises Dr Mona Kular. Doctors are not immune to stress. Quite the opposite, in fact. Evidence shows that in doctors prevalence of common mental disorders could be as high as 28 per...

MedEconomics: Extended Access - How to... extend surgery opening hours.
December 14, 2007... Our scheme costs came to pounds 6,000 a year and involves the whole practice team, say Dr Peter Smith and Susie Puffett. Our practice in Kingston, Surrey took a corporate decision to extend opening hours using our existing resources. The...

MedEconomics: A better way of reviewing your practice.
December 14, 2007... Reflective writing has been highly therapeutic for Dr Jonathan Knight and Dr Lucy Henshall. Reflective writing reaches the parts of general practice that appraisal cannot. A bold claim, perhaps, but one that we have found to be true. ...

MedEconomics: Life after a surgery revamp.
December 14, 2007... Was it all worth so much hassle? Dr Kevin Brown recalls times of stress and looks at the benefits. In case you missed episode one of our medical centre upgrade (GP, 6 April 2007, p56), we knocked down our flat-roofed, one-storey,...

MedEconomics: Find scanned letters easily.
December 14, 2007... Dr Paul Bromley has developed a software package to help GPs track letters to and from secondary care. Scanning incoming clinical mail as image files and then viewing it easily as part of the clinical record is an essential requirement of...

MedEconomics: Lease value and pension contributions.
December 14, 2007... - Superannuation I am confused about my NHS pension. As a junior doctor, I paid approximately 3.33 per cent of my gross salary toward my pension with the NHS employer making up my remaining 2.67 per cent to a total of 6 per cent. Now as...

MedEconomics: Picking the age to take your pension.
December 14, 2007... Age 58, 60, 63 or 65? When is the best age to draw NHS scheme benefits? Uncertainty over future pay is helping to fuel GPs' interest in taking 24-hour retirement. Doing this enables GPs to take their NHS pension and lump sum, and...

Dispensing: Recognise skills of experienced dispensers.
December 14, 2007... Dr Phillip Koopowitz calls for clarity on training exemptions for experienced dispensers. Last year, the dispensary services quality scheme (DSQS) launched in England and Wales. Like the GMS quality framework, it rewards dispensing...

GP Life: Porsche's polite performer.
December 14, 2007... The Porsche Cayman, a mid-engined two-seater Porsche, shares 40 per cent common parts with the cheaper Boxster convertible. But this one has a stiffened chassis and suspension and more horsepower than most 911s ever produced. Yet with the...

GP Life: Classical CD of the month.
December 14, 2007... Name: Songs by Samuel Barber Composer: Samuel Barber Artists: Gerald Finley, baritone, Julius Drake, pianoforte Label: Hypericon Julius Drake proves a predictably accomplished, thoughtful partner. The pair move easily from the...

GP Life: Win this month's cd.
December 14, 2007... We have five copies of Songs by Barber, to give away. For a chance to win one, send an email to GPlife@ haymarket.com, titled 'Songs by Barber' by Friday 4 January, giving your GMC number and postal address. Reader offer Try three...

GP Life: Win a pounds 1,500 shopping spree.
December 14, 2007... What would you do with pounds 1,500 worth of John Lewis vouchers? Boost your Christmas budget, or save it for the sales? You could book into a hotel near the flagship store in London and make it a weekend to remember. Or just log on to...

GP Life: Colour for the winter garden.
December 14, 2007... Dr Jonathan Holliday gives some festive tips and hints to gardeners and their partners. This is a time of year when berried plants can add interest and colour to a garden. I have always been keen on Cotoneaster horizontalis. Its tiny...

Plain Tales from the Surgery.(Brief article)
December 14, 2007... - Twenty-one again I recently visited an 83-year-old woman who had had a fall. She felt the need to explain to me that it was her birthday soon and that she would be 21 as she only celebrated every fourth birthday. I asked if she was...

Exclusive - Private firms score less on quality points.
December 14, 2007... More than half of practices taken over by private firms score below the English average in the quality framework, GP has found. Of the 30 practices run by private providers during 2006/7, 16 achieved less than the average score for...

Cow disease link to Crohn's disease.
December 14, 2007... A bacterium known to cause illness in cattle may cause Crohn's disease in humans, according to UK research. Mycobacterium paratuberculosis prevents white blood cells from killing Escherichia coli bacteria. E coli is known to be present...

DoH plans to incentivise GPs for stroke strategy.
December 14, 2007... The quality framework indicators for stroke could be expanded to help GPs achieve proposals outlined in the DoH's national stroke strategy, according to the health secretary. Alan Johnson took part in a live web chat last week in which he...

GPC denounces quality of APMS.
December 14, 2007... The GPC has written to the government complaining that plans to promote APMS contracts involving the commercial sector could leave patients in deprived areas with a second-class service. The letter says that lower quality framework scores...

MS lesions halved with antibiotics use.
December 14, 2007... Adding antibiotics to current multiple sclerosis (MS) treatment could help prevent relapses by halving the number of brain lesions formed by the condition, US researchers suggest. Patients with relapsing-remitting MS are prescribed...

Research briefs.
December 14, 2007... Cholesterol link to hearing Levels of cholesterol in the membranes of hair cells in the inner ear can affect hearing, US research suggests. Depleting levels of cholesterol resulted in hearing loss but adding cholesterol increased...

Newborns' respiratory problems linked to caesareans.
December 14, 2007... Elective caesareans increase the risk of respiratory problems in newborns by four-fold, claim Danish researchers. This could be because hormonal and physiological changes in pregnancy are vital for proper maturation of infant lungs. ...

SHAs exclude GPs from Darzi debate.
December 14, 2007... The groups formed to discuss clinical care for Lord Darzi's review of the NHS have been dismissed as 'a sham'. Both the BMA and the RCGP complained that many SHAs' care pathway groups were dominated by professional executive committee...

GP takes to the stage in Sweeney Todd.
December 14, 2007... GP Dr Maria Waters played evil pie-maker Mrs Lovett in The Bridewell Theatre's production of Sweeney Todd this month. Dr Waters, a part-time partner at Elthorne Park Surgery in Ealing, south-west London, found performing at the central...

Patients given social care funds.(Brief article)
December 14, 2007... Personal budgets will eventually be given to patients with chronic conditions in England, the DoH has announced. Half of the pounds 520 million set aside for the Putting People First reforms will come from the NHS budget and will be given...

NICE needs more rimonabant data.
December 14, 2007... Rimonabant should not be used for the treatment of obese and overweight adults, says NICE. More information on how the drug compares to diet and exercise, orlistat and sibutramine with regards to cost effectiveness is needed from...

GP practices to be licensed.
December 14, 2007... All GP practices in England will require a 'license to operate' by April 2010, the DoH has said. It confirmed that the new regulator, the Care Quality Commission, would be established by October 2008, and said that the new registration...

Media glare on GP practice in canoe man case.
December 14, 2007... A media frenzy has descended on the Gilesgate Medical Centre, County Durham, since the arrest of receptionist Anne Darwin. An unnamed member of staff at the practice in Glue Garth said: 'We've had loads of calls. We're not making any...

NICE stepped-care for eczema.
December 14, 2007... GPs should use stepped-care plans to improve control of atopic eczema in children, says NICE. In a guideline published this week, NICE recommends a stepped approach to treatment, with GPs taking into account severity of atopic eczema,...

Further HF concern in rosiglitazone use.
December 14, 2007... The use of rosiglitazone in older diabetic patients can increase the risk of heart failure by 60 per cent, according to US research. The findings add to concerns raised in May, when researchers showed rosiglitazone use was associated with...

GMC ready for challenge over proof.(General Medical Council)
December 14, 2007... The GMC is bracing itself for a High Court challenge in the wake of lowering the standard of proof in fitness-to-practise cases, according to its president. GMC president Professor Sir Graeme Catto said: 'It is a new law and should any...

News in brief.
December 14, 2007... - Joint replacement patients getting younger The average patient undergoing hip or knee joint replacement is now clinically obese and significantly younger than 10 years ago, according to a survey of orthopaedic surgeons. It found that...

Registrar: MRCGP Exam Update - Benefits of email consultations.
December 14, 2007... Current situation - Patients increasingly want to be able to communicate with healthcare professionals by email for various reasons. - Email consultations could potentially play an important role in the delivery of preventive...

Registrar: Pictorial case study.(Disease/Disorder overview)
December 14, 2007... The case A 79-year-old woman had felt slightly unwell for a few days and had then noticed pain over her posterior neck. She had assumed that she had a flu-like illness but then noticed a slight red rash on her neck when looking in the...

Independent Nurse: 1 in 6 nurses asked to do QOF work beyond their competence.
December 10, 2007... More than one in six nurses involved with QOF work have been asked to carry out tasks they felt were beyond their competence, an Independent Nurse survey has revealed. In addition, 30 per cent have been asked to carry out QOF-related...

Independent Nurse: Anger as NMC reverses registration agreement.
December 10, 2007... Union leaders are seeking legal advice over an NMC decision to reverse its stance on allowing nurses to register solely as specialist community public health nurses (SCPHNs). Under a December 2005 agreement, nurses were allowed to be...

Independent Nurse: Merry Christmas.
December 10, 2007... Our next issue will be published on 21 January 2008. We would like to wish all of our readers a merry Christmas and a happy new year. All the latest news can be accessed online at www.healthcarerepublic.com

Independent Nurse: Nurse Family Partnerships.
December 10, 2007... Health minister Ann Keen has promised to set out details of how pounds 30 million allocated to extend Nurse Family Partnership pilots will be spent by the end of the year. She was asked by the shadow health secretary Andrew Lansley in a...

Independent Nurse: Prescriptions.
December 10, 2007... The DoH in England has ruled out ending prescription charges, while Scotland formally announced plans to implement the move. Health secretary Alan Johnson said he believed cutting prescription charges was 'the wrong thing to do'. 'I think...

Independent Nurse: Strike pay.
December 10, 2007... Nurses who go on strike will have a lower proportion of their income docked in future after Unison won a 'landmark' legal case. The High Court ruled that employers must include annual leave and bank holidays when calculating how much pay to...

Independent Nurse: Gender gap.
December 10, 2007... The gender pay gap for nurses has widened since 2002, a report by a leading employment research firm shows. Figures from Incomes Data Services show male nurses earned 2.1 per cent more per hour, excluding overtime, in 2002. In 2007, the gap...

Independent Nurse: Scotland.
December 10, 2007... Chief nursing officer for Scotland Paul Martin has denied the country's review of nursing in the community will 'make traditional nursing roles obsolete'. In a letter to The Herald newspaper, Mr Martin said the plans aimed to make nursing...

Independent Nurse: PCT condemned over plans to cut community nursing service.
December 10, 2007... Nurse leaders have condemned a PCT that hired private sector consultants to cut pounds 2 million off the cost of the trust's community nursing services. PCTs are carrying out similar 'crude and ruthless' reviews across the country,...

Independent Nurse: QOF could rotate to widen clinical scope.
December 10, 2007... QOF targets could rotate every three or four years to allow the framework to cover more clinical areas, under proposals from academics who helped to devise the system. Experts from the University of Manchester's National Primary Care...

Independent Nurse: Home Office rules out cocaine licences.
December 10, 2007... The Home Office has ruled out allowing nurses to apply for licences to prescribe cocaine to manage drug addiction. The move came after the Advisory Council for the Misuse of Drugs formally advised the government to amend legislation to...

Independent Nurse: 41% of PCTs miss community matron recruitment target.
December 10, 2007... Forty-one per cent of PCTs failed to hit targets for recruiting community matrons and case managers in 2006/7, a report shows. In addition, only a third met the target for the number of people with long-term conditions under the care of a...

Independent Nurse: Journals watch.
December 10, 2007... - Broccoli hope for skin disease A natural compound found in broccoli could help to treat the genetic skin disorder epidermolysis bullosa simplex (EBS), US research presented at an American Association of Cell Biology meeting shows....

Independent Nurse: Vital Statistics - HIV and STIs.
December 10, 2007... 73,000 adults in the UK are now living with HIV 21,000 are not aware of their HIV status 10% of young adults tested positive for chlamydia in 2006 Around 73,000 adults in the UK now live with HIV, according to a Health Protection...

Independent Nurse: Antibiotics of little use for sinusitis.
December 10, 2007... Antibiotics and topical steroids are no more effective than placebo for treating acute sinusitis, according to UK researchers. It is another argument against the use of antibiotics, which are prescribed in an estimated 92 per cent of...

Independent Nurse: Plans to speed up stroke response.
December 10, 2007... Patients at high risk of suffering a TIA will be seen within 24 hours in England, under plans unveiled by the DoH. The pounds 105 million 10-year National Stroke Strategy aims to accelerate emergency response by setting out a framework...

Independent Nurse: World Outbreak Information - Week beginning 10 December.
December 10, 2007... Jamaica Health sources reported an outbreak of dengue fever across the island in November. There is no vaccine for this viral disease, which is transmitted by daytime biting mosquitoes. Uganda WHO confirmed an outbreak of Ebola...

Independent Nurse: Nurses need training for NICE plans.
December 10, 2007... Three quarters of the school nurse workforce may not be able to implement NICE guidance on tackling alcohol abuse, a union has warned. NICE guidance for schools on cutting alcohol use in children and young people calls for staff including...

Independent Nurse: QOF nurse survey - Are targets damaging patient care?
December 10, 2007... A survey by Independent Nurse has revealed widespread concern among nurses over the QOF. Nick Bostock reports. Some clinicians see ticking boxes on the QOF target list as a necessary evil, the drawbacks of which are outweighed by the...

Independent Nurse: What do you think?
December 10, 2007... 50% of primary care nurses think that the DoH's plan for five career pathways is a good idea. This week's question Do you think specialist community public health nurses should have to maintain their nurse or midwife registration as...

Independent Nurse: Editorial - Practices must recognise nurses' vital role.(Editorial)
December 10, 2007... Introduced in 2004, the QOF was designed to help improve standards in primary care, put an end to the postcode lottery and ensure all patients, particularly those with long-term conditions, received evidence-based care. By and large it...

Independent Nurse: Opinion - Fond farewell after three years of change.
December 10, 2007... This is my last column for Independent Nurse and a good time for reflection. It has been a privilege to be involved with the magazine for three years and I'd like to thank all of you who took the trouble to read my thoughts, especially...

Independent Nurse: Opinion - Sensitivity is key to combatting obesity.
December 10, 2007... As obesity is once again linked to depression, Jonathan Cunnington explains why a sensitive approach is needed. Earlier this year, The Obesity Awareness and Solutions Trust (TOAST), conducted some research that confirmed the link between...

Independent Nurse: Opinion - What the papers said - Poor sex education fails young people.
December 10, 2007... Sex education lessons are so poor 'that most teenagers have no idea about sexually transmitted diseases or pregnancy,' the Telegraph reported last week. Research among 20,000 young people by the UK Youth Parliament found that almost half...

Independent Nurse: Clinical - Prescribing for chest infections.(Disease/Disorder overview)
December 10, 2007... Careful assessment will help to identify which patients need antibiotics, says Gina Robinson. Chest infections are common at this time of year and this article outlines how to make a diagnosis of acute bronchitis and community acquired...

Independent Nurse: Clinical - Dermatology - A-Z Molluscum contagiosum.(Disease/Disorder overview)
December 10, 2007... This common viral infection occasionally requires referral but can often be left untreated, writes Debra Sprague. Molluscum contagiosum is a viral skin infection characterised by pale, dimpled papules. The condition, caused by a virus of...