GP articles from December 2011

GP archives from December 2011

Opinion: Why I take a childlike delight in Christmas.(Viewpoint essay)
December 9, 2011... Tidings of comfort and joy. To some people, Christmas sucks; 'Christmas is a sad time,' my Auntie Mamie would say. 'Very sad,' my Auntie Alice would reply, not to be outdone in the relentlessly pessimistic auntie department; their Irish...

Opinion: Promises, promises - they rarely work here.(Viewpoint essay)
December 9, 2011... People need to please those whose space they are in, which may be why Mr and Mrs Rothmans always agree readily to my suggestions of quitting their 30-a-day habit but then head straight to the Toe and Fungus for a pint and a fag. A bit of what...

Education: GP Trainers - Teaching medical students.
December 9, 2011... Planning lessons and varying teaching methods will help to engage students, says Dr Peter Washer. Teaching delivered in primary care has always been a feature of medical education, but in recent years this aspect of future doctors' training...

Commissioning: CCG Progress - The many successes and the odd failure of our CCG.(clinical commissioning group)(Discussion)
December 9, 2011... All of our achievements could be more significant, says Professor Ruth Chambers. The months have raced by since July when we became the clinical commissioning group (CCG) for the 55 practices in Stoke-on-Trent, as opposed to a GP consortium...

MedEconomics - Practice Management - Good delegation brings rewards.
December 9, 2011... GPs and their practice managers cannot afford not to delegate simpler tasks to others, says Fiona Dalziel. With delegation, many people think: 'Why bother? It will be faster to do it myself.' This is an attitude that GPs and practice managers...

MedEconomics: GP Moneysaver - Telephony tips for practices.
December 9, 2011... Choosing the right telephone system depends on what your surgery wants to get out of it, says Nick Coleman. Choosing the right telephone equipment for your surgery and deciding which telephone service to sign up to can be daunting even for...

MedEconomics: In a nutshell ... Junior ISAs for under-18s.
December 9, 2011... These spin-offs from ISAs for adults, Jisas, are suitable for saving for your children's future, says Liz Willis. The junior individual savings account (Jisa) is a new savings scheme for children. It was launched by the government on 1...

MedEconomics: Viewpoint - Premises and GP partner disputes.
December 9, 2011... Justin Cumberlege says a company and a good lease can stop GP partners from falling out badly. With a GP-owned surgery it is frequently the case that only some of the partners own a share in it. This can cause all manner of problems, but...

Journals Watch: Prostate disease and hyponatraemia.(Report)
December 9, 2011... Not had time to read the journals? Let Dr Simon Hunter bring you up to date with the latest research. Does benign prostate disease predict prostate cancer? Br J Gen Pract 2011; 61: e684-91 There are concerns that benign prostate disease...

Clinical: The basics - Concussion.(Report)
December 9, 2011... GPs are often asked to deal with minor head injuries and their consequences, says Dr Keith Barnard. Concussion and mild traumatic brain injury are common clinical problems Mild concussion may involve no, or very brief, loss of consciousness....

Dermatological signs of malignancy.
December 9, 2011... Contributed by Dr Jean Watkins, a retired GP in Hampshire. Acanthosis Nigricans In this condition there is hyperpigmentation and hyperkeratotic thickening of the skin in the flexures, and small papillomatous lesions that may also appear on...

Clinical: Insulin therapy in type-2 diabetes.
December 9, 2011... Insulin therapy is often required, but this effective therapy can be improved. The incidence of type-2 diabetes is increasing worldwide and appropriate and timely methods of management are often debated. Eventually most patients with...

Plain Tales from the Surgery.(Report)
December 9, 2011... The spine of the issue One afternoon I was alarmed to discover a message in my in-tray from one of our receptionists. The message read: 'Patient wanting to know whether he gets the flu injection, he says he has no spine.' Clearly perplexed...

GP online.com: A round-up of the best from GP's website this week.
December 9, 2011... - GP Commissioning Resource Your essential guide to the NHS reforms: how CCGs will work, key Health Bill documents, all in one place. GPonline.com/commissioning - GP internet and social media survey We want to know more about how you...

DoH urges small CCGs to learn from schools.
December 9, 2011... Schools offer template for CCGs, as DoH pledges to 'rural-proof' commissioning. Successful schools prove that clinical commissioning groups (CCGs) do not need to be large to cope with becoming statutory organisations, the health secretary has...

Private firms to benefit from cash squeeze.(Brief article)
December 9, 2011... CCGs are facing funding pressure. Financial pressure on clinical commissioning groups (CCGs) could force them to devolve key decisions to private consultants, GPs have warned. DoH managing director of commissioning development for England...

Conference News.(Conference news)
December 9, 2011... GP power GPs in England will have the power to make or break the government's health reforms, NHS experts have said. Professor Paul Corrigan said that if GPs decided to reject the government's plans it would be a political disaster. 'I can't...

CV and stroke risk is halved in patients who self-monitor anticoagulation.
December 9, 2011... Study finds 'striking' outcome improvements. Patients who self-monitor their warfarin therapy halve their risk of DVT, stroke and MI, research suggests. A University of Oxford team reported a 49 per cent reduction in thromboembolic events...

One HIV jab may offer protection.
December 9, 2011... Lifelong HIV protection could in future be provided by a single injection, US researchers believe. A team from California Institute of Technology published findings of research on a technique known as vectored immuno-prophylaxis (VIP). It...

Research Brief: Statins.
December 9, 2011... Statins do not reduce patients' risk of developing infections, researchers believe, despite studies suggesting a link (BMJ 2011; 343: d7281). -------------------- Did you find this article useful? Why not subscribe to the magazine? Please...

Research Brief: Fish tales.(Report)(Brief article)
December 9, 2011... Fish lovers may be protected from Alzheimer's disease, research suggests. But data presented at the Radiological Society of North America annual meeting show the benefit was lost when fish was fried. -------------------- Did you find this...

Can QOF reflect true patient outcomes?
December 9, 2011... Stephen Robinson looks at efforts to make QOF live up to its name. A recent NHS report on the QOF included a revealing line about its link to real patient outcomes: 'QOF has one true outcome-based indicator.' The report went on to say that...

Treating rhinitis can cut asthma risk.
December 9, 2011... Expert points to 50% cut in A&E visits for children with asthma if allergic rhinitis is well managed. GPs can halve emergency admissions for children with asthma by ensuring allergic rhinitis is properly managed, according to a paediatric...

MPs set to tackle drug shortages.
December 9, 2011... Continuing shortages of NHS prescription medicines are putting patients at risk and will be investigated, MPs have said. Shortages of prescription drugs including those for hypertension, depression, diabetes and respiratory disease are...

Patients 'should be paid' to join commissioning boards.
December 9, 2011... Report advises how to involve patients in CCGs, but GPC warns paying patients has risks. Patient representatives on clinical commissioning groups (CCGs) should be paid for their time and offered training, the Patients Association believes. ...

Boost for child headache care.
December 9, 2011... Children with headache could receive better care at school following the launch of a policy by the RCGP and the Royal College of Nursing. The policy gives schools a framework through which to identify and address headache problems in a school...

GPs can slash pounds 500m off A&E costs by 2015.
December 9, 2011... Audit Commission report warns closer links between health and social care vital in efficiency drive. Slashing emergency admissions in high-cost areas to national average rates could save the NHS in England more than pounds 500 million by...

GP develops COPD book for patients.
December 9, 2011... COPD patients in part of south London can carry diagnosis, medication and treatment plans in a wallet-sized booklet developed by a local GP. Patients in Croydon have poor COPD outcomes and the area is among the bottom 10 per cent in England...

Opinion: Ballot Box.
December 9, 2011... Take part in our daily polls at GPonline.com. Results from recent polls include: Are CCGs right to impose inter-practice agreements on their GPs? No 80% Yes 20% Is the BMA right to let GPs vote on the government's final pensions...

Opinion: Your say online.(Viewpoint essay)(Brief article)
December 9, 2011... CCG legal agreements threaten practices - Isn't this story itself creating an unnecessary 'them and us' debate? My opinion is that CCGs should be fully inclusive but surely there should be some form of mutual charter shouldn't there? The...

Letters: Blacklisting drugs is wrong - I rest my case.(Letter to the editor)
December 9, 2011... In response to your story 'PCTs 'blacklist' drugs backed by NICE' (GP, 25 November): Scene: Doctor in court after death of patient. Barrister: 'So doctor, you changed your patient to a cheap substitute for his usual heart drug in order to...

Letters: Managing budgets should not be easily condemned.(Letter to the editor)(Brief article)
December 9, 2011... It is all very well for Dr Sarah Jarvis to condemn commissioners who are trying to manage their budgets ('PCTs curb GP prescribing freedom', GP, 25 November). She doesn't have to balance them. The approval of dabigatran by NICE has a...

Letters: One consortia size does not fit all, Mr Lansley.(Letter to the editor)
December 9, 2011... Your story 'Managers are bullying CCGs over their size and shape' (GPonline.com), shows that a significant number of CCG leads have said they are being forced into larger PCT-size consortia and not being given enough time to agree to local...

Letters: GPs are being bullied into commissioning.(Letter to the editor)
December 9, 2011... All you commissioning lead enthusiasts are out there on your own There is widespread scepticism and there is little real engagement - more like a resigned sense that we have no choice but to go along with it or else we are out in the cold. ...

Editorial: The under-threat UK-wide contract must continue.(Editorial)
December 9, 2011... In an exclusive interview in this week's GP newspaper, GPC Scotland chairman Dr Dean Marshall thinks it is unlikely there will be a UK-wide contract in three to five years. He explains that those in England wanting GP contracts to be held by...

Opinion: Focusing on simple tests can save lots of money.(Viewpoint essay)
December 9, 2011... Despite reminders about reducing NHS expenditure, few realise what huge savings could be made through more focused use of imaging and lab tests. Some PCTs have cottoned on - but in typical PCT fashion, by imposing a blanket ban on the more...

Clinical Review: Subfertility in men.(Report)
December 9, 2011... Contributed by Mr Rowland Rees, consultant urological surgeon, Royal Hampshire County Hospital, Winchester. Section 1: Epidemiology and aetiology Subfertility is defined as failure of conception after 12 months of regular unprotected...

Clinical: New Book - MIMS Consultation Guide.
December 9, 2011... The MIMS Consultation Guide is a vital clinical reference tool for GPs and staff both in the surgery and community. The MIMS Consultation Guide is a new clinical reference book from the publishers of MIMS and GP newspaper. This...

Exclusive - UK GP contract is 'close to collapse'.
December 9, 2011... English NHS reforms are making UK deal untenable, warn GPC leaders. The UK-wide GP contract is heading for collapse in three to five years as NHS reforms create a 'gulf' between England and the other UK nations, GPC leaders have warned. ...

Merry Christmas to all our readers.
December 9, 2011... This is the last issue of GP for 2011. Our next issue will be with you in early January. Over the Christmas period you can keep up with the latest developments in the NHS and primary care, and access exclusive clinical and Medeconomics content...

PCTs plan 25% more work for GPs by 2014/15.
December 9, 2011... Primary care faces cuts but huge rise in GP work looms as NHS shifts work out of hospitals. GP practices could be expected to take on up to 25 per cent more work by 2014/15 as the NHS looks to cut costs by moving care out of hospitals. ...

PCTs hand GP services to other providers.(Brief article)
December 9, 2011... PCTs are increasingly handing GP services to other providers, with pharmacies given almost twice as many local enhanced service (LES) contracts as five years ago, data show. The GPC said practices were now at greater risk of having their...

GPs back historic pension strikes.
December 9, 2011... GPs across the UK showed their support on 30 November for public sector strikes in protest at pension cuts. GPC deputy chairman Dr Richard Vautrey was among GPs who went out to show their support in Manchester. East London GP Dr Kambiz...

Exclusive - GPC warning as NICE scraps GP-led QOF meeting.
December 9, 2011... NICE says QOF is transparent. An internal NICE team will draft new QOF indicators behind closed doors after the institute cancelled a meeting of independent GP advisers. The regular meeting scheduled for December was cancelled just weeks...

Pay is capped at 1% for two years.
December 9, 2011... GP pay awards for 2013/14 and 2014/15 look set to be capped at around 1 per cent after the public sector pay freeze is lifted in 2013. In his autumn review released last week, chancellor George Osborne said public sector pay awards would be...

League table fears as DoH opens up GP data.
December 9, 2011... Patients to have access to records online by 2015 and greater access for pharmaceutical companies. UK practice-level prescribing data will be published in 2012 and individual health records will be available online by 2015, the government has...

GP Diary.
December 9, 2011... NOW WASH YOUR HANDS You'd think it was taught on day one of medical school. Yet two thirds of medical students do not know when to wash their hands. More surprisingly still, these weren't freshers but third-year students Eighty-five of them...

CQC to draw up GP registration plan.
December 9, 2011... The Care Quality Commission (CQC) should draw up contingency plans for GP registration, according to a National Audit Office (NAO) report. The watchdog warned that to date, the CQC had failed to achieve value for money in its role as a...

CCGs 'could be led by managers'.
December 9, 2011... Senior DoH official also confirms that CCGs can buy services from GPs. Clinical commissioning groups (CCGs) could be led by managers instead of GPs, draft DoH guidance has confirmed. The guidance, which sets out plans for CCG governance...

Hard Times Ahead for Scottish GPs
December 9, 2011... GPC Scotland chairman Dr Dean Marshall speaks exclusively to Susie Sell about the tough decisions that lie ahead. Calls for the UK-wide GP contract to be scrapped surfaced at this year's LMCs conference, prompted by the yawning policy gap...

Opinion: Being published is no big thing - or so I'm told.
December 2, 2011... I have a confession to make; I've never had a paper published in a peer-reviewed journal. There, I've said it, it's a weight off my chest. It might not seem a big deal to you, but when I was a young doc, having a paper published was the...

Opinion: Nobody tops a GP when it comes to being nice.
December 2, 2011... A week into my stay in Brunei on a working trip I am gazing at palm trees fringing the South China Sea, and reflecting on how nice GPs always are, wherever you go. We could out-nice a nun. Even a nice nun. The view is made all the more...

Education: GP Training - Academic general practice.
December 2, 2011... Academia can provide a rewarding change from clinical practice, says Dr Mareeni Raymond. Last year I finished an academic ST4 post in general practice, one of the many routes that now exist to help GPs to develop a portfolio career. In the...

MedEconomics: Clinical skills - Ensure you stay competent as a GP.(General practitioners)
December 2, 2011... Using CPD knowledge to deliver excellent patient care is what really counts. Determination to keep your knowledge and skills up to date and to provide high-quality care to your patients is the crucial driving force needed to stay competent as...

MedEconomics: Guard against fraud at the surgery.
December 2, 2011... Fraud at practices could be rising, so GPs should take preventive measures, advises Russell Finn. Practices should take care not to put temptation in the way of practice team members who, if heavily in debt, and desperate enough, might steal...

Commissioning: Health and Wellbeing Boards - Play a leading role in health boards.
December 2, 2011... Joint health and wellbeing strategies are the key to success, write Ed Harding and Michelle Kane. The Health Bill places duties on clinical commissioning groups (CCGs) to take part in and collaborate with new local health and wellbeing...

Clinical: Journals Watch - Stroke risk and cervical cancer.
December 2, 2011... Not had time to read the journals? Let Dr Gwen Lewis bring you up to date with the latest research. Stroke risk and NSAID use - Med J Aust 2011: 195 (9): 525-9 This Australian retrospective cohort study of 162,065 veterans looked at NSAIDs...

Clinical: Clinical Review - Cellulitis and erysipelas.
December 2, 2011... Section 1: Epidemiology and aetiology Cellulitis and erysipelas are infections of the skin and subcutaneous tissues. Now widely regarded as variants of the same condition, elements of both often coexist within an affected area. Such...

Clinical: Rheumatoid arthritis.
December 2, 2011... Early presentation Around 400,000 people in the UK are thought to have rheumatoid arthritis (RA), with 10,000 new cases presenting each year. RA occurs most commonly in the over-70s. The importance of early recognition and urgent referral for...

Clinical: Rare diseases - Alport syndrome.
December 2, 2011... The key features of this inherited cause of kidney failure are summarised by Dr Raj Thakkar. What is it? - Alport syndrome is a rare inherited disorder, which can lead to nephritis and deafness. - It accounts for around one in 500 cases...

Clinical: The basics - Vitamin D deficiency.
December 2, 2011... Certain groups of people should be taking vitamin D supplements routinely, says Dr Louise R Newson. Vitamin D is important for calcium homeostasis and normal bone metabolism. About 90 per cent of the daily requirement is usually obtained from...

Education: A registrar survival guide ... dealing with latecomers.
December 2, 2011... Your surgery is running fairly smoothly, albeit you are 20 minutes behind. It appears that two patients have not attended, allowing you to catch up. A message appears from reception informing you that the two 'non-attenders' have arrived,...

MedEconomics: How good is the practice's bank?
December 2, 2011... If the service the practice is getting is unsatisfactory, consider moving your account. In an ideal world, banks would provide a truly personal service to GP practices, giving you the best financial advice and excellent customer support. ...

MedEconomics: In a Nutshell ... Disclosing patients' details to insurers.
December 2, 2011... The MDU's Dr Jacqueline Phillips guides you through the dos and don'ts. The GMC requires you to have explicit patient consent to provide a report for an insurance company, and you must always be satisfied that the patient understands the...

Commissioning: Viewpoint - Why abolish PCTs if all their staff are such good workers?(primary care trust)
December 2, 2011... Paul Corrigan suggests why Mr Lansley is recommending PCT staff to CCGs. Last month at the National Association of Primary Care conference in Birmingham I heard health secretary Andrew Lansley speak. What interested me most was the way in...

Plain Tales from the Surgery.(Column)
December 2, 2011... - Give us our nasal prayer A newly registered patient, who was a vicar new to the area, came to ask for his nasal spray to be put on as a repeat prescription. As I filled out the prescription form for him, we chatted about his move to the...

Protein finding opens door to novel eczema treatments.
December 2, 2011... Yeast linked to eczema can be killed by peptides. Novel treatments for eczema could be developed from a set of antifungal agents discovered by Swedish scientists. Researchers identified six small proteins that can enter yeast cells and...

Smokers' mortality risk lasts decades.
December 2, 2011... Ex-smokers continue to have higher annual mortality rates than those who have never smoked for 20 years after quitting, a US study has shown. Researchers from Harvard Medical School, Massachusetts, studied a group of 19,705 doctors, with an...

Research Brief: COPD study.
December 2, 2011... Treating COPD exacerbations that require mechanical ventilation with systemic corticosteroids improves patient outcomes. Researchers studied 354 adult patients admitted to ICUs and treated with IV methylprednisolone or placebo (Arch Intern Med...

Research Brief: Jaws evolution.
December 2, 2011... Diet has shaped human jaw bones, and this may explain why many people have problems with overcrowded teeth, researchers believe. Jaws grew shorter and broader as humans took on a more pastoral lifestyle Before this change mandibles were probably...

Privatisation fears fuel BMA anger over Health Bill reform.
December 2, 2011... BMA declares opposition to 'whole of Health Bill' amid fears over draft commissioning guidance. The BMA Council has declared its 'opposition to the whole Health Bill', warning draft DoH guidance signals plans to 'privatise' management support...

GP online.com: A round-up of the best from GP's website this week.
December 2, 2011... - GP internet and social media survey We would like to know more about how you use the internet both in your professional career and in your own personal time. Enter our internet usage and social media survey online and you will have a...

Commissioning funds review may fuel GP list cleaning drive.
December 2, 2011... GPC warns against 'excessive' drive to slash patient lists. A list cleaning drive that has unfairly stripped up to 30 per cent of patients from some practice lists could be stepped up under plans to base commissioning budgets on...

Politicians urge major NHS culture shift.(Brief article)
December 2, 2011... Doctors and patients need to embrace major cultural change in the NHS to prevent it becoming like a redundant 1970s car factory, a former Conservative health secretary has said. Senior figures from the Labour, Conservative and Liberal...

GPs demand veto over back-to-work referrals.
December 2, 2011... Patients' health could be undermined by government plan to cut back on long-term sick leave. GPs must have powers to veto referrals of patients on long-term sick leave to back-to-work schemes if they believe it could jeopardise their health,...

NHS promise to protect training.(united kingdom. national health services)(Brief article)
December 2, 2011... The DoH could top-slice provider income and tighten ring-fencing to boost education and training budgets, the NHS chief executive has suggested. Speaking at the NHS Employers conference in Liverpool last month, Sir David Nicholson faced...

Burnham anger at 'petulant' Lansley.
December 2, 2011... Labour's shadow health secretary has slammed a 'petulant' reply to his offer to help the DoH set up GP commissioning if it scrapped the Health Bill. Shadow health secretary Andy Burnham made the offer last month. Mr Lansley wrote back: 'I...

GP outcome data to be made public.
December 2, 2011... UK may follow plan to publish performance data for all London practices. Outcomes data covering all GPs across London will be made public this month under a deal agreed with LMC leaders. The move is likely to be a forerunner of outcomes...

Limited benefits of paying people to give up smoking.
December 2, 2011... Schemes paying people to quit smoking or lose weight provide only limited and short-term benefits, a review has found. The findings call into question NHS incentive schemes launched in recent years. In the latest review of the evidence,...

Bowel cancer deaths falling.
December 2, 2011... Surgical advances are cutting bowel cancer mortality rates, but better education is needed to reduce late presentation, a report has concluded. The National Bowel Cancer Audit, conducted on behalf of the DoH, assessed NHS bowel cancer care in...

Opinion: Ballot Box.
December 2, 2011... Take part in our daily polls at GPonline.com. Results from recent polls include: Should practices be paid on a pounds-per-patient formula basis rather than using the Carr-Hill formula? Yes 54% No 46% Source: GP. ...

Opinion: Your Say Online.
December 2, 2011... GPC can't support revalidation in its current form Glad there is some common sense out there. The ever-increasing bureaucracy and draconian implications are frankly leading me to despair. Revalidation is a useless tool and political PR. It...

Letters: GMC guidance already covers GPs' private life.(Letter to the editor)
December 2, 2011... Chris Lancelot's opinion piece 'The GMC should keep its nose out of my private life' (GP, 18 November) wrongly implies that the GMC is proposing new powers to regulate a doctor's life outside medicine. The GMC already makes clear in the...

Letters: Pounds-per-patient plan is not necessarily better.(Letter to the editor)
December 2, 2011... In reference to your story 'Pounds-per-patient may replace UK pay formula' (GP, 25 November), simpler sounds good but does it mean that a practice will receive the same money per year for a fit 20-year-old man as for a woman of 85 with chronic...