GP articles from February 2006

GP archives from February 2006

Patient views worth pounds 20,000.(average practice in England)
February 24, 2006... Increased emphasis on patient surveys in the revised GMS contract means that up to pounds 20,000 for the average practice in England will depend on patient opinion. GPs fear that the surveys could undermine patient care because they lack...

Clinical points 10% harder to achieve.(clinical quality)(Brief Article)
February 24, 2006... Practices that scored fewer than 400 of 550 clinical quality points will have to work at least 10 per cent harder to earn the same income from the revised framework, according to the BMA. Six per cent of practices scored below this level...

More complications of cocaine.(Brief Article)
February 24, 2006... In addition to cardiac and pulmonary problems, users of cocaine and crack cocaine risk gastrointestinal complications such as small or large bowel perforation or intra-peritoneal haemorrhage. These conditions are more common in younger...

NICE downgrades beta-blockers.(NICE and the British Hypertension Society)(beta-blockers)(Brief Article)
February 24, 2006... Draft joint hypertension guidelines from NICE and the British Hypertension Society (BHS) have deemed beta-blockers largely ineffective. The joint guidance, published earlier this week, is intended to clear up the confusion caused by...

Oral steroids raise risk of TB five-fold.
February 24, 2006... Patients on oral glucocorticoids are five times as likely as other patients to develop TB, according to an analysis of UK data. GPs should update their procedure for prescribing the drugs to include more detailed assessment of patients'...

'Quicker' flu vaccine under development.(Brief Article)
February 24, 2006... A new production method which would allow a large quantity of flu vaccine to be produced in weeks, instead of months is being developed. Although governments around the world have placed advance orders for a vaccine to combat a pandemic...

Research brief: Blood test tells stroke type.(Brief Article)
February 24, 2006... A blood test could be used rapidly to distinguish haemorrhagic and ischaemic stroke, say German researchers. They measured serum levels of glial fibrillary acidic protein (GFAP) in 135 stroke patients within six hours of symptoms. Serum...

Research brief: Ozone unsafe at any level.(Brief Article)
February 24, 2006... Any amount of ozone, produced when vehicle and industrial emissions react with sunlight, is harmful to health, US research has shown. The research analysed data on air pollution, weather and all-cause mortality from 98 urban areas between...

Research brief: Obesity affects asthma medication.(Brief Article)
February 24, 2006... Obesity is associated with more severe asthma, and reduced response to treatment, according to a meta-analysis of placebo-controlled clinical trials of beclomethasone and montelukast. The US researchers found that obese patients in both...

Research brief: Vitamin D does not prevent fracture.(Brief Article)
February 24, 2006... Supplementing post-menopausal women with vitamin D and calcium improves hip bone density, but does not reduce hip fracture, say US researchers. Their study assigned 36,282 postmenopausal women aged between 50 and 79 to receive either 1,000mg...

Research brief: Another look at deja vu.(Brief Article)
February 24, 2006... Some people live with the constant sensation that they have seen it all before, according to researchers at Leeds University. In the world's first study of chronic deja vu, they hope to learn more about the condition, which can often lead to...

Staff training and data gathering key to IT DES.(directed enhanced service)(Brief Article)
February 24, 2006... A breakdown of how all practices in England can earn pounds 1.33 per patient for preparing for Connecting for Health initiatives under an IT directed enhanced service (DES) was published this week. The DES is split into four components....

More work needed on DESs elsewhere in UK.(Directed enhanced services)(Brief Article)
February 24, 2006... Directed enhanced services (DESs) for Wales, Scotland and Northern Ireland have still not been finalised, according to the guidance on quality framework changes and enhanced services released this week. GPC Wales chairman Dr Andrew...

Pension problems resolved for now according to GPC.(Brief Article)
February 24, 2006... The GPC is quietly confident that pensions issues have been resolved sufficiently to allow changes to the GMS contract to be implemented from April. Although the DoH has yet to confirm it will not seek changes to the 2003 arrangements,...

Clinical markers become tougher.
February 24, 2006... Extensive revisions to the quality framework from April will mean GPs having to do more work for their points. As well as seven new clinical domains and 17 new indicators, 17 existing indicators will be made substantially tougher and...

Would-be GPs lack training places.(General Practitioner)
February 24, 2006... General practice is the most popular career choice for medical graduates, but many end up in secondary care because they cannot find a training place, according to a GMC survey. Many more graduates who qualified within the past three...

Private firms will not publish quality scores.(Department of Constitutional Affairs)(publish details of quality scores)(Brief Article)
February 24, 2006... Private providers of GP services will not have to publish details of quality scores because the information is deemed commercially sensitive. The Department of Constitutional Affairs said that private providers would not need to share...

UK biggest spender on CVD.(cardiovascular disease)(Brief Article)
February 24, 2006... UK spending on cardiovascular disease (CVD) is higher than in any other EU country, according to the first assessment of the economic burden of the disease in Europe. The study showed that in 2003, the EU spent 169 billion euros on...

GPs can keep 70% of commissioning savings, says DoH.(Brief Article)
February 24, 2006... Practices will be able to retain at least 70 per cent of savings under practice-based commissioning, the DoH has confirmed. The 'clarification' follows GP unrest over a paragraph in DoH guidance which appeared to state that any savings...

Income pledge key to premises development.
February 24, 2006... The GPC has called on the government to guarantee revenue funding to support new premises for at least 15 years. GPs need to be assured that they will be commissioned to provide a wide range of services or that the PCT will leave space in...

PM says competition will boost standards.(Brief Article)
February 24, 2006... Prime minister Tony Blair has pledged to push up the standards of GPs in deprived areas by forcing them to compete with the independent sector. Speaking at the House of Commons last week, he said that introducing new providers was...

Thermal test for arthritis.
February 24, 2006... Using a new thermal imaging technique to measure fluctuations in temperature of inflamed joints could be a more reliable measure of arthritis severity than typical scoring systems based on blood tests, according to US researchers. The...

Smoking ban ups cessation demand.
February 24, 2006... Primary care smoking cessation services are set to come under pressure as England prepares for a complete ban on smoking in public places next year. From summer 2007, smoking in all pubs, clubs and workplaces will be illegal after MPs in...

Public ignorant of stroke symptoms.
February 24, 2006... Awareness of stroke, particularly transient ischaemic events or 'mini-strokes', is dangerously low, a survey has found. Raising awareness of the symptoms and the need to seek immediate treatment would save lives. Of the 1,000 adults...

Guide to help GPs specialise in treatment of MS.(general practitioners)(multiple sclerosis)(Brief Article)
February 24, 2006... A guide on the management of MS in primary care has been launched to help GPs who want to offer enhanced services for MS patients or have a special interest in the condition. The guide, available on the MS Society's website, brings...

Exclusive: Choice software is slow and unreliable.
February 24, 2006... Almost half the GPs who use the Choose and Book IT system experience problems with it at least once a day, according to a GP survey. Nearly as many GPs say that bookings through it take at least 10 minutes. Of the GPs who used the...

First polyclinic reveals DoH vision.
February 24, 2006... The Centre, in east London, is the type of primary care facility the DoH wants across the country. Edward Davies reports. Last month, the DoH published a 236-page White Paper outlining its plans to move more work to primary care over the...

Behind the Headlines: Does nursery care make children more antisocial?
February 24, 2006... One-to-one care has important developmental benefits for the under-threes. What is the story? Children placed in a nursery before the age of three are more likely to become aggressive and withdrawn than their stay-at-home peers,...

Opinion: Leader - Time to open doors to rush of would-be GPs.(lack of training places )(Brief Article)
February 24, 2006... Good news: lots of medical graduates want to work in general practice. Bad news: there aren't enough training places so they are working in other specialties. Those two statements typify the lack of cohesive thinking about primary...

Opinion: Leader - Hewitt clears the air with a full ban.(Brief Article)
February 24, 2006... Patricia Hewitt should have gone back to her constituency last weekend feeling proud. She will be remembered as a politician who did something unique, that will save lives now and in the future through the most important improvement in public...

Opinion: We are still hell's gatekeepers.
February 24, 2006... Hardy: 'My wife says I think more of you than I do of her.' Laurel: 'Well, you do, don't you?' Hardy: 'Let's not go into that.' We are the thin brown line; like Horatius on the bridge across the Tiber, like the 300 Spartans at...

Opinion: GPs on a mission for satisfaction.
February 24, 2006... Has your practice got a mission statement? It should have, because it may help your mental well-being. There are two types of mission statement. The first is little more than an advert: 'We aim to be the world leaders in widgets.'...

Clinical: Journals Watch - Child obesity, cataracts and COPD.(Chronic Obstructive Pulmonary Disease)
February 24, 2006... Too busy to read the journals? Allow Dr Simon Hunter to guide you through the latest research. Obesity leads to bullying Arch Dis Child 2006; 91: 121-5 Childhood obesity is related to a plethora of adverse physical and...

Clinical: Case Study - How back pain revealed rare syndrome.
February 24, 2006... Acute-onset pain and progressive muscle weakness in an elderly lady initially puzzled Dr Honor Merriman. Rose, an independent and public-spirited 74-year-old, presented with acute onset of lumbar back pain. The pain was so acute that...

Clinical: Expert Opinion - A safer way of transfusion.(Autologous blood transfusion)
February 24, 2006... Autologous blood transfusion is a cost-effective option to bank blood. Autologous blood transfusion (ABT) is a technique that involves the collection of filtered blood from a patient's wound drain, inserted during surgery, and its...

Clinical: Recognising eating disorders in young people and children.
February 24, 2006... An important first step is to get young people to admit to an eating disorder, says Dr Anne Thompson. Eating disorders are a fairly rare form of child mental health disorder, but they can cause considerable morbidity in childhood and...

Clinical: Viewpoint - Medication overuse headache.(daily headache syndrome)
February 24, 2006... GPs need to be alert to the development of a daily headache syndrome, writes Dr David Kernick. Many GPs may be unaware that chronic regular use of medications to treat headache can lead to development of a daily headache syndrome. ...

Clinical: Sites on shoulder problems - part two.(http://orthoinfo.aaos.org/fact/thr_report.cfm)(www.aafp.org/afp/20000601/3291.html)(www.247painrelief.com/index.htm)(www.physsportsmed.com/issues/2002/12_02/levine.htm)
February 24, 2006... Websites related to this week's Clinical Review selected by Dr Keith Barnard. SHOULDER REPLACEMENT This site has mostly curiosity value because shoulder replacements make up only a fraction of the total joint rep- lacement operations...

Clinical: Equipment Review - Lightweight rescue chair handles well.(Sunflower Evacuation chair)
February 24, 2006... In the event of an emergency, this transit chair offers excellent mobility. The Sunflower chair is a lightweight, folding, wheeled chair for transporting immobile or injured patients securely out of buildings, down stairs, or into...

Clinical: Clinical Q&A - Alopecia and complete heart block.(Panel Discussion)
February 24, 2006... Our team of experts answers your questions on heart block and androgenic alopecia. One of my patients has recently been diagnosed as having complete heart block. This patient has not presented with any other signs of ischaemic heart...

Clinical: Shoulder problems - part two.(Shoulder dislocation)
February 24, 2006... THE ESSENTIALS - The shoulder is the most unstable and commonly dislocated joint. - Recurrent shoulder dislocation is a significant disability. - Shoulder replacement is not as successful as hip replacement. - Epicondylitis usually...

Registrar: A Problem Shared - Prescription drugs on the high street.
February 24, 2006... Dealing with drug addiction is a challenging situation and needs a multidisciplinary team effort. THE PROBLEM A woman in her fifties comes to request more diazepam for long-standing anxiety. As you start discussing the possible need...

Registrar: MR CGP Update - H pylori testing in dyspepsia.(Member of the Royal College of General Practitioners )
February 24, 2006... Current situation - Managing dyspepsia costs the NHS around pounds 1.1 billion each year. - There is currently inadequate evidence to guide whether full-dose treatment with a proton pump inhibitor for one month or H pylori 'test and...

Registrar: Pictorial Case Study.(lichen planus diagnosis and treatment )(Brief Article)
February 24, 2006... THE CASE A 50-year-old man presented with erosions on his buccal mucosa. Examination revealed lacy, reticulated streaks on cheeks, gums and lips. He also had purplish pigmented lesions on his arms. He was otherwise well. What are the...

Registrar: Jargon Buster - Local improvement finance trust (LIFT).(Brief Article)
February 24, 2006... What is LIFT? LIFT is a form of public-private partnership, involving the private sector in financing health infrastructure. Pros and cons? LIFT aims to upgrade or replace 3,000 primary care premises and fund 500 one-stop primary care...

Registrar: Patient information and safety.(www.capt.org.uk)(www.info.autism.org.uk)(Brief Article)
February 24, 2006... Website Child Accident Protection Trust www.capt.org.uk These colourful safety guides are suitable for all parents, including those with low literacy, plus professionals working with them, ranging from baby booklets to leaflets for...

Registrar: How to ... improve confidence.(Brief Article)
February 24, 2006... - Act as if you are confident Just as changing your mindset can change your behaviour, changing your behaviour can alter your mindset. Appearing confident and successful will also influence the way in which other people respond to you....

MedEconomics: Finance - How to ... meet the demand for a sports injury clinic.
February 24, 2006... For GPs keen to practise sports medicine, the private healthcare sector is a must. Demand for sports injury clinics is already high and expected to increase in the run-up to the London Olympics in 2012. A survey last year concluded that...

MedEconomics: GP-owned provider plans to keep private rivals at bay.
February 24, 2006... A GP-owned company aims to keep NHS services within primary care control, says one of its directors Dr Tim Kimber. A new GP-owned company is to provide NHS services in the community from April. Innovations in Primary Care (IPC) is owned...

MedEconomics: Develop your skills in leadership and management.
February 24, 2006... GPs are being given a chance to shadow leading figures of industry and the NHS. The RCGP Leadership Programme was launched in 2002 and is designed to develop leadership skills for GPs. The initiative is professionally led and gives GPs...

MedEconomics: Healing history for premises.
February 24, 2006... A GP surgery boasts healing connections for centuries. Nick Baxter finds out more. Dr Rebecca Hatjiosif's north-London premises has housed a GP surgery constantly since it was built in 1888. Before Dr Hatjiosif acquired the building,...

MedEconomics: Claim forms, premises and retirement.
February 24, 2006... NHS RULES Where do we stand regarding requests from insurance companies to complete insurance forms for holidays that have been cancelled due to the sudden unexpected death of a patient of ours, when the people travelling (and therefore...

MedEconomics: The complexities of discrimination law.
February 24, 2006... GPs need to be wary of indirect discrimination in the workplace, writes lawyer Rehan Pasha. The number of discrimination claims has been increasing. Discrimination can be subtle and it can be easy to discriminate unintentionally. ...

MedEconomics: Cut down on stamp duty land tax bills.(Stamp duty land tax)
February 24, 2006... Lynne Abbess explains how to avoid costly tax traps on surgery shares and new leases. Stamp duty land tax (SDLT) has been with us for more than two years yet unwary GPs are still falling into hidden traps that cost them dearly. ...

MedEconomics: Enjoy a great screen and full connectivity.
February 24, 2006... Dr Neil Paul tries out the many different functions of the Palm TX PDA. For years, people have either been in the Palm or the Microsoft camp for PDAs. Palms were cheaper, had better battery life and lots of free software and were...

GP Life: Hearty soup to warm up a chilly month.(General Practitioners)
February 24, 2006... If you're in need of some comfort food, try a tasty wholesome lentil soup, courtesy of Dr Chris Duckham. At this time of year it is often difficult to get excited about fresh, seasonal ingredients. Root vegetables have been the staple of...

GP Life: My best present ... Petzl Tikka headtorch.(General Practitioners)(Product/Service Evaluation)
February 24, 2006... Petzl Tikka PLUS LED Headtorch Price: from pounds 30 Available: www.cotswoldoutdoor.com Let me explain... I am slightly mad, being an early morning jogger, winter and summer, whatever the weather. I realise my folly every cold,...

Plain Tales from the Surgery.
February 24, 2006... OTHERWISE ENGAGED As a practice nurse for the past 13 years, I thought I had heard every possible excuse for missing appointments. However, the one I heard last week takes some beating. The patient in question came in for his...

Mary Selby: Insult me, I'm an English GP.(General Practitioners)
February 24, 2006... It was surprising to hear that UK GPs are insulted far more than their continental counterparts, particularly when you consider that, historically, you could insult an Italian if you smiled at his sister, whereas to insult an Englishman you...

Independent Nurse: Nurse prescribing - DoH admits blunder over confusing advice on unlicensed Mantoux test.(Department of Health)
February 24, 2006... The DoH has admitted that nurses cannot independently prescribe the unlicensed tuberculin in the Mantoux tests for TB. Intense confusion has surrounded the issue after two different departments at the DoH came up with contradictory guidance...

Independent Nurse: CVD - Stroke risk in type-2 diabetes quantified.(Cardiovascular Disease)(Brief Article)
February 24, 2006... Patients newly diagnosed with type-2 diabetes have twice the risk of stroke of the general population, while those diagnosed before the age of 55 are at even greater risk, according to the results of two studies presented at the American...

Independent Nurse: QOF - Quality thresholds likely to be tougher.(Brief Article)
February 24, 2006... Thresholds in the quality framework are likely to be made tougher following a review of the GMS contract, according to GP negotiators. The BMA's GP Committee and NHS Confederation have yet to release the full quality guidance, due to be...

Independent Nurse: Journals Watch - Bladder problems in pregnancy wane postnatally.(Brief Article)
February 24, 2006... A study of 344 first-time mothers in the Netherlands found half experienced overactive bladder (OAB) symptoms and 3.5 per cent had incontinence at 12 weeks of pregnancy. At 36 weeks, 15 per cent of women suffered incontinence, however after...

Independent Nurse: Journals Watch - Health effects of soy protein are negligible.(Brief Article)
February 24, 2006... The American Heart Association reviewed 22 studies of soy proteins and isoflavones and found large amounts reduced cholesterol by 3 per cent compared with milk or other proteins. However, soy protein did not reduce menopause or help treat...

Independent Nurse: Journals Watch - All vacuum cleaners are equal when it comes to dust mites.(Brief Article)
February 24, 2006... Researchers at the University of Manchester compared nasal air samples taken before and during vacuuming with high-efficiency particulate air (HEPA) filters and standard vacuum cleaners. They found no difference between the two and concluded...

Independent Nurse: Journals Watch - Bilingual brains keep old age at bay.(Brief Article)
February 24, 2006... A Canadian psychologist, Dr Ellen Bialystok, from York University in Toronto, carried out a computer reaction time test on 104 people between the ages of 30 and 88. Those who were bilingual had better reaction times and responded to rule...

Independent Nurse: White Paper - Blair urges nurses to play key role in NHS reform.(National Health Service)(Tony Blair)
February 24, 2006... Prime minister Tony Blair has called on nurses to use the increased powers his government has given them to drive through improvements in the NHS. At an impromptu question and answer session for journalists at Westminster last week, Mr...

Independent Nurse: Flu - Copper may help reduce spread.(Brief Article)
February 24, 2006... University of Southampton scientists placed two million plaque-forming units of influenza A on coupons of pure copper or stainless steel at room temperature. After six hours the virus on the copper surfaces was virtually eradicated. Influenza...

Independent Nurse: White Paper - Sainsbury's launches in-store GP surgeries.(Brief Article)
February 24, 2006... Sainsbury's is set to become the first supermarket in the UK to house GP surgeries in a radical move that will see clinicians advising patients just metres away from shopping aisles. The controversial step, predicted by Independent Nurse...

Independent Nurse: Patient Forums - Fears over changes to local health voice.(Brief Article)
February 24, 2006... The government is setting up a panel of experts, chaired by patients' czar Harry Cayton, to assess how a strong local voice in health and social care arrangements can be ensured. The move follows reports that patient forums could soon be...

Independent Nurse: What the papers said.(Brief Article)
February 24, 2006... 'Eating less fat doesn't cut cancer and heart disease risk' - The Scotsman 'Forget all you ever knew about diets' - The Independent 'Fruit, vegetables and low-fat diets have little impact on cancer risk' - The Times What did the...

Independent Nurse: Pensions - NHS pensions under threat as DoH encourages more private providers.(United Kingdom Department of Health)(Brief Article)
February 24, 2006... Nurses can no longer expect access to valuable NHS pensions, following confirmation that at least one new private provider cannot offer the scheme. The European arm of UnitedHealth, a pounds 16 billion US corporation that won contracts...

Independent Nurse: Flu - DoH advises antiviral use for flu-like illness.(Brief Article)
February 24, 2006... Nurses and doctors are being told to start prescribing antiviral drugs to treat flu-like illness after simultaneous outbreaks of influenza B and norovirus reportedly claimed the lives of two children and forced hundreds of schools to close in...

Independent Nurse: White paper - Taskforce examines specialist skills base.(Care Closer to Home Demonstration Group)(Brief Article)
February 24, 2006... The government has set up a taskforce of members of the royal colleges to investigate how to shift six specialties such as ENT and urology from hospitals into the community. Health minister Lord Warner said that the 'Care Closer to Home...

Independent Nurse: Vital statistics - Contraception.(Brief Article)
February 24, 2006... 47% of women are unaware of what type of Pill they are taking - 70% of women would welcome help on newer methods of contraception - 62% of women research contraception options but tend to investigate only two or three A study of...

Independent Nurse: World outbreak information - Week beginning 20 February.(spread of chikungunya disease )(Brief Article)
February 24, 2006... CANADA - Media sources have reported 164 cases (mostly in pre-school children) of whooping cough in Toronto in the last four months. Travellers should ensure their children are up to date with their primary vaccinations. MAURITIUS -...

Independent Nurse: Medical care practitioners - BMA raises concerns about MCP role.(British Medical Association)(medical care practitioners)(Brief Article)
February 24, 2006... The BMA has come out against the idea of medical care practitioners (MCPs) in its response to a government consultation on the roles. Echoing many of the same points made by the RCN in their response (IN, 6 February 2006), the BMA says...

Independent Nurse: Nurse prescribing - Nurse prescribing set to expand in NI.(Brief Article)
February 24, 2006... Nurse prescribers in Northern Ireland look set to follow their colleagues in Wales, Scotland and England in gaining access to the full formulary. A spokeswoman for the Northern Ireland Department of Health, Social Security and Public...

Independent Nurse: Hypertension - Reduced GFR a factor in CHD development.(glomerular filtration rate)(coronary heart disease)(Brief Article)
February 24, 2006... A US study of 30,000 hypertensive patients aged over 55 has found those with reduced glomerular filtration rate (GFR) are more likely to get CHD than end stage renal disease. In addition, in reduced GFR patients, neither ACE inhibitors...

Independent Nurse: News focus - Practice-based commissioning - Nurses win commissioning support.
February 24, 2006... There has been little advice for nurses on commissioning, but the situation is starting to change, says Tamsin Snow. The government is betting heavily that practice-based commissioning (PBC) will transform the NHS from a hospital-centred...

Independent Nurse: Editorial - Social enterprises need support right now.(Editorial)
February 24, 2006... With the NHS facing large financial deficits, the primary care White Paper signalling a shift in the way healthcare will be delivered and ongoing uncertainty for community nurses about where they will be employed, this is clearly a time of...

Independent Nurse: Opinion - We must grasp this exciting opportunity.
February 24, 2006... Well the long awaited White Paper has been out for a few weeks and much of what it mentions had been speculated on for some time, so there were not really many surprises. In terms of public health, I didn't read anything in the White...

Independent Nurse: Opinion - Problems persist in diabetes care.
February 24, 2006... Diabetes frameworks have helped, but care across the UK still has room for improvement, says Simon O'Neill. Diabetes UK and the All Party Group on Diabetes launched our State of the Nations report last December. The report examined...

Independent Nurse: Clinical - Travel health - Risks and symptoms of some rarer insect-borne infections.
February 24, 2006... Do not forget to consider rarer tropical diseases in a returning traveller, says Dr Mike Townend. Last week, some of the common insect-borne diseases for travellers were considered. This article examines some of the less well-known...