GP articles from January 2006

GP archives from January 2006

Exclusive: Services hit as PCTs disregard enhanced floor.
January 27, 2006... A third of PCTs will not spend up to their enhanced services floor in 2005/6, according to a GP investigation. As a result of the underspends, enhanced services, including those for sexual health, warfarin monitoring, dermatology and...

Toddler flu jab 'by next year'.(Brief Article)
January 27, 2006... Toddlers could be included in the annual flu campaign from as early as this year, a member of the Joint Committee on Vaccination and Immunisation (JCVI) has said, although he expects 2007 to be a more likely date. Birmingham GP and...

Paternal DNA eliminated.
January 27, 2006... The mitochondrial DNA of sperm is destroyed after fertilisation according to Japanese research. It found that the mitochondrial DNA in the sperm of medaka fish was completely digested by the egg within two hours of fertilisation. This could...

PCTs threaten maternity and sickness pay.(Brief Article)
January 27, 2006... Funds to cover locum costs while partners are on maternity, paternity or sick leave are under threat because of PCT funding deficits. Blackwater Valley and Hart and North Hampshire PCTs are considering stopping the locum payments from...

Low cholesterol may add to cataracts risk.
January 27, 2006... Low cholesterol levels may contribute to the development of cataracts, according to a Japanese study. The researchers warned that the findings could have implications for patients taking statins or other cholesterol-lowering medication,...

H pylori infection may protect against GORD.(Gastroesophageal reflux)(Brief Article)
January 27, 2006... Helicobacter pylori infection may protect some patients against GORD by reducing acid secretion in the stomach, Japanese researchers claim. In a study of 320 dyspeptic patients, those with an H pylori infection were found to be less...

Research brief: Female foetuses worsen asthma.(Brief Article)
January 27, 2006... Pregnant asthmatic women carrying a girl suffer worse asthma than those carrying a boy, US researchers have said. In the three-year study, the peak flow of 702 New England mothers-to-be was measured. Peak flow lability was calculated as per...

Research brief: Oseltamivir is effective against H5N1.(Brief Article)
January 27, 2006... US research has indicated that oseltamivir (Tamiflu) is effective against the H5N1 avian flu virus, at least in rodents. The research presented at 'Bird Flu: the first pandemic of the 21st Century', a conference held in London last week,...

Research brief: Contraceptive pill does not cause weight gain.(Brief Article)
January 27, 2006... The use of contraceptive pills and patches is not linked to weight gain, according to a comprehensive review of the literature. The analysis of data from 44 trials found that current evidence did not indicate a causal relationship between...

Research brief: A golden cure for Alzheimer's.(Brief Article)
January 27, 2006... Small particles of gold could form the basis of a new treatment for Alzheimer's, according to research carried out in Spain and Chile. Researchers attached gold nano-particles to beta amyloid fibrils in test tubes and exposed them to low...

NICE U-turn on Alzheimer's drugs.
January 27, 2006... NICE has partially reversed its controversial draft recommendation advising against the use of all four drugs licensed to treat Alzheimer's in the UK. New evidence was provided by the drug manufacturers after NICE's first draft guidance,...

GPs face monitoring over sick note levels.(Brief Article)
January 27, 2006... GPs could be monitored on the number of sick notes they sign, under plans unveiled by the government as GP went to press. The proposal is one of a raft of measures outlined in this week's Green Paper on welfare reform, which aims to cut...

Like master, like dog.
January 27, 2006... GP Dr Janet Menage is collecting height and weight data on dogs and their owners to test the hypothesis that the home environment rather than genes determines obesity. Dr Menage aims to compare the BMIs of at least 100 'human:dog units'....

GPC brands employers' MPIG letter inaccurate.(General Practitioners Committee)(Minimum Practice Income Guarantee)
January 27, 2006... The GPC has written to Dr Barbara Hakin, chairwoman of the NHS Employers' negotiators, to complain that her letter to primary care organisations (PCOs) last year, stating there was agreement over the phasing out of MPIG costs, was...

UK GPs are the second highest paid in world.(Brief Article)
January 27, 2006... UK GPs are the second highest paid in the world, only earning less than their counterparts in the US, according to Treasury figures. Figures weighted to reflect purchasing power show that UK GPs earn on average pounds 82,000 per year,...

CBT better for back pain than physical therapy.(cognitive behavioural therapy )
January 27, 2006... Patients with chronic lower back pain could benefit more from cognitive behavioural therapy (CBT) than from physical therapy, according to Dutch research. The study showed that patients given 30 hours of CBT experienced less pain than...

BMA and DoH back abortion ruling.(Brief Article)
January 27, 2006... The DoH and the BMA have backed a High Court ruling on Monday that will retain confidentiality for girls under 16 who seek an abortion. Sue Axon, from Baguley in Manchester, challenged the DoH's guidance for providing confidential abortion...

DoH keeps mum over its pension concerns.(Brief Article)
January 27, 2006... The DoH has yet officially to inform the GPC of its precise concerns about pensions, according to the GPC. When changes to the quality framework were announced in December, GPC negotiators said their implementation depended on agreement with...

NHS commuter centres launched.(Brief Article)
January 27, 2006... The first NHS commuter walk-in centres were launched in London and Manchester by health secretary Patricia Hewitt this week. The two centres, near London's Liverpool Street Station and Manchester Piccadilly Station, are the first of seven to...

CPD trainers fee paid to SHAs.(continuing professional development )(strategic health authorities)(Brief Article)
January 27, 2006... The GPC says the pounds 750 continuing professional development (CPD) fee recommended for GP trainers by the Review Body last year has been paid to strategic health authorities. However, the GPC will continue to monitor the situation. GPC...

Discounted use of GPAQ patient questionnaire.(Brief Article)
January 27, 2006... The Medical Defence Union (MDU) is offering a discount on an online questionnaire service to help GPs conduct patient surveys for the quality framework by 31 March. A secure link to the survey can be added from the practice website or...

Funding available for quality improvement projects.(Brief Article)
January 27, 2006... GPs running projects that aim to drive up clinical quality in primary care have been invited to bid for cash from a pounds 2.4 million fund by the Health Foundation charity. The charity will back up to six projects in total, focusing on...

Four GPs in 10 expect human H5N1 this year.(Brief Article)
January 27, 2006... Almost four in 10 UK GPs believe that the H5N1 avian flu virus will mutate to a human form in 2006. One third of UK GPs believe that mutation to a human form is fairly likely and four per cent think mutation this year is 'highly...

Reserve antivirals for pandemic use.(Brief Article)
January 27, 2006... Antivirals amantadine (Lysovir or Symmetrel) and rimantadine (Flumadine) should not be used for seasonal flu control because of serious side-effects such as insomnia and hallucinations, according to Italian and Australian researchers. ...

Life's a beach.
January 27, 2006... It is sometimes said that a holiday is good for your health. Now a GP in Wandsworth, south-west London, is testing this out by installing a beach in his waiting room, complete with sand, sun loungers and parasols. Dr Alex Bobak thinks...

GPC says patient consent vital to records database.
January 27, 2006... The GPC has voted to oppose IT agency Connecting for Health's plans to upload patient data to a national database without first seeking explicit consent. Under the agency's proposals, all patients in England will have a detailed record...

Pain relief.
January 27, 2006... An epidural injection of steroids and local anaesthetics cuts pain in the acute phase of herpes zoster infection (pictured), but does not prevent long-term postherpetic neuralgia, a Dutch study of 598 shingles patients found. Half were given...

Check family history for lung cancer risk.(Brief Article)
January 27, 2006... GPs have been urged to stay alert for lung cancer symptoms in patients with a strong family history of the disease because they are at high risk of developing the condition. The recommendation follows suggestions by US researchers that...

Patients want clearer consultants' letters.(Brief Article)
January 27, 2006... GPs have suggested that consultants' letters to GPs could be copied to patients if they were written more clearly. The system introduced by former health secretary John Reid whereby hospital doctors write directly to patients instead of...

Prize team.(Dr Peter Standing, Dr Helen Deakin and Dr Paul Norman)(Brief Article)
January 27, 2006... GPs Dr Peter Standing, Dr Helen Deakin and Dr Paul Norman from the Minden Medical Centre in Bury, Manchester, have won a pounds 7,000 award for hypertension research evaluating primary care hypertension management against UK quality targets...

Climb every mountain.
January 27, 2006... A Cumbrian GP and his wife have climbed all 214 Lake District peaks listed in a famous series of guidebooks. Peaks featured in the Pictorial Guides to the Lakeland Fells, written by Alfred Wainwright in the 1950s and 60s, are collectively...

Full indemnity must be mandatory for GPs.(Brief Article)
January 27, 2006... GPs could face a 12 per cent hike in indemnity fees if the government adopts recommendations from the Medical Defence Union (MDU) that all doctors should be fully indemnified. It is currently legal, though not advisable, for GPs to...

Test aids bladder cancer follow-up.(Brief Article)
January 27, 2006... A new protein test combined with cytoscopy can identify 99 per cent of all recurrences of bladder cancer, according to the results of a US study. It may mean that testing for recurrence of bladder cancer can move from secondary care to...

Behind the Headlines: Does diet affect mental health?
January 27, 2006... Could eating healthier food improve our state of mind? Tom Simonite investigates. What is the story? A significant rise in the number of patients suffering mental illness over the past 60 years is down to the increasingly bad British...

Letter: Demise of correction factor is wildly untrue.
January 27, 2006... Dear Editor I think your front-page headline 'GMS correction factor to end' (GP, 13 January) is wildly inaccurate. As a GPC member on the formula review group I can assure you that this is not the case. Indeed, as my practice depends...

Letter: Medico-legal problems if there is no examination.
January 27, 2006... Dear Editor I would like to comment on the advice that 'from a medico-legal perspective, all children must be examined in the presence of their guardian,' (GP, 16 December 2005). I would argue that, from a medico-legal perspective,...

Letter: Sorry nurses, GPs are always the first choice.
January 27, 2006... Dear Editor I have problems explaining to patients why they are not able to see a doctor when they are ill. Let us ask Tony Blair who would he like to see if he was ill - a GP or a nurse practitioner. If he needed a referral to...

Opinion: Dog tired for the midnight call.
January 27, 2006... Ask not for whom the phone rings; it rings for thee - especially late at night. 'Dr Farrell speaking,' I said, my tone of unctuous concern reminiscent of those recorded messages we get from financial institutions. There was a silence...

Opinion: Make the Carr-Hill formula work.
January 27, 2006... Looked at dispassionately, the Carr-Hill formula was actually a sensible attempt to reward practices according to their workload. In practice it failed miserably, being inequitable and unworkable. The government has only itself to blame: by...

Leader: GPs might be well paid but they deserve to be.(Brief Article)
January 27, 2006... UK GPs are the second highest paid in the world. Good news you'd think, except the figures come from a leaked Treasury presentation which called for higher productivity and more control on spending from the NHS. It is good news that,...

Leader: Time to change suspicious minds.
January 27, 2006... Far from 'putting patients at the centre of the NHS', the government's current advice on what correspondence patients should be sent by doctors leaves them feeling sidelined and suspicious that those treating them are holding information...

Clinical: Journals Watch - Statins, aspirin, NRT and dummies.
January 27, 2006... Too busy to keep up with the journals? Allow Dr Louise Newson be your guide to the latest research. Statins do not affect cancer rate JAMA 2006; 295: 74-80 Some analyses have suggested that statins reduce the risk of developing...

Clinical: Practice Dilemma - A reference for a shoplifting case.
January 27, 2006... A patient caught shoplifting wants a character reference. Should you oblige? THE DILEMMA Isabelle is 40 years old, middle class and married with four children. I have known her for four years, and she can be histrionic. She...

Clinical: Equipment Review - Perform cautery with no risk of burning.
January 27, 2006... Hyfrecator or diathermy? Dr Stefan Cembrowicz explains why he prefers the former. I was especially interested in the Conmed Hyfrecator 2000 because we have a much older version of it in the practice. Hyfrecators are an effective...

Clinical: Clinical Q&A - GGT levels, folate and Bell's palsy.(gamma-glutamyl transferase)
January 27, 2006... Our team of experts answer your questions on GGT, folate deficiency and Bell's palsy. I have a 47-year-old male patient who appeared healthy when he was found to have a gamma-glutamyl transferase (GGT) level of 106iu/e about eight years...

Clinical: Investigating carpal tunnel syndrome.
January 27, 2006... Carpal tunnel syndrome and how to manage it, by Dr Emma Lackey and Mr Ron Sutton The carpal tunnel is a bony trough sealed with the flexor retinaculum, containing the median nerve and nine tendons. The median nerve supplies sensation...

Clinical: Viewpoint - Use of lasers in prostatectomy.
January 27, 2006... Laser treatment has great advantages over traditional surgery, writes Mr Tim Larner. Despite the advances in medical therapy for benign prostatic hyperplasia (BPH) with alpha-blockers and 5-alpha reductase inhibitors, around 35,000 UK...

Clinical: Expert Opinion - Matching drugs to patients' DNA.
January 27, 2006... Personalised medicines could enable GPs to target drugs to those who will benefit. Pharmacogenetics, also called personalised medicines, aims to identify an individual's genetic makeup to target drugs to people who will benefit. ...

Clinical: Clinical Review - Thrombocytopenia.
January 27, 2006... THE ESSENTIALS - Platelet counts below 30x109/l can result in clinically significant bleeding. - Thrombocytopenia can be caused by aplastic anaemia. - Infectious diseases, especially viruses, can cause thrombocytopenia. -...

Registrar: A Problem Shared - Dealing with prejudice in practice.
January 27, 2006... GPs must not let patients' attitudes or prejudices prevent them from providing good care. THE PROBLEM A middle-aged male patient whom you have seen a couple of times before makes a somewhat racist, joking comment about the Asian...

Registrar: MRCGP Exam Update - The benefits of stroke units.
January 27, 2006... CURRENT SITUATION - Stroke is the fourth largest cause of death in the UK and the biggest single cause of major disability. - Each year over 130,000 people in England and Wales have a stroke. Of those, about a third are likely to die...

Registrar: Pictorial Case Study.(Brief Article)
January 27, 2006... THE CASE A 50-year-old man presented with an acutely painful left knee which had started five days before but which had worsened in intensity over the past 24 hours. There was no history of trauma. He had no other joint pain and was...

Registrar: What they forgot to tell you ... Removing foreign body in eye.(Brief Article)
January 27, 2006... Evert the eyelid by grasping the lashes and using a suitable small rod (like a swab stick) placed at the top of the tarsal plate. Gently press down with the stick as the eyelid is pulled outwards and upwards. Anaesthetic eye drops may be...

Registrar: How to ... take minutes.
January 27, 2006... - Prepare well Familiarise yourself with the meeting agenda in advance, plus minutes from the last meeting and relevant background documents. Prepare an outline beforehand. It is advisable to sit next to the chairman in case you need to...

MedEconomics: GP Finance - How to ... maximise quality income from AF.(General Practitioners)(Atrial fibrillation)
January 27, 2006... Streamlining data entry and clinical work will maximise the quality points you score for AF, says Dr Lis Rodgers. While the GPC says practices should not rush into work on the new clinical domains, many practices will have done some work...

MedEconomics: Avoid being caught out by IT.(information technology)
January 27, 2006... MDU medico-legal adviser Dr Nicholas Norwell offers advice on cases where technology can cause problems. Phone or email consultations A GP received an email from a new patient who had not yet visited the surgery. She had developed...

MedEconomics: Rules on partnerships and pensions.
January 27, 2006... NHS RULES I read your reply to the retiring single-handed GP (GP, 16 December) with great interest. I am in the process of taking over a practice and wondered on what regulations the requirements to give 28 days' notice to the...

MedEconomics: New pension rules set to benefit GPs - You and your pension.
January 27, 2006... Rules reform in April provides new ways to boost GP pensions, says Paul Kendall. For GPs keen to make the most of their pensions, 6 April is particularly significant this year. Not only is it day one of the 2006/7 tax year. HM...

MedEconomics: Take notes with a digital pad.(Product/Service Evaluation)
January 27, 2006... CONNECTED A great idea for meetings, a digital pad can translate your notes to your PC, says Dr Bryan Palmer. It's not often that you can road test a gadget by using it to write its own review. But the DigiMemo A501 is a portable...

MedEconomics: Websites on the thrombocytopenias.(www.bcshguidelines.com/pdf/BJH574.pdf)(Column)
January 27, 2006... Websites related to this week's Clinical Review selected by Dr Keith Barnard. DETAILED GUIDELINES There was a time when I would have said guidelines like these were over the top in primary care, but these days there are probably...

GP Life: Freetime - Take a laid-back caravan trip.
January 27, 2006... Tow your way to a relaxing holiday in the best locations. 'm sure that on more than one occasion we have all been stuck behind a slow-moving caravan on a road where it is impossible to overtake and we have cursed every caravan owner in...

GP Life: Calling all romantic GPs.
January 27, 2006... Send your loved one a Valentine's message through the pages of GP, and you could win a huge box of chocolates from Hotel Chocolat. Messages can be anonymous. We will publish a selection of the most entertaining, identifiable only by...

Plain Tales from the Surgery.(patient care)
January 27, 2006... GENTLE REMINDER Near the end of a long surgery, I rose to open the door for a lovely 85-year-old lady. As she neared the door, she uttered those immortal words: 'While I'm here, doctor, I am getting quite concerned about my memory'....

Mary Selby: Robbing Peter to save Paul.(primary care trust contracts)
January 27, 2006... Our remuneration, in all its forms (enhanced services, core services, practice-based commissioning) is challenging the tempers of the GPs and PCT board members of our little bit of Suffolk. As one who keeps her ear to the ground, I am...

Independent Nurse: Wales introduces independent nurse prescribing from the full formulary.(British Medical Association)(Royal College of Nursing)
January 27, 2006... Nurses in Wales will finally be allowed to prescribe independently from the full formulary, health minister Dr Brian Gibbons announced last week. The move, anticipated late last year (IN, 12 December 2005), will see Welsh nurses having...

Independent Nurse: Annual urea checks for diuretic patients.(urea and electrolytes test)(Brief Article)
January 27, 2006... Primary care practitioners have been urged to ensure that patients taking diuretics have an annual urea and electrolytes (U&E) test, after a study found no records of the test results for two thirds of a general practice population. The...

Independent Nurse: Support for reduction of sulphonylurea use.(Brief Article)
January 27, 2006... More evidence has emerged to support downgrading sulphonylureas from second- to third-line therapy when NICE reviews glitazones for type-2 diabetes later this year. A Canadian study has confirmed the results of previous trials indicating...

Independent Nurse: Journals Watch - Scorecard could predict high-risk stable angina patients.(Brief Article)
January 27, 2006... After following up more than 3,000 newly diagnosed patients with stable angina from 156 outpatient cardiology clinics, researchers devised a scorecard to show those at high risk of early mortality. Key risk factors include comorbidity,...

Independent Nurse: Journals Watch - Mental exercises heal back pain.(Brief Article)
January 27, 2006... Dutch researchers randomly assigned 223 chronic back pain sufferers to active physical treatment, psychological cognitive behavioural therapy (CBT), a combination of both, or no treatment at all for 10 weeks. They found both physical...

Independent Nurse: Journals Watch - Breastfeeding lowers C-reactive protein.(Brief Article)
January 27, 2006... A New Zealand study of 822 people aged 26 has found women who were breastfed for six months or more had lower average C-reactive protein levels (2.22mg/l) compared with those not breastfed (3.95mg/l). The researchers concluded early postnatal...

Independent Nurse: Journals Watch - Britain's gloomiest day.
January 27, 2006... Practices should expect an influx of patients with depressive symptoms today because 23 January has been named as the UK's worst day. Welsh researchers say the combination of bad weather, debt and the time since the Christmas break make today...

Independent Nurse: Primary care reform - RCN says nurses bidding for services need support.
January 27, 2006... The RCN has called on the government to ensure a level playing field for nurses competing against large corporations to run healthcare services. The union's policy adviser Howard Catton warned that nurses face a 'David against Goliath'...

Independent Nurse: AIDS Drugs delivered by yogurt.
January 27, 2006... Friendly bacteria in yogurt have been genetically modified to release a drug that blocks HIV infection. Researchers hope the bugs might one day be incorporated into yogurts that could be used on a woman's vagina so the bacteria live where the...

Independent Nurse: 'Thousands of NHS jobs could be lost'.(Brief Article)
January 27, 2006... Nearly 4,000 NHS posts could be lost as deficits hit pounds 1.2 billion, according to figures obtained by the RCN. The college, which has been tracking NHS deficits since 2005, said the deepening cash crisis was hitting patient services...

Independent Nurse: Guide for nurses setting up shop.
January 27, 2006... A practical guide on how nurses can set up healthcare services was published by the NHS Alliance last week. The Nuts and Bolts of Primary Care Provision, written for frontline staff, outlines why trusts are seeking new providers and what...

Independent Nurse: Nurses could lose decision-making roles as number of PCTs decreases.
January 27, 2006... Around 2,000 clinicians, including scores of nurses, will lose their place on influential PCT professional executive committees (PECs) when trusts merge, a leading organisation for primary care has warned. The number of PCTs in England is...

Independent Nurse: Antivirals ineffective for treatment of flu.(Brief Article)
January 27, 2006... Antivirals should not be prescribed for seasonal flu, according to Italian researchers. The study combined data from 50 trials on two classes of antiviral drugs, the M2 ion channel inhibitors, amantadine and rimantadine, and the newer...

Independent Nurse: RCN launches 'no pay cut' campaign.(Brief Article)
January 27, 2006... Nurses and doctors have both told Chancellor Gordon Brown to stay out of the workings of the independent pay review bodies. The RCN has started a 'No to a pay cut for nurses' campaign which urges nurses to sign and send an electronic postcard...

Independent Nurse: Vital statistics - Overactive bladders.(Brief Article)
January 27, 2006... 32% of people with overactive bladder (OAB) report they are depressed 43% of people with OAB would not consider consulting a doctor 75% of OAB sufferers say the condition makes daily activity difficult SOURCE: BJU International...

Independent Nurse: What the papers said.(intake of omega-3 fatty acids)(Brief Article)
January 27, 2006... 'The foods that could make us mentally ill'. Daily Mail. 'Poor diet link to rising cases of depression'. The Observer. 'Why what we eat has led to rise in mental problems'. The Daily Telegraph. Increasing rates of anxiety and...

Independent Nurse: PCT Deficits - Community hospital cuts will hit district nurses.(Primary Care Trust)
January 27, 2006... District nurses fear debt-ridden PCTs are planning to close community hospitals and pile more work on already depleted nursing teams. Health secretary Patricia Hewitt has implemented a zero tolerance approach to PCT deficits and many...

Independent Nurse: World Outbreak Information - Week beginning 23 January.(Brief Article)
January 27, 2006... AVIAN INFLUENZA UPDATE The WHO has reported the eighth human avian influenza case in China. This recent case was contracted in the southern province of Hunan. Previous cases were reported from five different provinces and five of the...

Independent Nurse: News focus - PCT reform - Will DoH back down on PCT reform?
January 27, 2006... A report by MPs slammed PCT reform as ill-judged and unworkable Tamsin Snow asks if it will make any difference. The Labour-dominated House of Commons health committee has added its voice to a growing number of calls for the government to...

Independent Nurse: Opinion - Cottage hospital closures make no sense.
January 27, 2006... Community hospitals are an important part of the primary care mix and are highly valued by the communities they serve, but they are increasingly at threat of closure as PCTs with financial deficits struggle to cut costs and balance their...