GP articles from January 2008

GP archives from January 2008

Opinion: Delivering stylish healthcare over substance.
January 25, 2008... The health centre sign blew down in last week's storm, and I'm replacing it with 'Crossmaglen Foundation Health Centre of Excellence'. If spin works for New Labour, it might just work for me as well. I'd thought Gordon Brown might be a...

Opinion: The spirit of evening surgeries yet to come.
January 25, 2008... It is last thing on Saturday night and I am working the surgery Darzi shift, eight till late, and I find myself with time to pen this message to my past self, the one who had time to write a column in a GP newspaper: My last six patients...

Clinical: Journals Watch - Influenza, migraine and ski injuries.
January 25, 2008... Short on time to catch up on research? Dr Bryan Palmer summarises his pick of the recent papers. - How to avoid catching a cold? BMJ 2008; 336: 77-80 It has been said that the next flu pandemic will travel by plane and perhaps will...

Clinical: Making the best use of clinical radiology services.
January 25, 2008... Dr Gwen Lewis reviews some helpful guidelines from the Royal College of Radiologists. This is the sixth edition of the Royal College's clinical radiology referral guidelines, which goes to show how successful it has been. With radiology...

Clinical: Case study - An unusual football knee injury.(Medical condition overview)
January 25, 2008... A 13-year-old boy suddenly seemed to be losing his form on the pitch, explains Dr Keith Barnard. I had discussed the various merits of the Premiership contenders with Mr Richards on more than one occasion. So when he brought his son...

Education: Medical management - Understanding medical certs.
January 25, 2008... Familiarise yourself with the different medical certificates and their uses, says Dr Lizzie Croton. As a GP in training, you will receive daily requests for correspondence, certificates and letters regarding your patients and their work...

MedEconomics: When a colleague makes a mistake.
January 25, 2008... Peter Mackenzie of the MPS explains what to do when you discover a colleague's error. You are the youngest partner in a five-doctor practice. You have a consultation with a 51-year-old patient who presented with postmenopausal bleeding....

MedEconomics: Ask the experts - Premises and pension.
January 25, 2008... The experts Email questions or phone our experts... NHS Rules - Dr Tim Kimber is a Littlehampton GP and deputy chairman of West Sussex LMC. Email: tim.kimber@nhs.net Investment planning - Liz Willis is an adviser at the medical...

MedEconomics: GP chef has the best of both worlds.
January 25, 2008... Running a restaurant on top of his work as a full-time GP keeps stress at bay for Dr Chris Duckham. People often ask me why I run a restaurant and, more to the point, how I find the time, given that I am a full-time GP who still does...

Dispensing: Representation - Rural GPs across UK need a voice.
January 25, 2008... Julie Griffiths talks to Scottish GPs who are urging the RCGP to establish a rural faculty. Dumfries and Galloway GP Dr Gordon Baird believes it is time for remote and rural GPs to stand up and be counted. He is hoping to set up a rural...

Exclusive - GPs win 70% of APMS contracts.
January 25, 2008... GP-led bids are beating conglomerates to PCT contracts to run surgeries. PCTs are awarding 70 per cent of tendered contracts to run GP services to local practices and GP-led companies rather than to national or multinational...

Prime minister's blanket CKD test may offer little benefit.
January 25, 2008... GPs should only check at-risk patients for chronic kidney disease (CKD), say UK researchers. A study has shown little benefit in screening the whole population for CKD, as promised by prime minister Gordon Brown. The research...

Access is 'not high priority for patients'.(Brief article)
January 25, 2008... Extended hours are not a priority for patients, according to comments attributed to SHA representatives. SHAs have since distanced themselves from the report in the Health Service Journal. Mandy Wearne, NHS North West executive lead...

GP bids to be MP to 'save the NHS'.
January 25, 2008... A Northumberland PMS GP has been spurred on by the privatisation threat to general practice to stand as an independent in the next general election. Dr Steven Ford hopes to represent Hexham, Northumberland, the constituency his practice,...

Doh pays for cardboard nurses.
January 25, 2008... Northumberland GPs have questioned a pounds 5 million DoH campaign to promote hand-washing in North East England, which includes being sent cardboard nurses. Dr Robert Lambourne, pictured with Dr Liz Batley, a partner at the Burnhouse...

Tackling dementia is as vital as cancer and CHD.
January 25, 2008... The DoH needs to put dementia high on its agenda to improve diagnosis rates and treatment in England, according to the Public Accounts Committee (PAC). An estimated 560,000 people in England have dementia, costing the economy pounds 14.3...

Access push will harm out-of-hours.
January 25, 2008... The GPC has expressed concern that extending opening hours will lead to more cases of tired foreign doctors working in the UK. GPC deputy chairman Dr Richard Vautrey said that fewer GPs would be prepared to work out of hours when extended...

Exclusive - Half of GPs lack guidance on tackling pandemic flu.
January 25, 2008... Only a quarter of practices ready to tackle a pandemic. Half of GPs believe that the DoH has failed to provide them with enough information about what to do in the event of an influenza pandemic, according to a GP survey. The survey...

Bid to fix flawed prevalence formula.
January 25, 2008... BMA plans to improve the prevalence formula depend on the DoH's overall settlement. A flaw in the quality framework's prevalence formula, which has seen practices with twice the average prevalence of some conditions paid the same as...

DoH strategy to battle obesity.
January 25, 2008... The DoH launched a strategy for England to fight the growing obesity epidemic this week. The strategy will focus on five areas: healthy children; promoting healthier food choices; building physical activity into daily life; creating...

Targeting immune system cuts heart failure mortality.
January 25, 2008... Modifying the immune system may cut the risk of a cardiac event. Modifying the immune system of heart failure patients could cut their risk of death and hospitalisation for a cardiac event, suggest US research findings. Non-specific...

Surgery helps cure diabetes in obese.
January 25, 2008... Gastric banding boosts the chance of remission from type-2 diabetes five-fold, according to US research findings. Findings come from a trial involving 60 obese patients with a BMI between 30 and 40. Patients were assigned to gastric...

Research briefs.
January 25, 2008... Coffee link to miscarriage Pregnant women should avoid drinking caffeinated drinks. US researchers have found that even moderate consumption could raise the risk of miscarriage. Researchers studied 1,063 pregnant women. Those who...

PCTs delay PBC roll-out by rejecting GP service plans.
January 25, 2008... DoH figures show PCTs are not accepting service redesign plans. PCTs are rejecting the majority of proposals from GP practices for service redesign, hindering the roll-out of new services under practice-based commissioning (PBC). A...

News in brief.
January 25, 2008... Nurse pay settlement Unions fear that the DoH will seek to impose a three-year pay settlement for nurses before the pay review body makes its recommendations next month. But, a three-year deal offered to teachers last week, which exceeds...

NICE guidance on commissioning.(Brief article)
January 25, 2008... NICE has issued six web-based commissioning guides to help GPs effectively commission evidence-based care for patients. The latest guides cover services for memory assessment, hysterectomy, endometrial ablation, female urinary...

GPs urged to register to retain software choice.
January 25, 2008... GP practices could lose the right to choose their clinical IT if they fail to sign up to GP Systems of Choice by April. Practices in England that want to retain control over which IT system they use have been advised to sign up to GP...

NICE breast cancer guideline needs a rethink.
January 25, 2008... Experts call for overhaul of breast cancer follow-up checks to ensure quick detection of recurrences. Better communication is needed between oncologists and GPs to help improve outcomes for breast cancer patients in remission, say...

'Give GPs nurse scrip training'.
January 25, 2008... GPs should be given the same training as nurse prescribers to help make savings on drugs, according to an RCN adviser. A report by the House of Commons Public Accounts Committee last week said the NHS could save more than pounds 200...

Dispensing GPs do not over-prescribe.
January 25, 2008... There is no evidence of higher levels of prescribing for dispensing GPs compared with non-dispensing GPs, according to the Dispensing Doctors' Association (DDA). Its analysis of the House of Commons Public Account Committee (PAC) report...

Elderly patients may lose out in extended hours.
January 25, 2008... Charities fear a loss of continuity of care. Charities are concerned that older patients may suffer because of the government's push to force practices to open for extended hours. Last week, GPC chairman Dr Laurence Buckman wrote to...

QOF needed for osteoporosis prevention.
January 25, 2008... The National Osteoporosis Society (NOS) has criticised the government's move to block improvements to the quality framework. The GPC had agreed improve-ments to the quality framework with NHS Employers. The GPC has written to the...

Practice nurses threaten to quit or go part time over extended hours.
January 25, 2008... Practice nurses may quit or go part time if the DoH imposes extended hours on general practice, nurse leaders have warned. Contract negotiations between the DoH and GP leaders collapsed in December because GPs rejected a deal to open...

Behind the headlines: Do calcium pills increase risk of MI and stroke?
January 25, 2008... Women taking calcium supplements to avoid osteoporosis may be increasing their risk of suffering an MI, according to the press. Research carried out in New Zealand on healthy, postmenopausal women found that they were more likely to have...

Jail fear for contaminated patients.
January 25, 2008... The new Health Bill could give magistrates draconian powers in infection cases, says Joe Lepper. Tucked away in the draft Health and Social Care Bill is a clause relating to public health that gives magistrates sweeping powers over the...

Letter: Letter of the Week - Next-stage review will let GPs influence the future.
January 25, 2008... I would urge GPs to remain engaged with the next-stage review (NSR) (GP, 14 December 2007). This is an opportunity to shape the local NHS for the next 10 years. While I understand the frustration felt by some, it is important to...

Letter: There is more to electric cars than the Toyota Prius.
January 25, 2008... I bought a G-Wiz in May 2003 and had 14,000 happy miles before the battery went (GP, 11 January). I now drive a Citroen Berlingo Electrique which is faster and has a greater range than the G-Wiz. Both are entirely electric. I am...

Letter: Nurses cannot know how quality money is spent.
January 25, 2008... I do not see how nurses, without access to practice accounts and minutes of partnership meetings, can authoritatively state that quality profits have not been reinvested in the practice (GP, 14 December 2007). Dr Jonathan Holbrook, Epsom,...

Your say online: www.healthcarerepublic.com.(Brief article)
January 25, 2008... Healthcare Republic users comments on Lord Darzi's explanation of why polyclinics are vital. What does a part time private consultant know about primary care? Lord Darzi hasn't explained why closing GP surgeries and requiring...

Ballot box.
January 25, 2008... Percentage of GPs opposing pregnancies being terminated in GP surgeries 90% Vote in this week's poll at healthcarerepublic.com

Editorial: GPs must maintain contract-winning ways.(Editorial)
January 25, 2008... Imagine you are planning some work at your surgery, an extension perhaps. How would you go about selecting someone to do the work? What criteria might you apply in awarding the contract? Experience in the type of work required, for a...

Opinion: Soon you'll have to deserve your healthcare.
January 25, 2008... I've gone off the prime minister. It began when his 'government of all the talents' failed to include either Conservatives or GPs. (He obviously has a selective definition of the word 'all'.) Now he has suggested that, instead of the NHS...

Clinical: Clinical Review - Palliative care in MND.
January 25, 2008... Section 1: Epidemiology and symptomatology Motor neurone disease (MND) is a group of related diseases characterised by progressive degeneration of motor neurones of the brain and spinal cord. It includes amyotrophic lateral sclerosis...

Clinical: Allergy or idiopathic anaphylaxis?
January 25, 2008... In the third of our series on food allergy, Dr Michael Radcliffe explains the cause of anaphylaxis. Janice, a 35-year-old veterinary nurse, attended for the results of allergy blood tests. She had experienced an attack of anaphylaxis...

Clinical: At a Glance - Bacterial conjunctivitis vs acute anterior uveitis.
January 25, 2008... Bacterial conjunctivitis Presentation - Conjunctivitis is inflammation of the conjunctiva caused by bacteria, virus or allergy or associated with foreign body. - Bacteria involved are commonly Staphylococcus, Streptococcus...

MedEconomics: How to ... Avoid age-related tribunal claims.
January 25, 2008... Practices should beware age discrimination complaints from job applicants and staff. GP employers must be careful to avoid inadvertently discriminating against job applicants and existing staff on age grounds. The Employment Equality...

Plain tales from the surgery.(Brief article)
January 25, 2008... Car doctor One busy morning, as I was driving to the surgery, my car started making a funny noise. It made me anxious regarding visits or a safe journey home. As luck would have it during surgery one of my patients said that he...

Independent Nurse: Pay - Unions fear government will impose three-year pay deal.
January 21, 2008... Unions fear that the DoH will seek to impose a three-year pay settlement for nurses before the pay review body makes its recommendations next month. However, a three-year deal offered to teachers last week, which exceeds the government's...

Independent Nurse: Community nursing - Scottish nursing plans spark grave concerns.
January 21, 2008... Health experts have expressed 'grave concerns' over job descriptions for nurses issued under a proposed overhaul of community nursing by the Scottish Government. Four health board areas, Tayside, Lothian, Borders and Highland, are to...

Independent Nurse: Prescribing - Call to give GPs nurse training.
January 21, 2008... GPs should be given the same training as nurse prescribers to help make savings on drugs, according to an RCN adviser. A report by MPs on the House of Commons Public Accounts Committee last week said the NHS could save more than pounds...

Independent Nurse: Practice nursing - Nurses may quit if hours are increased.
January 21, 2008... Practice nurses may quit or go part time if the DoH imposes extended hours on general practice, nurse leaders have warned. Contract negotiations between the DoH and GP leaders collapsed in December because GPs rejected a deal to open...

Independent Nurse: Sexual health - Practices treat STIs cheaper than clinics.
January 21, 2008... GP practices can treat STIs more cheaply than GUM clinics, analysis of a local enhanced service (LES) suggests. A study of a LES for treating STIs in City and Hackney PCT in East London showed that treating chlamydia and gonorrhoea cost...

Independent Nurse: Mileage rate rise.
January 21, 2008... NHS Employers is to recommend that from 1 January 2008 the mileage rate for staff travelling up to 9,000 miles per year in cars of up to 1,000cc should increase from 27p to 29.7p per mile, and from 16.2p to 17.8p after 9,000 miles. The rate...

Independent Nurse: Practice staff pay.
January 21, 2008... UNISON is demanding that GP practices consult staff over whether they want Agenda for Change pay scales implemented. Unison head of health Karen Jennings said 'pay parity across the NHS' was vital as the role of primary care increased

Independent Nurse: NICE stroke guidance.
January 21, 2008... A checklist to identify TIA patients who need rapid admission to hospital has been laid out by NICE in draft guidelines. Pre-hospital health professionals have been told to use the Fast Arm Speech Test (FAST) to diagnose stroke or TIA and...

Independent Nurse: Blood clot risk.
January 21, 2008... Sprained ankles and other minor leg injuries may carry a three-fold increased risk of blood clots, a Netherlands study suggests. Major injuries are a known risk factor for venous thrombosis, but experts have been uncertain whether the link is...

Independent Nurse: NHS Reform.
January 21, 2008... NHS staff are being asked for their views on Lord Darzi's 'Our NHS, Our Future' review of the health service. A staff consultation runs until 15 February. Visit www.ournhs.nhs.uk to take part. A separate consultation for members of the public...

Independent Nurse: Health visiting - Family Nurse Partnership scheme to cover 20 more PCTs.
January 21, 2008... The government has announced plans to triple the number of sites involved in the Family Nurse Partnership (FNP) programme during the 2008/9 financial year. Ministers said FNPs, a model of intensive nurse-led home visiting for vulnerable...

Independent Nurse: Journals watch.
January 21, 2008... Calcium pills pose vascular threat Calcium supplements may increase the risk of MI and stroke in postmenopausal women, claim New Zealand researchers. An analysis of 1,471 healthy postmenopausal women taking a daily calcium supplement or...

Independent Nurse: Preventive care - Screening plans could increase workload.
January 21, 2008... Primary care nurses fear DoH plans to expand screening programmes will create a huge increase in their workload. Prime minister Gordon Brown said this month that the DoH would offer all men over 65 ultrasound tests to detect abdominal...

Independent Nurse: Smoking - Patients' smoking status is unrecorded.
January 21, 2008... Recording of patients' smoking status in GP practices is often poor and many who want to quit are not offered the help they need, UK research shows. The proportion of patients for whom smoking status had been recorded varied from 42 per...

Independent Nurse: Vital statistics - Long-term conditions.
January 21, 2008... 15.4 million people in England have a long-term condition. Pounds 7 in every pounds 10 spent on the NHS goes on people with a long-term condition 65% of all outpatient appointments and 72 per cent of all inpatient bed days are for...

Independent Nurse: Workforce - DoH: NHS has enough nurses.
January 21, 2008... The DoH's top workforce official believes the NHS no longer needs to increase overall numbers of nurses and doctors, and refused to rule out further raids by NHS organisations on training budgets. In an interview with Independent Nurse's...

Independent Nurse: Emigration - Nurses leaving for abroad up by 75%.
January 21, 2008... The number of nurses leaving the UK to work in Australia increased by 75 per cent between 2003/4 and 2006/7, NMC figures show. A total of 4,764 registered in Australia in 2006/7, compared to just 2,708 in 2003/4. More than 10,000 in total...

Independent Nurse: Scotland - Community workers get legal protection.
January 21, 2008... The Scottish Parliament has approved the extension of the Emergency Workers Act to cover health professionals working in community settings. The act makes it an offence to assault, obstruct or hinder NHS staff on healthcare premises. ...

Independent Nurse: World outbreak information - Week beginning 21 January.
January 21, 2008... Brazil Two suspected cases of yellow fever have been reported this month in the Goias and Minas Gerais states. Travellers should ensure they are vaccinated and avoid mosquito bites. Italy Nine cases of meningococcal meningitis...

Independent Nurse: NICE - MPs urge NICE to review all new drugs.
January 21, 2008... MPs have urged NICE to base its cost-effectiveness calculations on hard evidence and to link them to what the NHS can afford. In a hard-hitting report on the institute, the House of Commons Health Select Committee told NICE to allow an...

Independent Nurse: Mortality - UK improves on preventable disease.
January 21, 2008... Deaths from preventable diseases in the UK fell dramatically in the six years after a Labour government was elected in 1997 but the country still lags behind most of Europe, new data show. A study into deaths from conditions including...

Independent Nurse: Online resources - Free webcasts on Healthcare Republic.
January 21, 2008... New webcasts on diabetes and continence care are available online from Independent Nurse's website (www.healthcarerepublic.com). The interactive site allows healthcare professionals to watch and listen to leading specialists discuss the...

Independent Nurse: News focus - NHS Reform - Will individual budgets improve care?
January 21, 2008... The DoH wants a more personalised service, but are individual budgets the way forward? Nick Bostock investigates. In July 2000, the NHS Plan promised 'fast, convenient, 24-hour, personalised care' by the end of the decade. With two years...

Independent Nurse: Editorial - Community pilots could spell disaster.(Editorial)
January 21, 2008... News that the Scottish government is pushing ahead with plans to reform community nursing has caused dismay. Pilots to test the new model, which will see a generic community nurse role replace district nurses, health visitors, school...

Independent Nurse: Opinion - A pivotal time for nursing in primary care.
January 21, 2008... I am delighted to have been invited to write a column for Independent Nurse, as we move into the next phase of the development of nursing in primary care. There are many parallels between the objectives of the Queen's Nursing Institute (QNI),...

Independent Nurse: Opinion - In my view - How social care is funded must change.
January 21, 2008... 'The Future of Care Funding: time for a change' is a report from The Caring Choices Coalition and the result of a year-long, public consultation on social care funding. The report found there was no enthusiasm for the current system of...

Independent Nurse: Clinical - What's in a nappy? - Child health.
January 21, 2008... Simple checks on a baby's stool can identify problems early and help the mother and child get the most from feeding, says Heather Welford. In the first week after birth, changes in a baby's stooling can help a breastfeeding mother and...

Independent Nurse: Controlling blood pressure in type-2 diabetes - Diabetes.
January 21, 2008... How much should blood pressure be lowered in type-2 diabetes? Dr Abd Tahrani and Professor Anthony Barnett assess the evidence. Diabetes mellitus is a common metabolic disorder that affected 2.35 million people in the UK in 2005.1 It is...

Independent Nurse: Optimising inhaler technique - Patient education.(Survey)
January 21, 2008... Many professionals cannot demonstrate correct inhaler technique, says Jon Bell. Preliminary findings from a 15-month survey of more than 3,000 UK health professionals have provided one explanation as to why so many patients do not use...

Independent Nurse: Clinical - At a glance - Orbital cellulitis vs Periorbital cellulitis.
January 21, 2008... Orbital cellulitis Discriminatory signs - Infection of the orbital soft tissues. - Usually caused by extension of sinusitis. - Affects older children (average age of 12 years). - Protrusion of the eyeball. - Eyelids...

Independent Nurse: Clinical focus - Primary headaches.(Disease/Disorder overview)
January 21, 2008... Overall key points - Headache is the commonest neurological condition seen in primary care. - Tension-type, chronic daily headache and migraine are the most prevalent. - A simple questionnaire can be used to diagnose most...

Independent Nurse: Clinical Prescribing - Developments in type-2 diabetes.
January 21, 2008... The latest developments relating to treatments for patients with type-2 diabetes are outlined by Dr David Morris. Two new agents for type-2 diabetes have recently been licensed that lower blood glucose levels by facilitating incretin...

Independent Nurse: Clinical Dermatology - Identifying chronic idiopathic urticaria.(Case study)
January 21, 2008... Case study - One third of cases are due to a physical trigger but, in most patients, the cause is unclear. Mrs H, a 32-year-old mother of one, presented at the surgery complaining of a rash, which had developed three weeks earlier, and an...

Independent Nurse: Professional - Developing careers in general practice nursing.
January 21, 2008... The Working in Partnership Programme has created a framework to help practice nurses map out their careers, writes Julie Griffiths. At a recent summit on practice nurse education, England's chief nursing officer Christine Beasley...

Independent Nurse: Professional - Meeting access targets in general practice.
January 21, 2008... A multi-disciplinary 'Same Day Team' is boosting access for patients in Suffolk, writes Carol Amis. Improving patient access to primary care is a pressing challenge for general practice due to access targets set in the enhanced services...

Independent Nurse: Professional Workplace - Career profile - Helen Isles, St Briavels, Gloucestershire.
January 21, 2008... Why did you become a nurse? I always wanted to be a nurse and when I was offered a place on a combined course of SRN/RMN training I knew I definitely wanted it. - How has your career developed since you started nursing? I began...

Independent Nurse: Professional Workplace - Q&As.
January 21, 2008... Accommodating staff with disabilities and consulting children under the age of five. Q: We are taking on new member of staff who is disabled. How can we meet her needs and comply with the Disability Discrimination Act? A: The Act...