GP articles from January 2009

GP archives from January 2009

Education: Emergency medicine - Always be prepared to give resuscitation.
January 23, 2009... Resuscitation is different outside the hospital environment, explain Dr Jon Dallimore and Professor Jonathan Benger. Management of cardiac arrest in the community or the surgery is very different to the management in a fully-staffed...

MedEconomics: Flexible working hours and a carer's rights.
January 23, 2009... Ensure the practice does not discriminate against staff with disabled dependents, warns Claire Brook. A ruling last year by the European Court of Justice (ECJ) could have important ramifications for GP employers when dealing with requests...

Ask the experts: Retirement, surgery rent and partners.
January 23, 2009... Q: Retirement Date I will be 60 in July and the practice's accounting year ends on 4 April Is it better to retire after my birthday or on 4 April? If I return part time at the practice do I still have to pay into the NHS Pension Scheme?...

Plain Tales From The Surgery.
January 23, 2009... - Choice of referral I referred a 60-year old chap recently with rather horrific looking piles. The poor chap had been to see me for a number of consultations and all usual means of gaining control had failed. I had no choice...

Opinion: Becoming a bona fide media slut.
January 23, 2009... 'We're planning a new series, Celebrity Doctor,' said the production company. 'And we wondered, being a celebrity yourself, would you consider mentoring one of the candidates?' My immediate reaction, apart from being secretly flattered...

Opinion: The ghost of healthcare's future.
January 23, 2009... Marley sat alone at PCT head office. A framed picture of Dr Dedicated stood on the mantel. It was Marley's favourite picture of her, the one where she was being dragged protesting from her surgery by antiterrorist police for giving teenage...

Clinical: Medical Antiques - The practise of phisick.
January 23, 2009... Percussion and the pleximeter Percussion is a familiar clinical sign, often taken for granted by most practising clinicians. Unlike many elusive clinical signs, it really can help to identify pathology and fluid in places otherwise...

Clinical: The basics - Hip pain.(Disease/Disorder overview)
January 23, 2009... Recognising hip pain can be difficult, explains Dr Louise Warburton. Hip pain can originate from the back, groin structures or the actual hip joint. It can be difficult to differentiate between the possible origins of the pain, but...

Education: New GP Curriculum Centre.
January 23, 2009... GP has launched a new online Curriculum Centre on Healthcare Republic. Colin Cooper answers your questions. What is the GP Curriculum Centre? The GP Curriculum Centre is a unique online resource that takes the RCGP curriculum for GPs...

Education: Journals club - Self-monitoring of blood glucose in type-2 diabetes.
January 23, 2009... Curriculum statement 15.6 Metabolic problems Key trials - The efficacy of self-monitoring of blood glucose in patients with newly diagnosed type-2 diabetes (ESMON) randomised controlled trial found that newly diagnosed type-2...

MedEconomics: How to ... Approach finding a salaried post.
January 23, 2009... Salaried GP Dr Osman Bhatti considers the current jobs market and employment terms and conditions. In the current tough recruitment climate many newly qualified GPs face difficulties finding a salaried post. While it may be tempting...

MedEconomics: Fit note will replace the sick note.
January 23, 2009... Dr Rob Hampton says that the new medical certificate will aid GPs and help patients return to work. Fishing around for the pad of sick notes feels anachronistic when just about every other administrative task that supports patient care...

Dispensing: Pharmacy white paper - Dispensing GPs saved.
January 23, 2009... There is good news, but more work needs to be done, says Dr Richard West. As I'm sure you will know by now, it appears that dispensing is safe for the time being. On 16 December, Phil Hope, the minister responsible for pharmacy made...

Clinical: Journals Watch - SSRI risk, diabetes and asthma.(selective serotonin reuptake inhibitors)(Disease/Disorder overview)
January 23, 2009... Too busy to catch up on the research? Let Dr Raj Thakkar guide you through some recent papers. Safety of SSRIs during pregnancy - Mayo Clin Proc 2009; 84: 23-7 Depression is common among women of childbearing age. A major concern for...

Clinical: Medico-legal - Going that extra mile.
January 23, 2009... Sometimes medics can do too much for their patients, says Dr Jim Rodger of the MDDUS. Doctors who display a warm, friendly and reassuring manner with their patients are more effective. There is no doubting this and research bears it out....

Clinical: Clinical Review - Non-alcoholic fatty liver disease.(Disease/Disorder overview)
January 23, 2009... - Section 1: Epidemiology and aetiology Obesity-induced liver disease, or non-alcoholic fatty liver disease (NAFLD), is now the most common cause of chronic liver disease in affluent countries. NAFLD describes a spectrum from...

Clinical: Red flag symptoms - Fever in children.(Disease/Disorder overview)
January 23, 2009... Dr Lizzie Croton highlights what to look for in children with fever. - Rash - Unresponsive to treatment - Grey colour, floppy or reduced consciousness - Photophobia or neck stiffness - History of travel overseas Seeing...

GPs are closing the gap on true prevalence of disease.
January 23, 2009... Number of undiagnosed hypertension and diabetes cases is falling. GPs are closing the gap between true levels of disease and cases identified on quality framework registers, analysis by GP shows. Estimated true prevalence of...

MPs query value of GP-led centres.
January 23, 2009... Doctors' leaders have welcomed a report from MPs which argues that GP-led health centres could waste millions of taxpayers' money. The Health Select Committee's report on last summer's Darzi review warned that not every PCT would benefit...

Breast cancer inherited even without BRCA gene.
January 23, 2009... Breast cancer study suggests family history is key risk factor. Women who have a strong family history of breast cancer, but who do not have the faulty BRCA gene, are four times more likely to develop the disease, a Canadian study has...

Saliva test could identify people at risk of diabetes.
January 23, 2009... Saliva tests for diabetes could be developed following the discovery of raised protein levels in people in the early stages of the disease. Researchers from India identified proteins present in saliva samples from 10 controls and 30...

Research briefs.(Report)(Brief article)
January 23, 2009... Dyspepsia treatment The order in which drugs are administered for dyspepsia has implications for cost-effectiveness, Dutch research suggests (The Lancet 2009; 373: 215-225). Hormone help US trials are already under way to see if offering...

Community nurse teams could compete with GPs.
January 23, 2009... Community nursing teams could compete with practices for enhanced services following a change in the way they are funded, doctors have warned. The DoH expects all in-house PCT providers to be in a contractual relationship with...

Win a Philips In-Car DVD player.
January 23, 2009... Enter our competition for a chance to win a Philips In-Car DVD player. With the Philips PET712 player, you can watch DVD movies, listen to music or display digital photos all from the comfort of your car. The dual 7-inch screens can be...

'Give GPs sexual health training in their practices'.
January 23, 2009... Providing sexual health training in GPs' own practices could revive services that are 'stretched to the limit', believes a GP interested in women's health. Practical education for contraception services is underfunded and training can be...

Behind the headlines: Can oral cancer be caused by mouthwash with alcohol?
January 23, 2009... Mouthwashes containing alcohol can cause oral cancer and should be removed from the shelves, media reports have claimed. Australian researchers say that there is now 'sufficient evidence' to prove the link. They propose that the ethanol...

Why GPs have deserted Labour.(general practitioners)(Survey)
January 23, 2009... Red tape and a loss of autonomy have overshadowed NHS advances, GPs say. Jonn Elledge reports. It is no surprise that GPs do not think much of the government Nonetheless, a few eyebrows were raised by the scale of the disaffection...

Opinion: Ballot box.
January 23, 2009... 74% of GPs do not believe the law should be changed so healthcare professionals can play a part in assisted dying. Source: Healthcare Republic. -------------------- Did you find this article useful? Why not subscribe to the...

Opinion: Your say online ... community.healthcarerepublic.com.
January 23, 2009... What GPs are saying online about the health secretary's New Year message for GPs. - How will GPs 'lead the fight against... lifestyle diseases such as obesity' exactly? - How about taxing unhealthy food and subsidising 'healthy'...

Editorial: Prevalence change has not been thought through.(Editorial)
January 23, 2009... Last October, the DoH and GPC proudly announced a change to how prevalence would affect practice funding. From this year, the square root factor is to be ditched and by 2010 pay will be weighted according to true prevalence. This plan...

Opinion: Doctors aren't immune to the impact of a slump.
January 23, 2009... What does the financial future hold for doctors as individuals? In the short term the outlook is relatively good. The government has pledged to keep NHS spending constant for the next two years, so medical jobs are unlikely to be...

Exclusive: GPs face a prevalence lottery.
January 23, 2009... GP investigation reveals extent of practices' gains and losses on prevalence. Practices in some primary care organisations (PCOs) will share up to pounds 1.9 million in extra prevalence funding over the next two years, a GP investigation...

Health Bill backs list-based GPs.
January 23, 2009... The NHS constitution will cement GPs' role at the heart of the NHS, the RCGP chairman has said. Professor Steve Field told GP that the document, published this week, made a 'very strong statement about the role of the GP as the main...

QOF checks for elderly 'pointless'.
January 23, 2009... Incentives to check blood pressure and cholesterol in older patients should be cut from the quality framework because the tests do not predict risk of death from heart disease, Dutch researchers say. Dr Wouter de Ruijter, GP researcher at...

Exclusive: First in-practice abortions 'by spring'.
January 23, 2009... PCTs are pushing ahead with plans to offer terminations in surgeries. PCTs are pushing ahead with plans to offer abortions in surgeries and polyclinics from as early as this spring, GP can reveal. Under the 1967 Abortion Act, an...

Exclusive: Key post-Shipman reform 'dropped'.
January 23, 2009... DoH set to abandon plan to keep records of concerns raised about doctors. One of the most controversial proposals of the new post-Shipman penal system for doctors looks set to be dropped. Recording concerns about fitness to practise,...

'Visit GP for free cancer scrips'.
January 23, 2009... Public health minister Dawn Primarolo this week urged England's 150,000 cancer patients to make an immediate appointment with their GP to discuss free prescriptions. Prime minister Gordon Brown announced that England's cancer sufferers...

Lifeline for PMS practices offered by appeal ruling.(personal medical services )(Brief article)
January 23, 2009... PMS PCTs cancelling contracts may be acting 'beyond their powers'. PCTs that cancel PMS contracts without significant cause are likely to be acting beyond their powers, solicitors have warned. The warning comes as PCTs renegotiate...

GP Diary.
January 23, 2009... GMC hearings - GPs who fear their independence is under siege from bureaucrats are unlikely to have been reassured by a list of upcoming GMC hearings. One alleges that Dr R, a locum, made a string of errors when treating two patients....

GMC urges caution on social networking sites.
January 23, 2009... Number of doctors facing GMC action over inappropriate comments made on social networking sites is on the rise. GPs must exercise extreme caution in making entries on social networking sites, medical defence experts say. A 'very...

London PCT raises bar with QOF-plus.(Primary Care Trusts)(Brief article)
January 23, 2009... Additional payments for improved patient outcomes are being offered to GPs by Hammersmith and Fulham PCT, in London. The PCT is spending pounds 2 million a year over the next three years on 'QOF-plus', an initiative it co-developed with...

Independent Nurse: GPs demand standardised pay scale for nurses in primary care.
January 19, 2009... GPs have called for the development of a standardised nurse pay scale for primary care, as a survey showed just 10 per cent of practices have adopted Agenda for Change (AfC). A survey by Independent Nurse's sister paper GP found that of...

Independent Nurse: Practices cut nurse jobs after fall in profits.
January 19, 2009... Nearly a quarter of UK practices cut staff as profits fell in 2008, a survey has found. One in five practices that cut staff said nurses were among those affected, according to the poll by Independent Nurse's sister publication GP. ...

Independent Nurse: Community nursing teams to face performance-related pay.
January 19, 2009... Funding for community nursing teams in England will be linked to the quality of the services they provide from April, the DoH has revealed. Currently 90 per cent of community health teams, including district nurses and health visitors,...

Independent Nurse: Weak management jeopardises plans.
January 19, 2009... The appalling standard of NHS management is threatening the implementation of the Darzi review, a parliamentary watchdog has warned. The Health Select Committee welcomed the review's emphasis on improving the quality of NHS services. But...

Independent Nurse: Health visitors could have postnatal role.
January 19, 2009... Health visitors can be trained to treat women with postnatal depression, according to UK research. It is estimated that 13 per cent of UK women experience post-natal depression in the year after giving birth. For the study, the...

Independent Nurse: News in brief.
January 19, 2009... CV risk - Homocysteine levels predict cardiovascular risk in older people better than classic measures and other biomarkers. Dutch researchers looked at how well risk factors used in Framingham scores and levels of homocysteine, folic...

Independent Nurse: QOF efforts have cut levels of undetected chronic disease.
January 19, 2009... Practices are closing the gap between true levels of disease and cases identified on QOF registers, analysis by Independent Nurse shows. Estimated true prevalence of hypertension in England rose by around 2.7 per cent from 2004/5 to...

Independent Nurse: Vital statistics - Measles.
January 19, 2009... 1,217 cases of measles were confirmed in England and Wales in 2008 22.9% was the increase compared with figures for 2007 25% of measles cases recorded in England in November 2008 were in London Cases of measles are on the...

Independent Nurse: Journals Watch.
January 19, 2009... Eat to beat flu Restricting calorific intake during influenza infection increases severity of symptoms and risk of death, a study in mice by US researchers suggests. Nutritional Immunology 2008; 138: 2,269 Implant defibrillator...

Independent Nurse: NPs able to manage acute in-hours care.
January 19, 2009... Nurse practitioners can successfully manage acute in-hours care and home visits, a south London study suggests. GP Dr Martin Edwards and colleagues explored the feasibility and outcomes of nurse practitio- ner management of same-day care...

Independent Nurse: Regulator fails to fill key council posts.
January 19, 2009... The NMC has started 2009 even slimmer than planned. The new council, down from 35 members to 14, has failed to fill one of seven seats for lay members. A spokesman could not say when it would be filled. Empty seats remain too on several...

Independent Nurse: Unite scraps plan for strikes over pay deal.
January 19, 2009... The UK's largest trade union, Unite, has scrapped plans for industrial action over the NHS pay deal. The decision comes despite 53 per cent of the union's members voting for strike action in November last year. A total of 95 per cent...

Independent Nurse: Expert defends use of PPV jabs for elderly.
January 19, 2009... Patients should still come forward for pneumococcal vaccination, despite research suggesting that the jab is ineffective in the elderly, a leading immunisation expert has urged. Currently, the pneumococcal polysaccharide vaccine (PPV) jab...

Independent Nurse: Teens failing to use condoms properly.
January 19, 2009... One in three teenagers who report using condoms are either not doing so or are using them incorrectly, a US study has found. Of 715 girls and women aged 15-21 years old who completed computer-based interviews, 186 said they had had sex in...

Independent Nurse: QNI warns district nursing 'undervalued'.
January 19, 2009... District nursing is losing its identity and merging with less skilled, generalist nursing, a report by the Queen's Nursing Institute (QNI) says. The term 'district nurse' is increasingly used to describe nurses without district nursing...

Independent Nurse: World Outbreak Information - Week beginning 19 January.
January 19, 2009... Egypt The WHO confirmed Egypt's 51st human case of avian influenza last month A total of 23 deaths have occurred from the disease. Travellers should avoid contact with poultry and wash their hands regularly. Russia A woman was...

Independent Nurse: QOF changes could increase inequality.
January 19, 2009... Proposed changes to the QOF could undermine the progress it has made in cutting health inequalities, the BMA has said. Changes proposed in the DoH consultation 'Developing the QOF: Proposals for a new, independent process' could also...

Independent Nurse: Surgeries told to fight flu together.
January 19, 2009... GP surgeries should 'buddy up' with neighbouring practices to share staff and resources in the event of a flu pandemic, according to new guidance. The guidance, produced jointly by the Royal College of GPs and the BMA, says that in the...

Independent Nurse: Extended opening at 69% of practices.
January 19, 2009... More than two out of three GP practices in England are now opening for extended hours, DoH figures show. The proportion of practices opening early mornings, evenings or weekends exceeded the government target of 50 per cent by the end of...

Independent Nurse: Obesity adverts win praise from sector.
January 19, 2009... Health professionals have welcomed an anti-obesity campaign that ministers hope will spark a 'lifestyle revolution'. Launched under the banner 'Change4Life', the DoH scheme is centred around an pounds 8.7 million advertising campaign...

Independent Nurse: FDA continues to back ezetimibe.
January 19, 2009... The US Food and Drug Administration (FDA) has reaffirmed its position that ezetimibe should continue to be used to lower cholesterol levels. Currently, the drug is recommended by NICE for use in patients with familial...

Independent Nurse: Community nursing - Deadline set for commissioning split.(National Health Service. Primary Care Trusts)
January 19, 2009... English PCTs are to separate commissioning from provision, but will services remain in the NHS, asks Jonn Elledge. Buried deep in the NHS operating framework for 2009/10 is a sentence that sounds like a tectonic shift for district and...

Independent Nurse: Opinion - Online ... see who's saying what at www.healthcarerepublic.com.
January 19, 2009... Practices should not be charging for access and therefore should not be using 0845 numbers. If the government wanted to do something about it, it could be made part of QOF quite easily. Nurses in the NHS and most larger independent sector...

Independent Nurse: Opinion - Make a resolution to shout about nursing.
January 19, 2009... If you believe what you read in the papers and hear from the pundits, 2009 is set to be a difficult year. Many people - including many nurses - will be grappling with their finances and job opportunities in the months to come. But it is...

Independent Nurse: In my view - 'Dignity proof' your nursing practice.
January 19, 2009... At the RCN, we believe dignity is integral to patient care. This boils down to simple, practical - but important - things like respecting patients' individual needs and privacy; being compassionate when a patient or relative requires...

Independent Nurse: Editorial - Pay for practice nurses needs a national policy.(Editorial)
January 19, 2009... Is the NHS in England managed centrally from Whitehall, or locally? Ministers say it is the letter. They are often at great pains to point out that they have devolved responsibility to SHAs and trusts in an effort to devise local solutions...

Independent Nurse: Clinical - Proactive allergic rhinitis care.(Disease/Disorder overview)
January 19, 2009... Immunotherapy may benefit patients with severe allergic rhinitis, writes Lisa Dixon. Allergic rhinitis (hay fever) affects approximately one in four individuals in the UK1 and is a major factor for developing asthma.2 The condition...

Independent Nurse: Clinical - At a glance - Oral candida vs geographic tongue.
January 19, 2009... Oral candida Discriminatory features - White, curd-like plaques on the buccal mucosa or tongue. - Plaques can be dislodged with a tongue depressor. - Lesions are painful, and underlying epithelium is erythematous, inflamed...

Independent Nurse: Clinical - Childhood immunisations.
January 19, 2009... The schedule for child vaccinations summarised by Gina Robinson. This article is a summary of a two-part feature published last year.1,2 These articles can be found at www.healthcare republic.com. The childhood immunisation programme...

Independent Nurse: Clinical - Managing lipid markers for atherosclerosis.
January 19, 2009... Clinical imaging trials have assessed the impact lipid management has on atherosclerosis. Dr Ian Menown explains. Cardiovascular risk factors correlate strongly with both atherosclerotic plaque volume and composition. Thus it is not...

Independent Nurse: Clinical - Pictures in practice - Genital warts.
January 19, 2009... Penile warts Genital warts are among the most common STIs and are caused by HPV infection. The incidence of HPV infection has risen dramatically in the past 20 years and it is now thought to occur in over half of the adult population,...

Independent Nurse: Clinical - Endocrinology - Managing thyroid disorders in adults.
January 19, 2009... Women are more at risk of thyroid disorders than men. Dr David Morris outlines the diagnosis and treatment options. Hypothyroidism most commonly affects women from middle age upwards and the most frequent underlying cause is autoimmune...

Independent Nurse: Clinical Focus - Caring for elderly skin.
January 19, 2009... Overall key points - It is estimated that about 70 per cent of elderly people have a skin disease that causes symptoms. - Skin dryness, which affects about 85 per cent of the elderly, can be treated using emollients. -...

Independent Nurse: Clinical - At a glance - Necrobiosis lipoidica vs gravitational eczema.(Disease/Disorder overview)(Brief article)
January 19, 2009... Necrobiosis lipoidica Discriminatory features - Affects shin of insulin-dependent diabetics. - Can also occur in non-diabetic patients. - One or more tender yellowish brown patches develop over months. - May be round,...

Independent Nurse: Online competition - Win a fantastic Philips in-car DVD player.
January 19, 2009... Enter our competition for your chance to win a Philips in-car DVD player with dual screens. With the Philips PET712 player, you can watch DVD movies, listen to music or display digital photos all from the comfort of your car. Keep...

Independent Nurse: Professional - Nursing through a recession.
January 19, 2009... Nurses have thorns and opportunities to grasp in times of economic uncertainty, writes Julie Griffiths. What a difference a few months makes. It was only in October that unions were demanding the government re-open pay talks amid threats...

Independent Nurse: Professional - Using clinical audit to standardise medicines management.
January 19, 2009... Conducting a systematic review of care can improve services for patients, writes Paul Cornforth. Clinical audit was first introduced as a part of the White Paper 'Working for Patients',1 before which it was known as medical audit Since...

Independent Nurse: Professional Resources - Worth a look.
January 19, 2009... - Engaging practice nurses in Scotland Seminar RCN Scotland invites practice nurses in Scotland to attend a free discussion event on Saturday 7 February at Stirling Royal Infirmary Taking place from 10am-1pm, it aims to identify...

Independent Nurse: Professional Resources - In numbers - Flu trends.
January 19, 2009... Researchers for search engine Google have claimed that monitoring Google searches can accurately predict influenza activity up to two weeks earlier than traditional reporting methods. They have looked at the correlation between the...

Independent Nurse: Professional Resources - Recommended patient resource.
January 19, 2009... What is this? Published in January, this cookery book has been written for people who need to increase their intake of omega-3 fats, for example CHD patients. The authors hope it will prove a resource for health professionals to signpost to...

Independent Nurse: Professional Resources - Policy digest.
January 19, 2009... Social Enterprise - Making a Difference: a guide to the Right to Request. What is this document? This guide aims to support NHS staff who are thinking of taking up the 'right to request' and setting up a social enterprise to deliver...

Independent Nurse: Professional Workplace - Career profile - Jan Procter-King, Yorkshire.(Interview)
January 19, 2009... - Why did you become a nurse? I worked as a helper at a local hospice every Thursday night when I was doing my A-levels and found that I loved people and caring. - How has your career developed since you started nursing? I failed...

Independent Nurse: Professional Workplace - Practical prescribing.
January 19, 2009... Molly Courtenay helps resolve everyday issues for nurse prescribers. Q: I am a community matron working in a five-practice locality. One practice has requested that I don't prescribe for their patients, but instead, ask the practice to...