GP articles from January 2010

GP archives from January 2010

Opinion: A beautiful bullock is too much to stomach.
January 29, 2010... I come from the last generation that actually killed what we ate, and I remember slaughtering day, usually in September, after the fat of summer, as a sombre day, not the day for high spirits; the animals were making the ultimate sacrifice for...

Opinion: I fancy a slice of cake, so let's play Twister.
January 29, 2010... The over-indulgence of Christmas is followed by the guilt of new year, and by February we start to wonder what we'll look like on the beach. The late winter surgeries which characterise these grey days generate a more-than-usual need for...

Clinical: Red flag symptoms - Hypertension - Consider the cause and know when to treat aggressively.
January 29, 2010... - Papilloedema - Pregnancy - Signs of end-organ damage - Very elevated BP with headache - Fits or coma - Heart failure Elevated BP is common over the age of 65. However, secondary causes of hypertension should be considered in younger...

Education: A registrar survival guide ... surviving an out-of-hours centre.
January 29, 2010... Arrive early Arrive 15 minutes before your shift starts. This will allow you time to familiarise yourself with the layout of the out of hours centre, the administrative staff, your telephone booth and your allocated driver, if appropriate to...

Education: Pictorial case study.(joint instability)(Case study)
January 29, 2010... The case Up until this time, this 19-year-old girl had used her ability to hyperextend her thumb and other joints as a party trick guaranteed to achieve lots of attention from her friends. However, she attended the surgery with complaints of...

Medeconomics: How to find the right partnership.(general practitioner amal Sidhu)(Occupation overview)
January 29, 2010... Dr Kamal Sidhu explains why he wanted to become a partner, how he went about finding the GP partnership which best suited his ambitions and the new responsibilities he faces. A business partnership is a bit like a marriage. It may be a...

Plain Tales from the Surgery.
January 29, 2010... Back to basics I had a call from an elderly lady worried about her husband's back pain 'With all this spine flu about, I wondered if it might be that?' she said. I suggested it probably wasn't but it wouldn't be a bad idea for the audiology...

Clinical: Clinical Review - Overactive bladder syndrome.(Disease/Disorder overview)
January 29, 2010... Contributed by Miss Jane Boddy, urology specialist registrar and Mr Zaki Almallah, consultant urologist at the Queen Elizabeth Hospital, University Hospital Birmingham NHS Foundation Trust. Section 1 Epidemiology and aetiology The...

Clinical: Case study - Postpartum dyspnoea.(Case study)
January 29, 2010... A common symptom of normal pregnancy could spell trouble and should not be overlooked, explains Dr Zara Aziz. Anna was a previously fit 35-year-old who had given birth around three weeks ago to her fourth child. She had normal deliveries with...

Education: Revalidation - Revalidation credit system explained.(Royal College of General Practitioners)
January 29, 2010... Time and impact are the important factors for achieving CPD credits. The new RCGP credits system provides a unique and straightforward way for GPs to record their CPD in order to support their personal and revalidation needs. Each royal...

Medeconomics: Commissioning - Time to dismantle PBC barriers.(practice-based commissioning)(United Kingdom. National Health Service. Primary Care Trusts)
January 29, 2010... GP-led, multi-specialty organisations will transform commissioning, say Dr Judith Smith and Julie Wood. With the NHS facing possibly its greatest management and financial challenge for a generation, it is vital that GPs and other clinicians...

Medeconomics: Meeting the alcohol DES targets.(directed enhanced service)(Occupation overview)
January 29, 2010... Dr Anita Sharma describes her practice's programme for identifying and helping problem drinkers. The UK has a drink problem. This is not confined to a small number of people going on a binge each weekend, but is driven by low prices and easy...

DoH looking to GPs to lead elderly health checks plan.
January 29, 2010... Elderly - GPs will be 'drivers' of services that pre-empt problems. GPs, community health professionals and social workers will be encouraged to find and sup-port vulnerable elderly patients, as part of major new reforms to health and social...

England football team seeks new recruits.
January 29, 2010... A GP and team doctor for England's medal-winning cerebral palsy football team is raising awareness to attract new players for the London 2012 Paralympics. Dr Richard Weiler, who is also a specialist registrar in sports and exercise medicine,...

Plans to reduce GP appointment times in London.(United Kingdom. National Health Service. Primary Care Trusts)(Brief article)
January 29, 2010... Plans to reduce primary care costs could see GP appointment times cut by a third in London. NHS London has told PCTs they must have plans to deliver against 'affordability assumptions' that include slicing 15 per cent off the drugs budget and...

Surgery 'superior' to drugs for paroxysmal AF group.
January 29, 2010... Atrial fibrillation - Early catheter ablation benefits some patients. Catheter ablation is more effective than medicines for patients with paroxysmal AF, a US study suggests. The study reflects the increasing specialisation of AF therapy,...

Two oral MS drugs shown to cut relapses.
January 29, 2010... Two oral drugs being investigated as possible treatments for MS have shown significant reduction in relapse in three new studies. The drugs also showed manageable adverse event profiles, researchers said. Cladribine and fingolimod were both...

Gastric surgery benefits studied.
January 29, 2010... Gastric bypass surgery improves life expectancy for most morbidly obese patients, the results of a study suggest. Researchers used a computer model to evaluate the risks and benefits of gastric bypass surgery using data from over 400,000...

Research briefs: Lung cancer.
January 29, 2010... Lung cancer patients' five-year survival chances double if they quit smoking, research suggests. The BMJ study found a five-year survival rate of 63-70 per cent among quitters versus 29-33 per cent among those who continued to smoke (BMJ Online...

Television risk.(Brief article)
January 29, 2010... Long periods spent watching television can increase the risk of an early death by up to 18 per cent, scientists have found. The researchers said that the increased risk was due to long periods of sedentary inactivity (Circulation Online 2010)....

Expert backs extended GP role in diagnosis of autism.
January 29, 2010... DoH wants audits showing improvements in detection. GPs could play a role in identifying adults with autistic-spectrum disorder, an expert believes. The suggestion comes as the DoH revealed that its upcoming autism strategy will require...

Cancer survivors 'need support'.
January 29, 2010... GPs should pay more attention to the long-term consequences of cancer, a DoH report says. The National Cancer Survivorship Initiative review highlights the lack of support offered to cancer survivors and calls for a new model of after-care to...

GP confidence in dementia diagnosis on the increase.
January 29, 2010... Quarter of GPs complain of training insufficiencies. There has been a 'positive shift' in the attitude of GPs towards the diagnosis of dementia since 2007, a report by a watchdog has suggested. The study by the National Audit Office...

MHRA issues advice on ADHD drug.
January 29, 2010... Updated guidelines on the safe use of methylphenidate in children with attention-deficit hyperactivity disorder (ADHD) have been issued by the MHRA. The guidelines state that methylphenidate is safe for children over the age of six, but that...

Child jab cover is extended.
January 29, 2010... Six more strains of pneumococcal bacteria will be covered by a new vaccine being introduced to the UK's childhood immunisation programme. The current vaccine protects against seven strains of pneumococcal bacteria, but Prevenar 13, to be...

NSAID period pain relief 'better than paracetamol'.
January 29, 2010... NSAIDs are more effective than paracetamol in the treatment of period pain, a Cochrane review has shown. Recent studies suggest that up to three quarters of women are affected by dysmenorrhoea. In up to 15 per cent pain can be severe,...

GPs warned over private screening.
January 29, 2010... The UK National Screening Committee (NSC) has issued advice for GPs on queries from patients considering private screening. NSC director Dr Anne Mackie exclusively revealed plans for the guidance in an interview with GP last October (GP, 16...

Election 2010: How GPs fit into Tory NHS vision.(general practitioners)(Conservative Party (United Kingdom))
January 29, 2010... Shadow health minister Mark Simmonds explains his party's plans to put GPs at the heart of NHS commissioning. The Conservative Party has pledged to make primary care more patientand outcome-focused, and believes the best way to do this is to...

Election 2010: Exclusive interview - 'Primary care reform must go on'.(health secretary Andy Burnham)(Interview)
January 29, 2010... Health secretary Andy Burnham tells Tom Ireland about plans to drive competition in primary care. Soon after becoming health secretary last year, Andy Burnham was hailed as a man planning to steer the NHS away from private providers when he...

Healthcarerepublic.com: Andy Burnham interview.
January 29, 2010... Watch highlights of GP's 30-minute exclusive interview with health secretary Andy Burnham at healthcare republic.com/video. There are also two clips here of our interview with primary care minister Mike O'Brien. CPD Find out how learning...

Opinion: Ballot box.
January 29, 2010... 54% of GPs think they should use software that calculates risk to start predicting if a patient has early cancer symptoms. Source: Healthcare Republic -------------------- Did you find this article useful? Why not subscribe to the...

Opinion: Your say online ... www.healthcarerepublic.com/forums.(Website overview)(Brief article)
January 29, 2010... Tories threaten to axe vascular screening in GP surgeries - We have made a great deal of effort to embrace this initiative. Tell it like it is Mr Lansley, you just want to cut spending. - I can foresee a situation where the majority of...

Letter: Do Tory-voting GPs have collective Alzheimer's?
January 29, 2010... I could hardly believe my eyes when I saw the front page of GP (15 January): 53 per cent of GPs plan to vote Conservative. Have my colleagues suddenly developed collective Alzheimer's disease? Have they forgotten what the last Conservative...

Letter: Let's go green by stopping unnecessary home visits.
January 29, 2010... Open up any journal and there is a 'go green' mantra. GPs have to take a lead role in promoting, be it healthy living, healthy eating or a go green lifestyle. Turning off electricity, recycling papers, replacing insulation or changing an old...

Letter: Claims of antipsychotics overuse insults GPs.
January 29, 2010... It is insulting to GPs to accuse us of profligate overuse of antipsychotics in dementia patients. We know the problems of using antipsychotics, but we are the ones who have to try to care for people with dementia and the people who care for...

Editorial: Competition forcing GPs to do more with less.(Editorial)
January 29, 2010... General practice has always combined providing quality clinical care with running an effective business. But politicians are now expecting practices to become increasingly entrepreneurial and business orientated. Competition is the name of...

Opinion: Parkinson's third law is the NHS in a nutshell.
January 29, 2010... Everyone knows Parkinson's first law - 'Work expands to fill the time available' - but he also devised two more. His third law interests me the most because it is so relevant to the NHS: 'Growth leads to complexity, complexity to decay.' Not...

Clinical: Journals watch - Lung cancer, TIA and dementia.(transient ischemic attack)
January 29, 2010... Too busy to keep up with new research? Let Dr Jonathan Holliday update you on the latest papers. Incidence of lung cancer after hospitalisation for pneumonia - Am J Med 2010:123(1); 66-71 This was a retrospective study conducted over the...

Clinical: Lumps and bumps.(Case study)
January 29, 2010... Trauma - This woman fell and sustained this injury to her forehead. She was not knocked out, and was otherwise well. She presented two weeks later complaining that she was 'not right'. Again no obvious cause was found, but she was referred to...

Clinical: How the national strategy for COPD will improve care.(chronic obstructive pulmonary disease)(Disease/Disorder overview)
January 29, 2010... A 10-year national plan for COPD, which is due to be published shortly, aims to raise the standards of care, write Jane Scullion and Dr Steve Holmes. A national clinical strategy (previously national service framework) for COPD is being...

Clinical: The basics Management of acne.(Disease/Disorder overview)
January 29, 2010... Early assessment of disease severity will aid the selection of suitable therapies, explains Clive Tubb. Acne vulgaris is a common disorder affecting the face, chest and back It is most frequently seen in adolescents. Estimates suggest 1.7...

Clinical: Substance misuse - The risks of cocaine use.
January 29, 2010... Discuss the route of use and discourage sharing equipment to minimise risk. Cocaine misuse is extremely prevalent. One in 20 British adults reports having taken the drug in the past 12 months, giving us the highest rate of use in Europe.1...

MedEconomics: Ask the experts - Under-insurance and room rental.
January 29, 2010... Q: UNDER-INSURANCE Our practice insurance company says we may not be insuring the surgery contents for the right amount, and so we might not get the full claims payment. What does this mean? The sum insured for your surgery should represent...

MedEconomics: Dispensing - Understanding pharmacy organisations.
January 29, 2010... It is important that dispensing GPs know who's who in the world of pharmacy, writes Dr Jeremy Phipps. I recently attended a large commercial exhibition aimed primarily at pharmacists. Representatives of several national organisations for...

Burnham will force GPs to compete.
January 29, 2010... Health secretary Andy Burnham speaks to GP about the future of primary care. Health secretary Andy Burnham has revealed plans to drive increasing competition between practices in England in an exclusive interview with GP. Scrapping...

GPC unveils roadmap for practice boundary reform.
January 29, 2010... Temporary resident system reform proposed by GPC. The GPC has published a roadmap for reforming practice boundaries in England in a way it believes will cause less disruption than current DoH plans. The report proposes an overhaul of...

Expenses clawback fear as 'tax amnesty' begins.
January 29, 2010... Panicked GPs are inundating accountants with calls after Her Majesty's Revenue and Customs (HRMC) announced a 'tax amnesty' in the run up to an investigation of 20 years' worth of doctors' tax records. HMRC has said it has 'specific...

GPs to treat neighbours' patients in extended hours.
January 29, 2010... Patients from practices in England not offering extended hours will be able to book evening and weekend appointments at neighbouring practices from April. Alternatively, they will be allowed to book routine appointments with their local...

An apology.(Brief article)
January 29, 2010... GP would like to make a full apology to primary care minister Mike O'Brien and the DoH over the story headlined 'Practices could face efficiency test' (GP, 11 December). We would like to make it clear that the 'leaked DoH memo' in the story...

GPs on the verge of missing swine flu jab uptake targets.
January 29, 2010... GPs may miss out on thousands of pounds in patient survey payments after data showed that uptake of swine flu jabs is falling short of pay thresholds. Uptake of 50.7 per cent is required for the thresholds of the patient experience indicators...

RCGP warns not to collect certificates for revalidation.
January 29, 2010... Latest drafts of CPD and revalidation guides released. The RCGP's latest guides to revalidation and CPD have clarified the requirements for GPs and warned that the quality of activity is just as important as the time spent. In the third...

GP Diary.
January 29, 2010... Brown-nosing With a general election around the corner, campaigning is becoming more than a little desperate. Who could be the author of the stack of (somewhat basic) leaflets discovered behind the sofa in the reception area of the DoH?...

Obesity drug suspension cuts choice of treatment.
January 29, 2010... Sibutramine suspended after EMEA 'risk' ruling. Suspension of the anti-obesity drug sibutramine (Reductil) leaves patients who have benefitted from the therapy facing weight gain and raised CVD risk, an expert has warned. The MHRA has...

Out-of-hours providers to face public ratings report.(Brief article)
January 29, 2010... Out-of-hours providers will be compared publicly this year, according to a group of primary care experts which advises the DoH and other organisations. The Primary Care Foundation has completed two exercises on the quality of PCTs and their...

New STI guidelines will 'boost the consistency of care'.(sexually transmitted diseases)(Brief article)
January 29, 2010... Nine new standards of care for STIs, the first of their kind, have been drawn up to improve quality and consistency of commissioning and management of care across England. Aimed at primary care and specialist services, the standards cover...

Vascular checks may be ditched under Tory plans.
January 29, 2010... GP concern over policy proposal. Shadow health secretary Andrew Lansley has signalled that he may scrap the vascular health checks scheme being rolled out across England if the Conservatives are elected. At the launch of a new green paper...

GPs in Northern Ireland back federating practices.
January 29, 2010... GP leaders in Northern Ireland have published a 10-year strategy paper setting out how general practice can evolve while keeping its core values intact. The joint RCGP and GPC document sets out a list of general practice 'core values',...

'Befriending' can ease depression.
January 29, 2010... Emotional support can reduce symptoms and distress for depressed patients in the community, research shows. More than 500 charitable and voluntary organisations in the UK offer emotional support, known as 'befriending', to patients in the...

Independent Nurse: Vascular screening programme at risk if Conservatives elected.
January 18, 2010... Shadow health secretary Andrew Lansley has signalled that he may scrap the vascular health checks being rolled out across England if the Conservatives are elected. At the launch last week of A Healthier Nation, a green paper on public health,...

Independent Nurse: Tories criticised for saying courses 'too academic'.
January 18, 2010... The Conservatives have been accused of 'vote hunting' and failing to understand modern nursing over claims that nursing courses are 'too academic'. Meanwhile, universities have warned that efficiency savings required from 2010/11 may force...

Independent Nurse: Changes to prescribing laws hand nurses greater control.
January 18, 2010... UK nurse and pharmacist independent prescribers have been handed the same powers to prescribe unlicensed medicines and direct others to mix medicines as doctors. Changes to prescribing rules for unlicensed medicines are set out in the January...

Independent Nurse: Tories still committed to health visitor boost.
January 18, 2010... Conservative leader David Cameron has reiterated plans to double health visitor numbers after the pledge disappeared from the party's latest health manifesto. As the Conservatives' election campaign kicked off earlier this month, a 'draft'...

Independent Nurse: MPs call for greater QOF focus on alcohol.
January 18, 2010... Incentives for early detection and intervention to tackle alcohol-related ill health should be provided in the QOF, according to a report by MPs. The health select committee report suggests the current state of alcohol treatment services is...

Independent Nurse: News in Brief.
January 18, 2010... Sunbeds: Proposals to ban sunbeds for under-18s have been backed by the DoH. Health secretary Andy Burnham announced last week that the government would support a private members' bill on the issue introduced by Julie Morgan, Labour MP for...

Independent Nurse: Watchdog calls for introduction of specialist dementia training.
January 18, 2010... The DoH should introduce accredited dementia training for healthcare professionals in England this year, a report suggests. There is currently no required dementia training for generalist healthcare professionals, the National Audit Office...

Independent Nurse: Vital Statistics - Cancer and deprivation.
January 18, 2010... 54% of breast cancer patients in the most deprived areas of England have breast conserving surgery 64% in the least deprived areas have this surgery 8.1% more patients treated with anterior resection in least deprived areas than most...

Independent Nurse: Journals Watch.
January 18, 2010... Prostate cancer gene found: A gene associated with aggressive prostate cancer has been identified by US researchers. The team from Wake Forest University, North Carolina, hope the discovery may lead the way for treatment decisions to be guided...

Independent Nurse: Pharmacists to switch to generic drugs.
January 18, 2010... Pharmacists in England may be allowed to switch prescriptions for 37 branded drugs included on a DoH shortlist to generic alternatives. Prescribers will be able to endorse any scrip to opt it out of the arrangements. But this drug...

Independent Nurse: NMC to look into the regulation of HCAs.
January 18, 2010... The NMC is to commission research into the potential regulation of healthcare assistants. The RCN welcomed the news, and said it was a 'matter of public safety' that these staff were properly regulated. Janet Davies, executive director of...

Independent Nurse: NICE committee reveals QOF update plans.
January 18, 2010... A peripheral arterial disease (PAD) register and an asthma care plan indicator should be considered for inclusion in the 2012/13 QOF, NICE has said. The institute's Primary Care QOF Indicator Advisory Committee decided at its meeting in...

Independent Nurse: Nurse increase can save the NHS money.
January 18, 2010... Substantial savings can be achieved by increasing nurse involvement in primary care, research suggests. The study, published in the British Journal of General Practice, compared the costs of consultations by GPs and nurse practitioners in...

Independent Nurse: Eye test may identify early Alzheimer's.
January 18, 2010... Alzheimer's disease could be diagnosed early by assessing cell death in the retina, the findings of a new UK study suggest. A team from University College London developed a technique for measuring brain cell death in rats in real time. The...

Independent Nurse: World Outbreak Information - Week beginning 18 January.
January 18, 2010... Australia: Three holidaymakers were bitten by a rabid flying fox in Queensland this month. The risk is generally low and rabies pre-exposure vaccines are not usually recommended but travellers should seek medical advice if in close contact with...

Independent Nurse: Flu incidence 'below the normal levels'.
January 18, 2010... Swine and seasonal flu cases have fallen below the levels normally seen for seasonal flu figures show. Consultations for flu-like illness in England decreased to 11.2 per 100,000 last week, under the English 'baseline' threshold of 30 per...

Independent Nurse: Call to boost statin therapy adherence.
January 18, 2010... Improving adherence to statin therapy would have more impact than widening its use, a UK study suggests. Researchers reviewed studies of adherence to statin medication in clinical trials and in normal practice. They compared the effect of...

Independent Nurse: Diabetes can raise risk of dementia.
January 18, 2010... Diabetes is associated with a three-fold increased risk of dementia in older people with memory loss, a UK study suggests. Previous research has linked type-2 diabetes to increased risk of cognitive impairment, such as impaired...

Independent Nurse: Nurses' dedication in cold snap is praised.
January 18, 2010... The RCN has paid tribute to nurses continuing to provide vital care as the UK endured its worst cold weather in 30 years. Dr Peter Carter, RCN chief executive and general secretary, said: 'Nursing staff are facing extraordinary disruption and...

Independent Nurse: News Focus - How NICE makes decisions on QOF.(Quality and Outcomes Framework)(United Kingdom. National Institute for Clinical Excellence)(Conference news)
January 18, 2010... NICE has now started work on reviewing the QOF. Tom Moberly sat in on the committee's first open meeting. Having conducted its first meeting behind closed doors, NICE's Independent QOF Review Committee opened its second hearing, held last...

Independent Nurse: Opinion - Online.
January 18, 2010... Linking nurses' pay to productivity is dangerous. French community nurses are paid 'per client visit' hence the more patients nurses can cram into their morning, the better their pay. Extended hours are a waste of time. There is minimal...

Independent Nurse: Editorial - Beware politicians in electioneering mode.(Editorial)
January 18, 2010... The debate over what constitutes appropriate training for modern nurses rumbles on, even though the decision has been taken to make nursing an all-graduate profession from 2013. According to the NMC, the new degree course - a single entry...

Independent Nurse: Opinion - An exciting new future may await the NHS.
January 18, 2010... The end of 2009 was marked by some rocking of the NHS boat. Social enterprise had been the policy makers' goal for community services for a long time, then suddenly the NHS chief executive was saying that a financial crisis was the wrong time to...

Independent Nurse: In My View - Link workers vital to tackle type-2 diabetes.
January 18, 2010... Type-2 diabetes affects certain ethnic groups more than others and is six times more common in South Asian people than in caucasians. South Asians also tend to develop diabetes a decade earlier than caucasian counterparts, so are more prone...

Independent Nurse: Clinical - Winter weather and COPD.
January 18, 2010... The winter cold can exacerbate COPD. Jo Riley explains how to minimise patients' risk. Cold winter days are upon us and for patients with COPD the winter can be a time of misery and fear. The impact of cold weather and winter infections can...

Independent Nurse: Clinical - Gastroenterology - Opioid induced constipation.
January 18, 2010... Constipation caused by opioid analgesics can be challenging to manage, writes Gaye Kyle. Constipation is rarely life-threatening, yet it can reduce quality of life. In fact, patients may rate constipation above pain in terms of the distress...