GP articles from July 2010

GP archives from July 2010

Clinical: Wales to update organ donor rules.
July 23, 2010... Wales could become the first UK nation to introduce presumed consent for organ donation under plans put before the devolved government. The Welsh Assembly government will seek powers to introduce a scheme that would mean people have to opt...

Clinical: Warning over age bias in CVD checks.
July 23, 2010... CVD RISK - Using lifetime risk measure may make checks suitable for all patients, expert says. Cardiovascular risk charts should be based on lifetime risk estimates to remove an age-based bias, the president of the British Cardiovascular...

Clinical: NICE wants improved COPD diagnosis and management.
July 23, 2010... NICE has issued updated COPD guidance designed to improve diagnosis and treatment of the disease. The institute said diagnosis and management of adults with COPD in primary and secondary care could improve. The guidance advises measuring...

Clinical: Behind the headlines - Is vitamin D connected to Parkinson's?
July 23, 2010... Vitamin D deficiency increases the risk of developing Parkinson's disease, newspapers have reported. Finnish researchers tracked the serum vitamin D levels of 3,173 people aged 50-79 over two years, and followed them up 29 years later. The...

Clinical: Swine flu 'cannot be identified by high fever', study suggests.
July 23, 2010... High fever is a poor discriminator of whether or not patients have swine flu, a UK analysis suggests. A team led by Professor Peter Openshaw of Imperial College, London, studied data from 631 patients admitted to UK hospitals with swine flu....

Clinical: A round-up of the best from GP's website this week.(healthcarerepublic.com)(Website overview)
July 23, 2010... - Emergency medicine Refresh your knowledge with our emergency medicine centre. Read the articles covering everything from breathlessness to basic life support. There are practical tips on how to manage outside of the hospital setting and...

Letters: Correction.(Correction notice)
July 23, 2010... The figures for locums' pay for Borders, Dumfries and Galloway on page 65 of our July 9 issue were incorrect. The 2010 figures should read: day rate range, pounds 340; half-day range, pounds 180; two-hour session range, pounds 120. We are...

Opinion: Where has all the swine flu gone? I don't know.
July 23, 2010... My intellect is easy-going and pliable; I've met him, and at his age he has learned equanimity and doesn't get annoyed too easily by things that don't seem to make any sense. Over the years he has seen too many ludicrous health policies being...

Opinion: No need to give GPs their 10 commandments.
July 23, 2010... Our church had a find the other day - a pair of Victorian painted plaques listing the 10 commandments, a throwback to a time when society was forthright about its moral righteousness and liked to post rules on the wall to remind sinners...

Clinical: Journals Watch - Petechiae and erectile dysfunction.(Clinical report)
July 23, 2010... Not had time to catch up on the latest research? Dr Lizzie Croton brings you up to date on the journals. Petechial spots in well infants - Arch Dis Child 2010; 95: 518-20 When in primary care should we worry about petechial spots in young...

Clinical: The basics - Uveitis.(Disease/Disorder overview)
July 23, 2010... Uveitis should be considered in patients with ocular pathology including reduced vision. Within the eye, the uveal tract consists of the iris, the ciliary body and the choroid. Uveitis is the inflammation of the uveal tract and panuveitis...

Clinical: Red flag symptoms - Urinary retention.(Disease/Disorder overview)
July 23, 2010... It is vital to differentiate between acute and chronic urinary retention. - Painless acute retention - Haematuria/clots - History of prolonged bladder outflow obstruction Urinary retention is a common problem in older men but it also...

Clinical: Emergency medicine - How to assess and manage head injuries.(Disease/Disorder overview)
July 23, 2010... A normal neurological examination does not reliably indicate the absence of a lesion following head injury. Each year, an estimated 700,000 people attend hospital as a result of a head injury.1 The wide spectrum of injury coupled with the...

Clinical: Expert opinion - Ankle brachial pressure index.
July 23, 2010... The pros and cons of using Doppler to assess arterial and venous disease. The ankle brachial pressure index (ABPI) calculation is based on the Doppler principle, which states that the frequency of a sound emitted or reflected from a moving...

Clinical: Children's faces.(Report)
July 23, 2010... - Facial weakness This young man has neurofibromatosis and developed this facial weakness following surgery to remove one of his bilateral acoustic neuromas. The facial nerve had to be cut and reanastamosed, but his facial weakness persisted....

Clinical: Clinical Review - Peptic ulcer disease.
July 23, 2010... Contributed by Dr Alex Wilkins, surgical registrar, and Miss Sophie-Anne Welchman, specialist registrar, Derriford Hospital, Devon. Section 1: Aetiology and epidemiology Peptic ulcer disease (PUD) is a common problem in the UK and has a...

Education: GP curriculum - Learn using digital mind maps.
July 23, 2010... Dr Juno Jesuthasan explains how to get the most out of the RCGP curriculum using an online tool. The RCGP Curriculum covers the whole of general practice from practice management to specific clinical areas. However, many GPs do not refer to...

Education: CPD Organiser puts you in control.(continued professional development)(Healthcare Republic )
July 23, 2010... We answer your questions on our newly launched CPD Organiser at healthcarerepublic.com/cpd. The CPD Organiser aims to provide a user-friendly option for GPs struggling to get to grips with the new credits-based learning system. This guide...

MedEconomics: How to ... Deal with a stalking problem.
July 23, 2010... GPs are at a bigger than average risk from stalkers. Mary Salmon advises on steps the victim can take. Imagine an inebriated ex- patient regularly phoning you at home late at night to leave long messages complaining about their new GP. You do...

MedEconomics: Pensions tax penalties binned.
July 23, 2010... Dropping the former chancellor's income-based rules to restrict pensions tax relief will significantly benefit high earning GPs. While GPs are worried that the coalition government's public sector pensions review will cut GPs' benefits, at...

MedEconomics: Book Review - Leo makes an important point.
July 23, 2010... Dr Jeremy Phipps says a novel about living with an alcoholic GP father has a key message for young people. To review a novel, The Truth About Leo, in a medical publication is unusual, especially one aimed at adolescents, but this is written...

MedEconomics: The GP gender earnings gap.
July 23, 2010... The Equality Act may lessen the pounds 15,425 pay disparity between female and male doctors. The 2009 report by the National Working Group on Women in Medicine made recommendations to remove the obstacles and compromises women must make when...

MedEconomics: Locums - Negotiation tips for locum GPs.
July 23, 2010... Balance your needs with those of the practice with which you are negotiating. When working as a locum GP, negotiating acceptable pay, terms and conditions is essential for job satisfaction, morale, self esteem and to prevent 'burn-out'. ...

Good Practice: Streamlined care - Full spectrum ultrasound scans.(practice-based commissioning)(United Kingdom. National Health Service. Primary Care Trusts)
July 23, 2010... Marion Long describes a highly successful PBC service in Surrey and its plans for satellite clinics. Our practice, Dr O'Donnell & Partners in Farnham, has been running a diagnostic ultrasound service since 2008. Initially this was for our...

Plain Tales from the Surgery.
July 23, 2010... - A tasty therapy for all A patient's husband called me to say his wife has vaginal thrush. He told me she had tried the tablet from the pharmacy and the patisserie and cream. I think we should treat all our ladies' thrush with a trip to a...

GP anger at being forced into consortia.
July 23, 2010... Exclusive - GP survey discovers widespread concern over 'untested' White Paper plans. Two thirds of GPs oppose DoH plans to force practices to join commissioning consortia, and almost all say the profession should have been consulted in...

Single contract means the end of PMS.
July 23, 2010... APMS-style deals loom for all GPs. NICE role widened. GPC urges 'no panic'. Salaried GPs. The White Paper's proposal to move to a single national GP contract confirms the end of PMS and could lead to time-limited, APMS-style contracts, senior...

NICE handed role in setting GP commissioning objectives.
July 23, 2010... The role of NICE and use of QOF data is to expand significantly under plans outlined in the White Paper. NICE will be required to 'rapidly' increase its library of care pathways, creating a bank of 150 of the best practice guides by 2015. ...

Doctors urged not to panic by GPC.
July 23, 2010... Doctors should not panic about the changes outlined in the White Paper, the GPC says. GPC chairman Dr Laurence Buckman said he had heard reports of some PCTs telling GPs to 'get on with it', after the White Paper set out plans to scrap PCTs...

Health White Paper - Consortia roles suit salaried GPs.
July 23, 2010... Salaried GPs could be 'even better suited' to roles in GP consortia than partners, a GPC negotiator says. Dr Beth McCarron-Nash, who sits on the GPC's sessional GP representation committee, urged salaried and locum GPs to contribute to...

Health White Paper - Consortia must 'be same size as PCTs'.
July 23, 2010... Former DoH commissioning chief warns against small GP groups. GP consortia will not succeed unless they are as big as PCTs, according to former DoH commissioning chief Mark Britnell. Mr Britnell, former DoH director of commissioning and...

Revalidation is '98 per cent sure to go ahead'.(General Medical Council)
July 23, 2010... GMC sets out plans to simplify revalidation, cutting back the burden of appraisal and feedback. RCGP revalidation lead Professor Mike Pringle says he is '98 per cent confident' revalidation will go ahead under the Conservative-Liberal...

GPC demands SCRs suspension.(summary care records)(British Medical Association General Practitioners Committee)(Brief article)
July 23, 2010... The use of existing summary care records (SCRs) should be suspended in light of emerging patient safety issues, the GPC has said. GPC chairman Dr Laurence Buckman said the SCRs used in pilot sites did not 'update in a way you might expect'...

GP access targets facing overhaul.
July 23, 2010... King's Fund inquiry sets out vision of wider-ranging set of data to measure access. GP access measures could be radically overhauled under plans set out in research that will feed into the wide-ranging King's Fund inquiry into the quality of...

GP Diary.
July 23, 2010... TOP QUALITY DEATH British people have the worst quality of life in Europe, says a report that highlights the long hours, bad weather and high price of consumer goods. On the upside, the UK leads the world in 'quality of death' according to a...

GPs could judge patients' right to die in new proposal.
July 23, 2010... Exclusive - Calls for GPs to play key role in assessing cases. GPs could decide whether terminally ill patients are granted an assisted death under controversial proposals to regulate the practice if it were legalised. Former health...

Nurse roles need checking, says MP.
July 23, 2010... Advanced nurses need to be evaluated over longer time periods to work out if they are clinically and cost effective, a health minister has said. In a parliamentary response, Anne Milton warned that evidence showed advanced nurse roles were...

DoH to outline public health targets for GPs.
July 23, 2010... Autumn White Paper will set out raft of government plans and target outcome improvements. Practices will be expected to meet public health targets under plans the DoH will set out in a public health White Paper this autumn, health secretary...

Impact of HPV jab is underestimated.
July 23, 2010... Vaccination could prevent up to 10 per cent more cervical cancer cases than previously thought, UK research suggests. A study found that 73-77 per cent of cervical cancer cases were caused by either HPV type 16 or 18, both of which are...

Watchdog slams failures that led to Ubani drug error.(Clinical report)
July 23, 2010... Report says patient death was 'only a matter of time'. The out-of-hours provider that employed German locum Dr Daniel Ubani failed to heed warnings that it was 'only a matter of time' before a patient was killed, a report says. The Care...

Severe asthma patients face discrimination, report says.
July 23, 2010... People with severe asthma face widespread discrimination, according to the findings of an Asthma UK report. The charity is calling on healthcare professionals, as well as commissioners, policy-makers and others, to recognise that severe...

GMC warnings will have five-year lifetime.(General Medical Council)
July 23, 2010... Warnings to be struck from records after five years, but the GMC may still tell employers. Warnings on the medical register about a doctor's behaviour or performance will only be kept in the public domain for five years, the GMC has...

DoH launches pounds 4 million personal NHS budget plan.
July 23, 2010... The DoH has allocated pounds 4 million to pilot schemes for personal health budgets. Care services minister Paul Burstow said the money will be used to support the creation and running of personal health budget pilot sites. Personal...

Waist-lipid test spots CHD risk other checks miss.
July 23, 2010... Canadian study finds hypertriglyceridaemic-waist phenotype linked to doubling in disease risk. Even in the absence of traditional risk factors, people with large waistlines and high blood lipid levels may be at greater risk of heart disease,...

Morning ACR test backed by study.
July 23, 2010... Renal events in people with type-2 diabetes are best predicted from albumin to creatinine ratio (ACR) derived from a first morning void, a Dutch study shows. Researchers studied 701 patients with type-2 diabetes and nephropathy. They...

Stool calprotectin testing 'can identify IBD patients'.(Clinical report)
July 23, 2010... Levels of the protein calprotectin can identify patients at risk of inflammatory bowel disease (IBD), a meta-analysis suggests. Researchers looked at whether measuring faecal levels of calprotectin, which is known to be a sensitive marker of...

Research Brief: Influenza vaccination.
July 23, 2010... Patches covered in tiny needles can be used to deliver influenza vaccines, a study in mice has shown. Given that the skin is an active immune organ, delivering vaccines to skin rather than muscle may produce larger antibody responses, the...

Research Brief: Overweight crisp packets.
July 23, 2010... Oversize crisp packets are increasing child obesity, a survey suggests. The Daily Telegraph looked at 20 convenience stores near schools and found almost half of crisp packets weighed at least 50g, more than the current standard size of...

NHS World Cup online game costs taxpayer thousands.
July 23, 2010... More queries over value for money of IT spending. The DoH spent thousands of pounds developing a Facebook 'health game' themed on the football World Cup, GP has learned. The 'NHS World Cup Football Fan Fitness Challenge' cost the...

GMC to overhaul child protection advice.
July 23, 2010... The GMC is to carry out a review of child protection guidance to build confidence in this 'complex and challenging' area of practice. The GMC said it would set up a working group to develop the guidance by the end of 2011 to help doctors...

Wales to update organ donor rules.
July 23, 2010... Wales could become the first UK nation to introduce presumed consent for organ donation under plans put before the devolved government. The Welsh Assembly government will seek powers to introduce a scheme that would mean people have to opt...

NICE wants improved COPD diagnosis and management.
July 23, 2010... NICE has issued updated COPD guidance designed to improve diagnosis and treatment of the disease. The institute said diagnosis and management of adults with COPD in primary and secondary care could improve. The guidance advises measuring...

Warning over age bias in CVD checks.
July 23, 2010... Using lifetime risk measure may make checks suitable for all patients, expert says. Cardiovascular risk charts should be based on lifetime risk estimates to remove an age-based bias, the president of the British Cardiovascular Society has...

How GP consortia will take charge of commissioning.(United Kingdom. Department of Health)(general practitioners)
July 23, 2010... The Health White Paper sketches out a new role for GPs, but has not filled in all the gaps. Tom Ireland reports. The long-awaited DoH White Paper is finally out, with a strong message for GPs: if you are not part of a consortium, you need to...

Behind the Headlines: Is vitamin D connected to Parkinson's?
July 23, 2010... Vitamin D deficiency increases the risk of developing Parkinson's disease, newspapers have reported. Finnish researchers tracked the serum vitamin D levels of 3,173 people aged 50-79 over two years, and followed them up 29 years later. The...

Swine flu 'cannot be identified by high fever', study suggests.
July 23, 2010... High fever is a poor discriminator of whether or not patients have swine flu, a UK analysis suggests. A team led by Professor Peter Openshaw of Imperial College, London, studied data from 631 patients admitted to UK hospitals with swine flu....

Healthcarerepublic.com: A round-up of the best from GP's website this week.(Website overview)
July 23, 2010... Emergency medicine Refresh your knowledge with our emergency medicine centre. Read the articles covering everything from breathlessness to basic life support. There are practical tips on how to manage outside of the hospital setting and...

Opinion: Ballot box.
July 23, 2010... 76% of GPs think the NHS should stop funding homeopathy. Source: Healthcare Republic. -------------------- Did you find this article useful? Why not subscribe to the magazine? Please call 08451 55 73 55 for more information or visit...

Opinion: Your say online.
July 23, 2010... Health White Paper - Last night I went to bed relatively well-off. This morning I woke to find that I have pounds 80 billion to spend. Why do I feel poorer? - Great news! PCTs undermine the GP's decision to give patients the treatment they...

Correction.(Correction notice)
July 23, 2010... The figures for locums' pay for Borders, Dumfries and Galloway on page 65 of our July 9 issue were incorrect. The 2010 figures should read: day rate range, pounds 340; half-day range, pounds 180; two-hour session range, pounds 120. We are...

Editorial: Reform puts GPs in the driving seat of the NHS.(Editorial)
July 23, 2010... It has been a busy time for the DoH as it embarks on one of the biggest restructures of the NHS in England in its 62-year history. However, the health White Paper raises far more questions than it answers, and it is already clear that many...

Opinion: Can we handle a professionally-led profession?
July 23, 2010... The government is still generating sensible healthcare decisions. Latest in the firing line are access targets for GPs and A&E. At long last clinicians will be able to return to treating patients according to clinical importance, rather...

Independent Nurse: Nurses will face 'pay lottery' in health White Paper plans.
July 19, 2010... DoH plans to scrap national NHS pay scales and open provision of community services to 'any willing provider' could destabilise services and create a pay lottery, unions say. The health White Paper Liberating the NHS, published last week,...

Independent Nurse: White Paper's vast programme of NHS reform.
July 19, 2010... The DoH White Paper Liberating the NHS set out a vast programme of NHS reform that will see all PCTs and SHAs scrapped by 2013 as commissioning powers transfer to GP-led consortia. Every GP will have to join a commissioning consortium by...

Independent Nurse: News in brief.
July 19, 2010... BUDGETS The DoH has allocated pounds 4 million to pilot schemes for personal health budgets. Care services minister Paul Burstow said the money would be used to support the creation and running of personal health budget pilot sites. Personal...

Independent Nurse: Nurses fearing job losses as QOF shifts focus to outcomes.
July 19, 2010... Nurse jobs could be at risk under DoH plans to shift the focus of the QOF from processes to patient outcomes, a senior nurse has warned. Margaret Briggs, former chair of the Scottish Practice Nurses Association, said changes to funding...

Independent Nurse: 'Non clinical' work for new health visitor role.
July 19, 2010... A new breed of health visitor will take on more non-clinical work, says children's minister Sarah Teather. Ms Teather told the Association of Directors of Children's Services' conference in Manchester this month that 'a new type of Sure Start...

Independent Nurse: Clinical posts are for the chop, warns RCN.
July 19, 2010... PCTs are already looking to cut clinical posts as part of the NHS efficiency drive, according to the RCN. The college has evidence of up to 10,000 planned job losses across the NHS. It says the details 'explode the myth' that frontline...

Independent Nurse: DoH calls for more research into advanced nursing roles.
July 19, 2010... Advanced nurses must be evaluated over longer periods if their clinical and cost effectiveness is to be fully understood, a health minister has said. In a parliamentary response, Anne Milton pointed to evidence that enhanced services run by...

Independent Nurse: Vital Statistics - Dementia.
July 19, 2010... 1 million people in the UK will be living with dementia in 15 years' time 30% reduction of outpatient costs if dementia is diagnosed early 1 in 3 people over 65 will die with dementia Diagnosing dementia early can cut outpatient costs...

Independent Nurse: Diabetes patients 'ignore jab advice'.
July 19, 2010... Insulin-treated diabetes patients are hampering their glucose control by failing to follow best practice when injecting, UK research suggests. Debbie Hicks, a nurse consultant in diabetes at NHS Enfield community services in north London,...

Independent Nurse: UTI history can guide present treatments.
July 19, 2010... Information about previous UTIs can guide decisions about treatment of subsequent infections, results of an Irish study suggest. Akke Vellinga and colleagues from the National University of Ireland examined samples from 3,413 patients who had...

Independent Nurse: Journals Watch.
July 19, 2010... Doubt over glucosamine benefits for low back pain Glucosamine provides little benefit for chronic low back pain, a study suggests. A six-month trial found little difference in measures of pain-related disability, low back and leg pain and...

Independent Nurse: District nurse scheme boosts cancer care.
July 19, 2010... A district nursing team that launched a clinic to tackle unmet need among cancer patients could be voted the UK's top primary care innovators. The team, based at the Drs Ross and Robinson Practice in Glasgow, started the clinic after...

Independent Nurse: World Outbreak Information - Week beginning 19 July.
July 19, 2010... Vietnam, Cambodia, Thailand Cholera cases continue to be reported in many regions. At least 144 cases have been recorded in Hanoi, Vietnam this month. More than 1,300 cases have been reported in Cambodia in the last three months, and more...

Independent Nurse: Early detection is key for meningitis.
July 19, 2010... Correctly spotting meningitis symptoms early is key to preventing deaths in children, NICE says. The advice comes in guidance for diagnosis and treatment of bacterial meningitis and meningococcal septicaemia. It will help to save lives by...

Independent Nurse: Fever 'poor indicator of swine flu'.
July 19, 2010... High fever is a poor discriminator of whether or not patients have swine flu, a UK analysis suggests. Researchers from Imperial College, London, studied data from 631 patients admitted to UK hospitals with swine flu. Their data showed a...

Independent Nurse: Funding of palliative care to be reviewed.
July 19, 2010... Funding of palliative care services will be reviewed to improve decisions on spending, the government has announced. The review, to be led by Tom Hughes-Hallet, chief executive of charity Marie Curie Cancer Care, will examine how the...

Independent Nurse: HPV may increase chance of skin cancer.
July 19, 2010... HPV infection may increase the risk of developing certain skin cancers, research suggests. Several types of HPV increase a person's risk of developing squamous cell carcinoma (SCC) by up to 1.5 times, a US study showed. The team from...

Independent Nurse: Hyperglycaemia clue to diabetes risk.
July 19, 2010... Hyperglycaemia in patients with acute illness increases the risk of developing diabetes, research suggests. A study of non-diabetic patients suffering from acute illness showed those who had hyperglycaemia were more likely to go on to develop...

Independent Nurse: News Focus - Caution over public health outcomes.(Faculty of Public Health)(United Kingdom. National Health Service)(Conference news)
July 19, 2010... The health secretary's plans to re-focus public health on outcomes may prove complex. Tom Moberly reports. Health secretary Andrew Lansley's announcement of a ringfenced public health budget has been welcomed by nurses and public health...

Independent Nurse: Opinion - Should we automatically support change?
July 19, 2010... 'Innovation good, tradition bad?' There has been so much emphasis on innovation, change, deregulation and deconstruction across public services, it is easy to believe this mantra is written on the walls of every government department. In...

Independent Nurse: In my view - Falls are not an inevitable part of ageing.
July 19, 2010... The challenge faced by NHS frontline staff in raising awareness of falls prevention remains significant: spreading the message to an audience that has not experienced a fall, or may think it is not an issue that affects them, has proven...

Independent Nurse: Editorial - Nurses must retain influence in new NHS.(Editorial)
July 19, 2010... As with all change, the new health White Paper presents opportunities and concerns for primary care nurses. The decision to devolve commissioning to frontline health professionals could provide nurses the chance to reshape services to better...