GP articles from June 2003

GP archives from June 2003

GPs warned to maximise pay.
June 30, 2003... GPs have been warned to maximise their earnings this year to ensure the best deal under the new GMS contract. About 80 per cent of practices will start under the minimum practice income guarantee (MPIG) based on previous earnings. Any...

BMA moves to secure fixed locum pay rates.
June 30, 2003... The BMA is to conduct a survey of locum pay rates in a process that could ultimately lead to non-principal pay being fixed by the Review Body. Over the summer, LMCs will provide the BMA's professional fees subcommittee with details of...

GP Enterprise Award winners.
June 30, 2003... A wigwam in the waiting room helped Dr Paul Bennett and practice manager Heather du Plessis' Bath practice to win this year's GP Enterprise Award for premises management. The practice wins pounds 3,000, a celebratory meal for all the staff...

Autumn deadline for GP contract IT.
June 30, 2003... GPs must have computer systems capable of supporting the new GMS contract working by October, the GPC has argued. But the DoH, which controls the necessary funding, has refused to give any solid assurance that this deadline will be met....

'Overhaul negotiating structure'.
June 30, 2003... Despite the upbeat outcome of the new GMS contract ballot, doctors are calling for a radical overhaul of the BMA's negotiating structure. Liverpool GPs are standing by their criticism of the BMA's negotiating practices and calling for...

Give them what they want.(survey finds need for telephone consultation)(Brief Article)
June 30, 2003... Patients want more access to telephone consultations, according to one practice's research. Dr William Tong and the Binfield Practice in Berkshire have been using an online version of the 'General Practice Assessment Questionnaire' for a...

Reid speech ignores GPs.(John Reid, new health secretary of the National Health Service)(Brief Article)
June 30, 2003... New health secretary John Reid only mentioned GPs once in his 20-page maiden speech as head of the NHS. He referred to the 'medical brilliance' of surgeons, the 'nurturing and expertise' of nurses and the 'inspirational decision making'...

Prescribing costs set to rise under quality framework.(Brief Article)
June 30, 2003... Chief NHS Confederation negotiator Mike Farrar has admitted that the quality framework in the new GMS contract will push up prescribing costs. Speaking at the confederation's annual conference in Glasgow, Mr Farrar responded to concerns...

Tax threat to GP pensions.
June 30, 2003... GPs may have to pay tax on pension income above pounds 65,000 a year, under proposals being considered by the government. The cap is due to be introduced in April 2005 as part of Treasury and Department of Work and Pensions plans to...

13% pay rise to boost registrar recruitment.(Brief Article)
June 30, 2003... A 13 per cent increase in GP registrar pay has been welcomed as a step towards improving recruitment to the profession. GPC registrars' subcommittee member Dr Beth McCarron-Nash said the average rise of about pounds 5,000 'made general...

Avez-vous travaille en France?(Brief Article)
June 30, 2003... Dr Zara Bieler has just completed her VTS, 18 months of which were carried out in France. Originally from Belfast, Dr Bieler believes she is the first GP to achieve JCPTGP certification in this way. She is working as a locum in France and...

Sleep apnoea doubles risk of diabetes in men.(Brief Article)
June 30, 2003... Men with sleep apnoea are twice as likely to develop diabetes as ordinary snorers, according to French research. Researchers looked at 600 men who were referred to the sleep disorders unit at Angers University Hospital between 1998 and...

Clinical image of the week.(MRI scan of twin fetuses)(Brief Article)(Illustration)
June 30, 2003... This week is Twins and Triplets week. This coloured MRI scan is of 32-week-old twin male fetuses. Last week the government released a White Paper on genetics testing, which could see every baby genetically screened at birth to identify those...

RESEARCH BRIEFS: HRT and breast cancer risk.(hormone replacement therapy)(Brief Article)
June 30, 2003... Women over 65 years who have taken the combined oestrogen and progestogen HRT for more than five years are twice as likely to develop breast cancer. The US researchers also found breast cancers diagnosed in women taking combined HRT were...

RESEARCH BRIEFS: One pill for several ills.(polypill to prevent cardiovascular disease)(Brief Article)
June 30, 2003... A single pill may reduce MI and stroke in the population by up to 80 per cent, according to UK researchers. The 'polypill' containing components of aspirin, a statin, three anti-hypertensives at half standard doses and folic acid, could be...

RESEARCH BRIEFS: Pneumococcal jab not whole solution for otitis media.(pneumococcal conjugate vaccine )(Brief Article)
June 30, 2003... The pneumococcal conjugate vaccine is ineffective in preventing acute otitis media in children older than one year who suffer from recurrent otitis media, according to a study. Researchers from the Netherlands concluded that to protect...

RESEARCH BRIEFS: Cumulative work stress could affect blood pressure.(systolic blood pressure)(Brief Article)
June 30, 2003... US researchers have found that there is some evidence to support the cumulative burden of work stress on systolic blood pressure. They found systolic blood pressure was 4.8mmHg higher at work and 7.9mmHg higher at home among men who had...

RESEARCH BRIEFS: Not everyone for tennis.(risks to amateur tennis players)(Brief Article)
June 30, 2003... Budding tennis players who try to emulate the professionals may be at risk of developing back and shoulder injuries. Researchers from the University of Greenwich said that professional tennis players use an open stance and rotate their bodies...

London GPs launch fight for 'equitable' PCT funds.
June 30, 2003... Metropolitan GPs may miss out under the new GMS contract because PCT funds will continue to be allocated according to census data rather than the true number of patients that they serve. GPs in London are planning to launch a campaign to...

NEWS IN BRIEF: Thumbs up for foundation hospitals.(Brief Article)
June 30, 2003... An NHS Confederation survey indicates that two thirds of NHS chief executives welcome the prospect of foundation hospitals. The survey of 102 NHS leaders showed 59 per cent were positive about the impact of foundation trusts. However, 92 per...

NEWS IN BRIEF: Bursary to boost leadership skills.
June 30, 2003... GPs keen to develop leadership skills can apply for a pounds 2,500 bursary to fund half the cost of a place on the RCGP leadership programme, starting in October. Three bursary winners will join other young doctors shadowing industry leaders...

NEWS IN BRIEF: GP honoured with MBE.(Matta Setty)(Brief Article)
June 30, 2003... An MBE for services to primary care has been awarded to Dr Matta Setty. Dr Setty, who practises in Ashford, Kent, is a member of the executive committee of his PCT, as well as clinical lead for older people. He has been involved in reshaping...

NEWS IN BRIEF: Patients demand high-level healthcare.(Brief Article)
June 30, 2003... Patients want to be treated like informed consumers, a survey by charity the Picker Institute Europe has found. Results from 8,000 patients in eight European countries, including the UK, found that expectations in all aspects of healthcare...

NEWS IN BRIEF: Driving challenge for hospital.
June 30, 2003... Car or wine enthusiasts in general practice are invited to take part in a charity driving challenge to raise money for London's Great Ormond Street Hospital. Participating GPs would drive through the night from Brands Hatch in Kent to Macon...

NEWS IN BRIEF: Breast cancer reconstruction options.(Brief Article)
June 30, 2003... A booklet outlining the benefits and limitations of breast reconstruction for women who have lost breast tissue through cancer has been newly revised by Cancer BACUP. Understanding breast reconstruction also covers current methods of...

GPs appeal to minister over patient allocation.
June 30, 2003... Norfolk GPs have protested to the health secretary over their PCT's violent patients scheme. Dr Diarmuid Tiernan, who practises in rural Terrington St Clement, five miles outside Kings Lynn, told Dr John Reid in a letter last week that...

No substitute for experience.
June 30, 2003... Dr Richard Orr's Lancashire practice is the first to take part in an initiative to encourage school pupils to consider medicine as a career. Seventeen-year-old Houssain Ahmed spent a week at Chadderton South Health Centre, in Oldham, gaining...

BMA to lead medical careers advice plan.
June 30, 2003... A clearly signposted medical careers advice service is set to replace today's 'haphazard and inconsistent' patchwork of provision for undecided or unhappy doctors. Medical careers stakeholders are to come together to set the agenda for a...

Talks on separate deal for Scottish consultants fail.
June 30, 2003... Hopes of a separate Scottish consultant contract were dashed last week, as talks between BMA Scotland and the Scottish Executive collapsed. The breakdown came after disagreement over potentially unlawful elements of the proposed...

Northern Irish GPC chairman steps down.(Brian Patterson)(Brief Article)
June 30, 2003... GPC Northern Ireland chairman Dr Brian Patterson is stepping down after six years in the role, saying new blood should implement the new GMS contract. Dr Patterson told GP: 'It's time for a fresh face. I would have hated to have stepped...

Language tests 'too tough'.
June 30, 2003... English language tests used to assess overseas doctors who want to practise in the UK may be pitched too high, according to experts. Ongoing research by the Westminster Adult Education Service has shown that the majority of UK doctors and...

Rebuilding after war.
June 30, 2003... Army GP Dr Kevin Burgess has set up a surgery in former Iraqi president Saddam Hussein's Basra palace. Dr Burgess said the deposed dictator's home is furnished in marble and features ornate ceilings throughout. He said: 'It is huge and in a...

Funding cuts hit training.
June 30, 2003... The Scottish GPC has warned that cuts in funding for GP training means doctors keen to work in general practice were being turned away. The SGPC said that unless there was immediate action to tackle the workforce crisis, GPs would be...

Lords will not delay contract.
June 30, 2003... The GPC has allayed GP fears that the abolition of the post of Lord Chancellor could delay implementation of the new GMS contract. Some doctors had expressed concern that the House of Lords could delay the Health and Social Care Bill...

Weighty matters.(Doctor Martin Strong loses weight for his own health and charity)(Brief Article)
June 30, 2003... Swindon GP Dr Martin Strong has lost two and a half stone in a sponsored slim. 'I was getting a bit chubby but I lost the weight rather faster than recommended,' said Dr Strong. 'I did exactly what I tell my patients - I ate less and I...

Allergy treatment is falling to GPs.
June 30, 2003... GPs are bearing the brunt of caring for patients with allergies because of inadequate services and a lack of specialists, according to a report from the Royal College of Physicians (RCP). Shortages of specialists mean patients with...

GPs aiming for historic election win.(doctors running for Chairman of the Board for the British Medical Association )
June 30, 2003... There are three GPs among the seven candidates standing for the post of chairman in this week's BMA elections. Dr John Chisholm, Dr George Rae and Dr Sam Everington will face election by the 57 members of the BMA Council who are eligible...

Pounds 171 million obesity bill hits NHS Scotland.(Andrew Walker's report on the cost of obesity)(Brief Article)
June 30, 2003... Obesity will cost NHS Scotland more than pounds 171 million, with 70 per cent of the expense in primary care, according to a report from the University of Glasgow. 'The Cost of Doing Nothing - the Economics of Obesity in Scotland',...

MMR uptake falls again.(measles, mumps, rubella vaccines)(Brief Article)
June 30, 2003... Uptake of the MMR vaccine has fallen by 9 percentage points in part of Somerset within the past year, say public health officials. Immunisation rates in the Mendip area have fallen from 82 to 73 per cent, while figures for the whole of...

GP incentives required for London.
June 30, 2003... How can the problems of recruitment and closed lists in the capital be tackled? Incentives such as financial help with housing and the provision of local childcare are just two ways to attract GPs to London. This is according to GP...

Why the GP majority voted 'yes'.
June 30, 2003... The new contract is at last to become a reality. Julie Griffiths gauges GPs' reactions No wonder GPC chairman Dr John Chisholm was delighted. There must have been days during the past two years when securing almost 80 per cent...

The birth of a one-stop primary care shop.
June 30, 2003... Merging A&E and a walk-in centre has made access to primary care easier. Prisca Middlemiss took a closer look Walk in - as you are invited - to the walk-in centre at Charing Cross Hospital in Hammersmith in west London and you are in for...

Facing up to a life without Alan.(Alan Milburn)(Brief Article)
June 30, 2003... There has been much speculation as to the 'real' reason for the shock resignation of health secretary Alan Milburn. His departure has been particularly mourned by the nation's press photographers, who found Mr Milburn's dramatic public...

OPINION: Letters Special - GPs express their views on the new GMS contract following the resounding 'yes' vote.
June 30, 2003... The new contract is an opportunity for all GPs Dear Editor Thank God the silent majority were not beaten and bullied into submission by some of the loud-mouthed radicals who have conveyed the impression over the past few months that...

LETTERS: Our cowardice puts patient care at risk.
June 30, 2003... Dear Editor I find it hard to believe that so many GPs put their trust in the new GMS contract and therefore in the government. I think that most GPs were frustrated with all the faffing around and decided to go for it, so that...

LETTERS: Like fresh paint on a crumbling edifice.
June 30, 2003... Dear Editor I voted for the contract because I am fed up with the messing around and have no desire for things to drag on with GMS as it is with no hope of improvement. My vote in favour was not because I approve of the contract. I...

LETTERS: Just be happy that we are rid of the Red Book.
June 30, 2003... Dear Editor Now that the votes have been counted, we should be sighing with relief that this stage of the process is over. While the new contract may not be perfect,it is a good deal better that the Red Book. As the contract is...

LETTERS: Deal is done - now we have to live with it.
June 30, 2003... Dear Editor I am sorry that the majority of GPs voted for the new contract. I hope that they thought through their decision and have not been bought by the promise of lots of money if we dance to the government's tune. I fear...

LETTERS: 60% voted 'yes' in the absence of alternative.
June 30, 2003... Dear Editor It was interesting to learn that 60 per cent of those who voted 'yes' did so because there was 'no alternative'. I was under the impression that we were on a tried and tested alternative called the Red Book which had...

LETTERS: Healthcare provision for asylum seekers.
June 30, 2003... Dear Editor The article 'Your responsibility of care to refugees' (GP, 9 June) brings welcome attention to the healthcare provision for asylum seekers and refugees. I would, however, like to draw attention to another resource...

LETTERS: GPs and PCTs must work together on IT.
June 30, 2003... Dear Editor I was interested to read that GPC chairman Dr John Chisholm has pledged to fight to defend practices' right to choose which practice systems they use. As the patient interface and an integral part of the PCT, it is...

OPINION: Hold on tight for the contract ride.
June 30, 2003... Well, now we know. We are going to have a new contract. Let us hope that our remaining concerns about it are addressed quickly. Even so, a whole area of the new GMS contract has not yet been properly explored: its personal impact on...

OPINION: Saving our youth from boredom.
June 30, 2003... 'You'll rear that child,' predicted the midwife, and boy was she right. For years she has been an enthusiastic champion of stuffing raw cabbage down the bra as a treatment for mastitis, which has always made me rather circumspect about...

OPINION: Leader - An opportunity for the GPC to regain GPs' trust.
June 30, 2003... Our letters pages this week throw up a mixture of views on the news that the new GMS contract has been accepted by the profession - well, 55 per cent of the profession. Despite the high turnout and 79 per cent vote in favour, there are...

OPINION: Leader - Ask why locum rates are so high.
June 30, 2003... The BMA's efforts to regulate locum rates, possibly through the Review Body, is a case of treating the symptom rather than the disease. GPC members are right when they say that rates of pounds 500 a day are crippling some practices, but...

GP NET: Mobile Data System - Portable practice at your fingertips.
June 30, 2003... After three years of using the handheld notes system from EMIS, Dr Bill Westwood has come to rely on PalmGP In an ever-more computerised medical world, one of the problems has been how to deal with home visits. Paper notes are not much...

GP NET: Competition - Win a Palm.
June 30, 2003... Win a Tungsten T, a powerful, compact handheld from Palm With or without EMIS, the Palm Tungsten T will prove a perfect partner for the hectic lifestyle of the GP. It has a colour screen, one-handed navigation, fast and efficient...

GP NET: Tip of the week - Simple address.
June 30, 2003... Secure yourself a sensible NHS e-mail address I never give out my NHS e-mail address to anyone because it is far too unwieldy for me to remember. Fortunately, we are all to receive more memorable e-mail addresses, and I have chosen...

GP NET: E-shopping and auctions.
June 30, 2003... Online shopping offers variety and easy access to auctions. Dr Bill Wheeldin gives some tips Shopping on the internet has many advantages, but take precautions, especially if you plan to take part in an auction. Online shopping...

GP NET: Managing aspects of angina.
June 30, 2003... This week's Clinical Review on page 49 is all about angina. Dr Keith Barnard recommends some relevant websites. You can go directly to these sites from the Medicine on the Web pages at gponline.com CHRONIC REFRACTORY ANGINA ...

GP NET: Design with Dreamweaver.
June 30, 2003... Having explained how to build a simple website, Dr Simon Auty describes the benefits of his favourite internet design software As with most things in life, preparation is the key to creating a website. You need to be clear why you want to...

GP NET: Improving diabetic care.
June 30, 2003... A software system is helping GPs to improve diabetes care in Sussex. John Hutchings explains how Diabetes is a growing disease that affects 1.4 million of the UK population. This number is expected to double by the year 2010. In addition...

ENTERPRISE AWARDS 2003: The Winning Practices.
June 30, 2003... The first run of the GP Enterprise Awards has achieved exactly what we set out to do. Together with the Royal College of General Practitioners, we aimed to bring out some of the best new initiatives in hard-working surgeries around the UK....

GP LIFE: Food - Anyone for Scottish strawberries?
June 30, 2003... In the midst of a decorating disaster Dr Chris Duckham found time to enjoy a simple recipe for strawberries In between surgeries for the past week or so we have been busy starting to decorate our new home. Although things generally have a...

GP LIFE: Drink - Keeping wine for the optimum time.
June 30, 2003... In the second of his pieces on the perfect wines for a dinner party, Dr Idango Adoki enjoys a well-aged Chablis I returned to my glass of Champagne which I had left on the garden table. I had gone to help my wife with the finishing...

GP LIFE: The complementary con.
June 30, 2003... A gentle foot rub in an intimate setting is all very well, says Dr Margaret McCartney. Just don't pretend it is anything else I declare an interest. I would just love it if reflexology worked. I would adore enforced time to relax, gentle...

GP LIFE: Magical medical history trip for winning GP.
June 30, 2003... Learning for its own sake - one GP prize winner, Dr Lindsey Compson, gives an account of her tour of Italy Imagine the scene: a busy GP and mother of four - whose husband's job takes him away for 12 days out of 14; the general grind of...

GP LIFE: GP RESOURCES: Equipment Review - Taking temperatures the easy way.
June 30, 2003... Recently, ear thermometers have come in for criticism, so Dr Bryan Palmer was persuaded to try a forehead thermometer Tympanic thermometers have certainly made my life easier. I have become so dedicated to mine that when I recently saw a...

PLAIN TALES FROM THE SURGERY.
June 30, 2003... Waterworks It was rather a difficult consultation with a new patient who had a plethora of symptoms which were long standing and vague. She spoke very little English but I thought we had bridged the gap reasonably well with the help of...

June is the thinnest month.
June 30, 2003... The sun is out, the grass is growing, and the time has crept around for that inevitable fact of rural life, the village fete. Now you discover, when you live in a village, that once you commit yourself to something at the fete one year, you...

GP CLINICAL: Behind The Headlines - Is pollen causing more allergies?
June 30, 2003... Evidence is now pointing to hygiene as a possible cause of the increase in allergies, says Emma Baines In recent weeks, extensive coverage has been given to the record numbers of people who now have hay fever. The media reported that the...

GP CLINICAL: Inhaled steroids are best at lower doses.(asthma treatment)
June 30, 2003... New guidelines on asthma indicate that high doses may not be best practice, says Dr Martin Duerden Inhaled steroids are an essential part of asthma treatment for many patients. However, it has become increasingly apparent that for...

GP CLINICAL: The increasing applications of AIIRAs.(angiotensin II receptor antagonists)
June 30, 2003... 10 Tips On Scrips - There is more to angiotensin II receptor antagonists than you might think. Dr David Morris explains why 1 Like ACE inhibitors, angiotensin II receptor antagonists (AIIRAs) target the renin-angiotensin-aldosterone...

GP CLINICAL: Pressure sores and smoking film stars.(brief summaries from research journals)
June 30, 2003... Journals Watch - If your head is full of contract coverage, let Dr Mark Clayson ease your path through the medical journals Unusual risk factors for pressure ulcers - Age Ageing 2003; 32: 259-64 What groups of patients are most...

GP CLINICAL: How can I win these patients' trust?(general practitioner has trouble gaining trust of immigrant family)
June 30, 2003... Practice Dilemma - Our panel advise on a young family of refugees who want their son's mild eczema referred to a specialist THE DILEMMA A family of asylum-seekers from Iraq recently registered with our practice. The couple, who do...

GP CLINICAL: Managing growth of type-2 diabetes.
June 30, 2003... The Basics - Dr Roo Tindall has a reminder of the key points for GPs caring for patients with diabetes Diabetes is a huge and growing health problem in the western world. It is estimated that 1.4 million people in the UK have the...

GP CLINICAL: At a Glance - Psoriasis of the nail versus tinea unguium.
June 30, 2003... Psoriasis of the nail Discriminatory features - Most commonly presents in young adults but may occur at any age. - Most patients have other signs of psoriasis. - Nails are usually affected symmetrically. - Nail changes include...

GP CLINICAL: THE GOOD OLD DAYS - Intestinal obstruction.
June 30, 2003... Treatment of suspected intestinal obstruction should include a pint of warm water given by mouth. This is usually returned by vomiting, and washes out the stomach and comforts the patient. If the patient is collapsed, he should have an enema...

GP CLINICAL: Angina.
June 30, 2003... THE ESSENTIALS - Cardiovascular disease is still the commonest cause of death in the UK - Drugs improve symptoms but their effect on mortality is not known - One third of angiograms may be normal, but reassurance is valuable - Surgery...

GP CLINICAL: Safety of complementary therapies when pregnant.
June 30, 2003... Many women use alternative therapies during pregnancy. Mark Stuart explains what GPs should tell their patients Lack of information about drug safety in pregnancy limits the options for treating pregnancy-associated conditions, so many...

GP CLINICAL: Steroid Injections Guide - Part 7 - trigger finger.
June 30, 2003... 1. The mechanism Swelling on tendon A trigger finger or thumb is caused by a bulbous swelling or nodule of the flexor tendon in association with thickening of the mouth of the fibrous flexor sheath. When the finger is flexed,...

YOUR NEW GP CONTRACT: It's 'yes'.(general medical services contract)
June 23, 2003... GPC negotiators were celebrating a resounding 'yes' vote last week, with eight out of 10 GPs voting in favour of the new GMS contract. With a 70 per cent turnout in the ballot, this represented more than half of the total number of UK...

What's in a name?(doctor and wood carver)(Brief Article)
June 23, 2003... Former Hertfordshire GP Dr Mary Wood is pictured with a selection of her hardwood carvings. Dr Wood has been carving for 30 years and, although not exhibiting this year, is a regular contributor to the annual Medical Arts Society exhibition...

GPs claim Hib booster campaign is a fiasco.(Brief Article)
June 23, 2003... GPs charged with delivering the DoH's Hib booster campaign say it is turning into a flop. Only tiny numbers of children under four years have turned up to receive their fourth Hib dose. GPs are blaming the low-profile media campaign...