GP articles from June 2008

GP archives from June 2008

GPs treat people, they do not fix machines.
June 27, 2008... NHS Alliance chairman Dr Michael Dixon is supporting the Valuing General Practice campaign. Listening to Radio Four recently, I heard an interview with Roy Lilley, a former NHS trust chairman often quoted in the media as an NHS expert....

Opinion: They just come bouncing back.(Postgraduate medical meetings)(Viewpoint essay)
June 27, 2008... I don't usually go to postgraduate medical meetings, but to my surprise I actually enjoyed it. It was good to see that the drug reps are still flogging their stuff, and I took enough free pens to last 100 years. It was also good to...

Opinion: The stiff upper lip of this sceptred isle.(United Kingdom. National Health Service)
June 27, 2008... Mrs Posh has fallen foul of the NHS zero-tolerance campaign yet again. She gazes at me, apologetically, as I explain carefully that you cannot say f***ing hell to our dispensary manager if you want your frusemide to actually be...

Clinical: Journals Watch.(Patient education for awarness of the risk of Attention deficit hyperactivity disorder, Coronary heart disease and Sciatica diseases)
June 27, 2008... CHD, sciatica, ADHD and yoga Too busy to catch up on research? Let Dr Louise Newson update you. - Preventive care for high-risk CHD patients Lancet 2008; 371: 1,999-2,012 This European trial investigated whether a...

Clinical: Viewpoint - Safety of metformin.(Report)
June 27, 2008... Many clinicians wrongly fear metformin, by Dr Abd A Tahrani. Metformin was first available in the UK in 1957. It is used mainly in the treatment of type-2 diabetes, but also in conditions in which insulin resistance is a feature, such...

Clinical: At a Glance - Necrobiosis lipoidica vs gravitational eczema.(Disease/Disorder overview)(Brief article)
June 27, 2008... 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,...

Clinical: Competition answers.
June 27, 2008... MIMS prescribing quiz MIMS is the perfect place to refresh your prescribing knowledge and our monthly quiz helps keep you up to date, with the added incentive of a prize draw for pounds 50 of John Lewis vouchers. Winner Thank...

Clinical: Clinical Review - Primary hyperparathyroidism.(Disease/Disorder overview)
June 27, 2008... Contributed by Mr David Scott-Coombes, consultant endocrine surgeon at the University Hospital of Wales, Cardiff. Section 1 Epidemiology and pathology On the surface of every parathyroid cell is a calcium-sensing receptor (set to...

Clinical: The basics - Crohn's disease.
June 27, 2008... An overview of the presentation, diagnosis, treatment options and likely outcomes, by Dr Taqi Hashmi. Crohn's disease, named after Dr Bernard Crohn, is a chronic relapsing and remitting inflammatory disease of unknown aetiology. It...

Education: Professional development - Effective delegation in the surgery.
June 27, 2008... Delegation is an essential skill for GPs. Here Dr Tillmann Jacobi offers some practical tips. As in any workplace, the smooth running of the GP practice relies on well-managed teamwork. As you progress through your career the need to...

MedEconomics: Extra earnings ... Take on medico-legal reports work.
June 27, 2008... GPs can put their knowledge and experience to additional use to boost their income. In the mid-1990s orthopaedic surgeons did three quarters of all medico-legal reporting work. A decade later, it is GPs who carry out that same...

MedEconomics: Ask the experts - Premises, pay and pensions.(United Kingdom. National Health Service)(Personal account)
June 27, 2008... Q: Tenancy agreement My ex-partner who has just retired owns the surgery premises and used to receive the notional rent reimbursement. Now we need to have a solid landlord:tenant agreement. The solicitor we approached drafted an...

MedEconomics: France changes to the UK system.
June 27, 2008... Healthcare budget deficits led the French to adopt our GP gatekeeper model, writes Fiona Barr. The current threats to UK general practice come at a time when our nearest neighbour is moving closer to our existing model and values. ...

Dispensing: Dispensing regulations - The importance of clear labelling.
June 27, 2008... Good practice and common sense play a large part in the labelling process, writes Annette Arthur. Most of us have met patients who are convinced that all dispensers have to do is take a box off the shelf and stick a label on it. The...

Plain tales from the surgery.(Brief article)
June 27, 2008... Needless colonoscopy 'This lady attended for colonoscopy... the results of which are as follows: 'Sedation: lignocaine throat spray. 'Findings: oesophagus, stomach and duodenum were all normal.' Ouch! Dr Susanna...

GPs face sanctions on prescribing.
June 27, 2008... Exclusive - Ministers pledge 'zero tolerance' of anti-psychotic use in dementia patients. GPs could face sanctions for prescribing anti-psychotic drugs for dementia when there is no alternative, as ministers pledged a 'zero tolerance'...

RCGP urges practices to unite to improve services.(Royal College of General Practitioners)(Brief article)
June 27, 2008... Practices should band together in social enterprises or charities in order to improve services and save money, according to the RCGP. In a report out this week, 'Primary Care Federations - putting patients first', the RCGP recommends that...

NICE lipid modification advice 'flawed'.
June 27, 2008... Cardiovascular tool underestimates risk in ethnic minorities, say researchers. NICE lipid modification guidelines will lead to social inequalities and miss cardiovascular risk in ethnic minority patients, say UK researchers who developed...

GPC readies plan to reform funding.
June 27, 2008... GPC negotiators are preparing proposals for practice funding that would see correction factors incorporated into a larger global sum. Practice funding should emulate the way PCTs are funded, said GPC negotiator Dr Chaand Nagpaul....

Continuity of care.
June 27, 2008... As the NHS approaches its 60th birthday, on 5 July, Dr Alan Merson has a claim to be Britain's longest-serving GP. The 86-year-old began work in his father's practice in Dewsbury, West Yorkshire on 1 April 1948, three months before the...

Northern Ireland to fund GPs to target PAD patient care.
June 27, 2008... Exclusive - PAD, osteoporosis and heart failure made DESs. In a move that signals a split in a UK-wide GMS contract, Northern Ireland has decided to fund identification and care of peripheral arterial disease (PAD) in general practice....

News in brief.(United Kingdom. National Health Servicerefusal to sign a petition against Darzi health centres)(Heart attack receives primary angioplasty treatment)(Papillomavirus vaccines that does not protect against genital warts)(Brief article)
June 27, 2008... Darzi's Desert Island Discs Health minister Lord Ara Darzi appeared on Radio 4's Desert Island Discs last weekend. His luxury item was a pen and paper and his favourite book was Yes Minister, while a diverse playlist ranged from choral...

MPIG top negotiating priority.
June 27, 2008... GPs feel that protecting their practice income is the main priority for GPC negotiators as expenses soar. A GP survey of 107 delegates at this year's LMCs conference revealed a third felt MPIG protection should be the GPC negotiators'...

Low vitamin D is found to double risk of CVD death.
June 27, 2008... Better surveillance of vitamin D needed to detect those at high risk. GPs should measure vitamin D frequently in high-risk patients, as low levels of the sunshine vitamin can double the risk of death from cardiovascular disease (CVD),...

News in brief.
June 27, 2008... Heel test for osteoporosis An ultrasound exam of the heel could help to identify women at risk of developing osteoporosis, according to a Swiss study involving 6,174 women aged 60-85. After 32 months, 6 per cent of those classified as...

Darzi report promises to 'let clinicians set NHS priorities'.(United Kingdom. National Health Service)(Report)(Brief article)
June 27, 2008... The Darzi review will be built on local priorities and hand clinicians powers to set local NHS priorities, the DoH has pledged. Health secretary Alan Johnson told last week's NHS Confederation conference that the report's contents would...

Health inequality 'unacceptable'.(United Kingdom. Department of Health preseant a report on health gap between the most affluent and deprived areas in England )(Brief article)(Clinical report)
June 27, 2008... The health gap between the most affluent and deprived areas in England remains 'unacceptable', says the DoH. The statement follows publication of health profiles of every SHA in the country, reiterating the differences in wellbeing...

GPs to be allowed to buy LIFT stakes.
June 27, 2008... Plans aim to boost investment in NHS LIFT. GPs are to be allowed to buy stakes in premises built under NHS LIFT. A spokesman for Community Health Partnerships (CHP), the agency responsible for the programme, said that it was...

GPs question the need for patient co-payments.
June 27, 2008... The boundaries between NHS and private treatment could blur after the DoH reviews rules governing co-payments, health experts warn. National clinical director for cancer Professor Mike Richards is to review a 20-year-old edict that means...

New GMS: an opportunity lost?(General Medical Services)(Negotiation Between United Kingdom. Department of Health and British Medical Association about General Medical Services)
June 27, 2008... BMA-DoH relations have hit an all-time low. Rachel Liddle looks at how new GMS has turned sour. How have we got to the point where differences of opinion between MPs and doctors' leaders has become a very public slanging match? ...

Behind the headlines: Can taking statins prevent emergency caesareans?
June 27, 2008... Taking statins during pregnancy could help to reduce the risk of an emergency caesarean in obese women, media reports suggest. UK researchers found that obese pregnant women were 3.5 times more likely to require a caesarean than pregnant...

Opinion: Ballot box.
June 27, 2008... GPs who think there should not be more nurse partners 80% Source: www.healthcarerepublic.com

Editorial: Darzi must back the entrepreneurial GP spirit.(Editorial)
June 27, 2008... Two years ago the GPC drew up a shortlist of its negotiating priorities. GP has used this as the basis for surveying GPs on what they think the number-one priority for the GPC should be. This week we can reveal the results of the 2008...

Opinion: Shredding the administrative paper trail.
June 27, 2008... In all the doom and gloom of our chaotic NHS, it really is good once in a while to be able to report progress. Our practice has been cleaning out its archives to make more space. Naturally, we kept all the clinical information but a large...

Opinion: Celebrating a person's life is all about... timing.
June 20, 2008... In Ireland we have an ambivalent approach to death. Before it happens we are defensive and guarded, and denial is our most popular coping mechanism. But after death (if it's somebody else's) our attitude changes radically, and we have...

Opinion: Patients prefer to be at home in bad weather.
June 20, 2008... My father-in-law was a GP in the sixties when Dr Finlay's Casebook ruled the TV ratings and Z-Cars never fitted anyone up. GPs visited from dawn till dusk but were so universally respected that no politician ever wanted rid of them. We...

Clinical: Journals Watch - Scabies, thrombosis and RA.(Clinical report)
June 20, 2008... Too busy to read the journals? Dr Honor Merriman catches up on the latest research. Diagnosis of scabies - CMAJ 3 June 2008; 178 (12) doi:10.1503/cmaj.061753 Scabies is traditionally diagnosed by clinical symptoms and signs, and...

Clinical: Interview with an expert - NICE guidelines on lipid modification.(United Kingdom. National Institute for Clinical Excellence)(Interview)
June 20, 2008... Dr Rubin Minhas talks to GP about the latest lipid modification guidelines from NICE. Q: Are the NICE guidelines designed for primary or secondary prevention? Both. These guidelines update the relevant sections of the NSF for CHD...

Clinical: Case study - Dysfunctional uterine bleeding.(Case study)
June 20, 2008... Dr Lizzie Croton discusses a case of menorrhagia with a sinister cause. Ms Price, a 43-year-old nulliparous woman, presented with recent onset irregular menstrual bleeding. The bleeding was heavy and erratic with a variable cycle length...

Clinical: Test Yourself - MIMS prescribing quiz.
June 20, 2008... MIMS is the perfect place to refresh your prescribing knowledge, and we have devised this monthly quiz to help you keep up to date, with the added incentive of a prize draw for pounds 50 of John Lewis vouchers. Each monthly edition of...

Clinical: Clinical Review - Headache in children.(Clinical report)
June 20, 2008... Section 1: Aetiology and epidemiology Headache is the most frequent neurological symptom, and a common manifestation of pain in children.1 Patients want answers to three questions: what is the cause of their headache, what would make it...

Education: Consultation skills - Telephone consultations.
June 20, 2008... Remote consultations are an important tool for GPs, as Dr Mona Kular explains. Telephone consultations can play a valuable role in the delivery of information and healthcare in general practice when provided in the correct context and...

MedEconomics: How to... Resolve child dilemmas.(Case study)
June 20, 2008... Dr Brigid Simpson advises on children's capacity to consent to treatment. Treating children can pose difficulties for GPs. There can be occasions when you may need to judge whether children have the capacity to consent to treatment...

MedEconomics: Why polyclinics are so costly to run.
June 20, 2008... Experts say practices could cost pounds 150,000 a year more to run in a polyclinic, reports Carole Slingsby. Whether or not you own your surgery, it is a valuable asset to your patients and, as it is taxation-funded, to the UK. By...

MedEconomics: Ask the experts - Investment risk and added years.
June 20, 2008... - Q: Investment Risks When I talk to colleagues about investing, it seems that everyone has a different understanding of 'adequate risk'. How do I know what level of investment risk to take? Appetite for risk is subjective. In...

Dispensing: Practice finance - Increasing your dispensing list.
June 20, 2008... Dr Jeremy Phipps recommends checking patient eligibility for dispensing. With the average dispensing patient earning pounds 30 to pounds 50 for the practice, if you are to keep the practice profitable and provide all the services that...

Plain tales from the surgery.
June 20, 2008... - In rude health I was visiting a delightful 84-year-old woman with dementia. She had a nasty pneumonia and was dehydrated. 'You're a little dry, Mrs X,' I stated. 'As the bishop said to the actress my dear,' she chortled!...

Rheumatoid arthritis drug could prevent kidney cysts.
June 20, 2008... Drug offers new hope to patients with polycystic kidney disease. A drug currently used to treat rheumatoid arthritis (RA) could offer fresh hope to sufferers of polycystic kidney disease by preventing the formation of cysts, findings from...

Research Briefs.(Brief article)
June 20, 2008... - Poison patch could end travel bug misery A skin patch has been developed that could help prevent stomach bugs during foreign travel, say US researchers. The patch, which contains poisons produced by Escherichia Coli, was found to be 75...

Stress test better on diabetes risk.
June 20, 2008... Obese children, who are at an increased risk of developing pre-diabetes and metabolic syndrome, may not be detected using the fasting plasma glucose test, say Canadian researchers. The use of what is known as the oral glucose stress test...

DoH attacks 'mendacious' BMA petition on polyclinics.(United Kingdom. Department of Health)(British Medical Association)(Brief article)
June 20, 2008... LMCs conference 2008 DoH attacks BMA petition and criticism of new MRCP exam and its funding. Ministers have dismissed a petition against polyclinics signed by over a million patients as the result of a 'misleading and mendacious'...

MRCGP exam faces criticism.(The Examination for Membership of the Royal College of General Practitioners)(Brief article)
June 20, 2008... Trainers and trainees joined forces in damning the new MRCGP exam at this year's LMCs conference. The workload is heavy and the numerous assessments detract from training opportunities, agreed the delegates, led by Scottish LMCs. The...

GPC delivers petition to Downing St.
June 20, 2008... A deputation of GPs and patients delivered a petition of more than a million signatures to Number 10, calling on the government to end plans that would mean the end of the traditional family doctor

LMCs pass 'no confidence' vote in ministers.(Local medical centers)(Brief article)
June 20, 2008... LMCs conference 2008 Backing for GPC, premises investment failure slammed and Darzi's impact on GPs. The government was sent a clear message of 'no confidence' by delegates at the LMCs conference this year. GPs also expressed their...

Premises need adequate funds.
June 20, 2008... GPs at the LMCs conference rebuked the government for failing to invest in their premises. Delegates backed unanimously a call by Dr John Doyle from Surrey LMC who pointed out that if PCTs are to shift care from the secondary to the...

No support for Darzi from LMCs.
June 20, 2008... The Darzi review will be 'positive' for GPs, RCGP chairman Dr Steve Field has claimed. 'We believe we've had a real impact on the paper,' he told LMC delegates. 'When it started back in October, general practice was seen to be a...

DoH fights back over polyclinics.
June 20, 2008... Exclusive - Public petitions against changes. There was proof that the BMA's campaign against polyclinics could be damaging the government last week, as the DoH began a public relations counter-attack. After health secretary Alan...

Behind the headlines: Can oily fish prevent eye disease?
June 20, 2008... Eating food rich in omega-3, such as oily fish like mackerel and sardines, could help cut the risk of developing age-related macular degeneration (AMD), recent media reports suggest. Participants who ate the most omega-3 rich foods were...

'Encourage development of existing practices'.
June 20, 2008... Online think tank www.2020health.org explains why it backs the Valuing General Practice campaign. GP has come out strongly supporting the values of traditional general practice. These views are shared by www.2020health.org, but it...

Opinion: Ballot box.
June 20, 2008... GPs who think the DoH should not raid the quality fund to boost global sums: 83%

Editorial: The cost of polyclinics is far too prohibitive.(Editorial)
June 20, 2008... NHS spending was pounds 35 billion when Labour came into power in 1997. By 2010/11 it is expected to reach pounds 110 billion. It would be ironic if Labour lost the next election despite more than trebling the NHS budget. When households...

Opinion: Save the NHS from decay with a simple KISS.(National Health Service)
June 20, 2008... Parkinson's third law says 'Growth leads to complexity, complexity to decay'. It couldn't describe the NHS better - expensive, inefficient and grinding to a halt. The treatment for over-complexity starts with an acronym - KISS: 'Keep It...

Polyclinics will cost an extra pounds 250m.
June 20, 2008... Exclusive: Expert cost analysis undermines DoH claims that polyclinics will save cash. Moving into a polyclinic will more than double an average practice's premises costs, a GP investigation has revealed. The policy could cost the...

London GPs feel pressure as PCTs back Darzi plans.
June 20, 2008... Chief executives of London's 31 PCTs formally agreed to push forward with plans for polyclinics last week. By 2018, NHS London wants a network of up to 150 polyclinics to be in place across the capital. GPs in Redbridge and Waltham...

Systolic BP 'most use in over-50s'.
June 20, 2008... GPs should only use systolic BP to measure and diagnose hypertension in the over-50s, leading experts have advised. Current NICE guidance recommends that GPs measure both systolic and diastolic BP when identifying patients with...

Caption competition.
June 20, 2008... It's been a controversial week for health minister Ben Bradshaw, pictured at a health centre last week. The minister seems to be keeping his chin up despite relations with the BMA reaching a new low. But what's got him laughing? Here's a...

DDRB failed fully to understand MPIG.(Doctors and Dentists Review Body )(Minimum practice income guarantee)(Brief article)
June 20, 2008... The DDRB did not fully understand the need for MPIG when it recommended that core pay rises should cut correction factors, a GPC negotiator has said. Dr Holden told last week's LMCs conference: 'There has been an admission it may not...

BMA tells DoH to 'put up or shut up'.
June 20, 2008... Exchange of letters between minister and BMA reveals depth of mistrust and anger. The BMA has told the DoH to put up or shut up over allegations that GPs have pressurised patients into signing the petition in support of NHS general...

Valuing general practice.
June 20, 2008... 'General practice care for a whole year costs less than a single day's hospital admission.' RCGP. Think tank www.2020health.org is calling on the DoH to encourage the development of existing practices. Board member Dr Paul Charlson...

GPs must 'safeguard their future' by embracing PBC.
June 20, 2008... Exclusive: Top GP warns practices of danger of ignoring PBC. GPs must get involved in practice-based commissioning (PBC) to secure their future in general practice, a leading GP has warned. Professor Michael Dixon, chairman of the NHS...

News in brief.
June 20, 2008... Extended hours spread Over half of practices in 21 PCTs are offering extended hours, says the DoH. Across England, 20 per cent of practices are opening on evenings or weekends, up from 12 per cent in April. GPs 'need more...

GPC leader lambasts DoH 'dishonesty'.
June 20, 2008... LMCs conference 2008 Buckman lambasts the DoH, concerns over vascular screens and IT confidentiality. In a maiden address as chairman of the GPC, Dr Laurence Buckman galvanised colleagues at the opening of the 2008 conference of LMCs. ...

Over-40s screening to 'drain resources'.(Brief article)
June 20, 2008... A motion condemning the DoH national screening programme for over-40s in England was passed easily, after GPC negotiator Dr Chaand Nagpaul told delegates it was 'policy by political announcement'. 'There was no discussion with us as a...

No confidence in IT confidentiality.(Brief article)
June 20, 2008... GPs have no confidence in the security of the summary care record. GPs backed motions criticising the government's lax attitude to IT security and demanded that patients have the final say over whether or not their details are uploaded to...

Independent Nurse: Nurses back campaign to save surgeries from polyclinic threat.
June 16, 2008... More than 1.2 million patients have signed a BMA petition calling on the government to support existing surgeries and stop encouraging private firms into primary care. Nurse leaders said practice-based nurses supported the campaign....

Independent Nurse: Glasgow plans will 'undermine child protection'.
June 16, 2008... Child protection and vaccination programmes could be undermined by proposed changes to health visitors' roles in Glasgow, experts have warned. Greater Glasgow and Clyde NHS Board is considering a move that would align health visitors...

Independent Nurse: DoH's rejection of QOF indicators could delay dementia diagnosis.
June 16, 2008... Practices could struggle to identify treatable cases of dementia after a number of new QOF indicators were rejected by the DoH. The National Primary Care Research and Development Centre has published recommendations by expert panels for...

Independent Nurse: MPs lash out at 'weak' NHS cost forecasts.
June 16, 2008... MPs have hit out at tactics used to build up a pounds 515 million NHS surplus in 2006/7, as the DoH announced the 2007/8 surplus had soared to pounds 1.6 billion. A report from the House of Commons Public Accounts Select Committee says...

Independent Nurse: Labour's NHS reforms 'have not borne fruit'.
June 16, 2008... Key elements of NHS system reform brought in by the Labour government have yet to bear fruit, public sector watchdogs have warned. Choice needs more time to work, and patients need more realistic options, and more accurate and timely...

Independent Nurse: NHS Direct.
June 16, 2008... NHS Direct has published data showing it cuts pressure on other health services. NHS Direct referred 28 per cent of callers to their GP and 11 per cent to A&E, but without the service, 44 per cent would have gone to the GP, and 29 per cent to...

Independent Nurse: Breast cancer.
June 16, 2008... Postmenopausal women taking the osteoporosis drug raloxifene could also halve their risk of invasive breast cancer, US research findings suggest. Raloxifene is currently approved by NICE for the secondary prevention of osteoporosis in women...

Independent Nurse: Fuel costs.
June 16, 2008... The RCN and Unison have demanded a rise in the fuel allowance for NHS nurses to help cover the soaring price of petrol. Unison is calling for a 10 per cent hike in fuel allowances. It says they were set in 2000 when the average cost of petrol...

Independent Nurse: Nurse-led care.
June 16, 2008... Nurse-led prevention programmes can improve lifestyle and cut metabolic risk factors for cardiovascular disease, research shows. An evaluation of programmes working across primary and secondary care in the UK and Europe showed that nurses...

Independent Nurse: Online tool.
June 16, 2008... A website to link family carers, community and district nurses, healthcare assistants, social care workers and others to share information and support was launched last week. ConnectingforCare.co.uk was developed by the Queen's Nursing...