GP articles from June 2010

GP archives from June 2010

Opinion: Paying through the nose is not medically wise.
June 25, 2010... I've had private health insurance for years now, just in case. After a while it becomes like a trap; you feel that having been with it so long, to get out would be inviting disaster, life being the sneaky bitch it is. But I've been looking at...

Opinion: Adaptability is the icing on a home made cake.
June 25, 2010... All of life, when you write for a living, has the habit of being a metaphor, and so it is with cake. Today, I toil in the kitchen, wrapped in a cloud of icing sugar, for the village fete. I have, by dint of not dying yet, become one of its...

Clinical: Headache fact file - Part 5 - Headache in children and the elderly.(Disease/Disorder overview)
June 25, 2010... In the final part of this series, Dr David Kernick discusses the challenges of headaches in different age groups. Headache in children Headache is the most frequent neurological symptom and the most common manifestation of pain in...

Clinical: The Basics - Carpal tunnel syndrome.(Disease/Disorder overview)
June 25, 2010... CTS is one of the most common conditions affecting the nerves of the hand. Carpal tunnel syndrome (CTS) is caused by high pressure within the carpal tunnel which results in ischaemia of the median nerve. The resulting impaired nerve...

Clinical: Emergency medicine - Dermatological emergencies.(Disease/Disorder overview)
June 25, 2010... GPs see few dermatological emergencies, but must be aware. By Dr Alvin Lee and Dr Anshoo Sahota. Dermatological emergencies are uncommon but important because they can have fatal outcomes. Cellulitis Erysipelas and cellulitis are...

Clinical: Clinical Review - Gastro-oesophageal reflux disease.
June 25, 2010... By Dr Kathryn Oakland, foundation doctor, North East Thames and Mr Joseph Dawson, specialist registrar, North East Thames Section 1 Epidemiology and aetiology. Gastro-oesophageal reflux is the involuntary passage of gastric contents from the...

Education: Consultation skills - The impact of end-of-life care.
June 25, 2010... GPs can find caring for palliative care patients both challenging and rewarding, says Dr Murray Fletcher. It is in our nature and training to find a cure, but one of the first things that must be accepted in palliative and end-of-life care is...

Education: Pictorial case study.(Case study)
June 25, 2010... The case This 25-year-old woman had been in India for a holiday and developed an ulcerated, crusted plaque on her knee. The condition was assumed to be impetigo and she was prescribed topical fusidic acid cream and oral flucloxacillin. ...

Education: A registrar survival guide ... Planning a teaching episode.
June 25, 2010... Teaching forms a part of the GP curriculum and is a skill essential to GP registrars to promote learning in a complex medical world. GP registrars may be involved with teaching first year medical students through to F1 doctors, which includes...

MedEconomics: How to ... Carry out clinical research.
June 25, 2010... The MDU's Dr Claire Macaulay says GPs must follow GMC guidance and put patients' interests first. Clinical research is vitally imp-ortant for improving healthcare However, GPs involved in research are responsible for ensuring participants are...

Enterprise Awards 2010: The winning practices.
June 25, 2010... The GP Enterprise Awards have once again achieved exactly what they set out to do. Together with the RCGP, and our sponsors the MDU, we aimed to seek out and highlight some of the best new initiatives in hard-working surgeries around the UK. ...

Public 'not interested' in elected health boards.
June 25, 2010... NHS Reform Poor voter turn-out and high cost of health board election pilots prompt warning from BMA. Doubts have been raised over plans to roll out elected NHS boards across the UK after reports of poor turn-out and skewed representation in...

NICE increases fracture options.
June 25, 2010... GPs will have a greater range of treatment options for preventing fractures in postmenopausal women under draft guidance from NICE. Women at increased risk of osteoporotic fractures should be treated with newly licensed injectable drug...

GI risk in arthritis treatment 'varies across pain therapies'.
June 25, 2010... Arthritis - Study shows reduced GI risk with celecoxib treatment. Arthritis pain relief with celecoxib is less likely to cause GI side-effects than a non-selective NSAID plus a PPI, research suggests. However, the authors of an...

CV risk of dairy products 'over-estimated'.
June 25, 2010... The negative impact of dairy products' high saturated fat levels may be offset by their omega-6 fatty acid content, research suggests. Previous studies have suggested that the high saturated fat content of milk may contribute to...

Research Brief: Diabetes.
June 25, 2010... Adults with diabetes are at higher long-term risk of liver disease, researchers studying 438,069 patients with the condition have found. The annual incidence of liver disease was eight per 10,000 in people diagnosed with diabetes, compared with...

Research Brief: Colin.(Report)(Brief article)
June 25, 2010... Men called Colin are most likely to suffer from high BP, a report claims. The survey by Lloyd's Pharmacy compared popular names over the past 80 years with the rate of heart problems. Men called Daniel have the lowest chance of hypertension. ...

Five-way race starts for RCGP vice-chairman post.(Royal College of General Practitioners)
June 25, 2010... Five aspirant RCGP leaders have joined the hustings in the first election for the position of vice-chairman. Revalidation-sceptic Dr Una Coales is battling marketisation-opponent Dr Helena McKeown and three college educators, Professor Nigel...

GP commissioning plan is in sight.(general practitioners)(United Kingdom. National Health Service. Primary Care Trusts)
June 25, 2010... Will GPs be tempted by commissioning plans or will they be put off by the risks? Tom Ireland reports. A White Paper due in early July will outline the DoH's first detailed vision of an NHS in England commissioned by GPs. Crucial questions...

A round-up of the best from GP's website this week.
June 25, 2010... GP Curriculum Centre The Curriculum Centre provides a range of educational articles mapped against each area of the RCGP curriculum. The centre is regularly updated with new content and there are recent updates to the sections on...

Opinion: Ballot Box.
June 25, 2010... 93% of GPs think the GP patient survey should be axed 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.(Website overview)(Brief article)
June 25, 2010... Darzi centre ad targets GPs' patients - This is to be expected; how else can they attract patients and survive? We need to exclude them from GP consortia and isolate these practices in every possible aspect. The PCT will help those people...

Editorial: PCTs need to raise game to stave off abolition.(Editorial)
June 25, 2010... This week, GP exclusively reveals that one in six PCTs is failing in its duty to check the language skills of European GPs working out-of-hours shifts across England. One would have expected language tests to be a priority for PCTs following...

Opinion: I never thought I'd yearn for the bad old days.
June 25, 2010... I'm beginning to feel like King Gama in Gilbert and Sullivan's comic opera Princess Ida. The ultimate sarcastic critic, he gets his come-uppance when everyone around him is so exquisitely polite that he has nothing whatever to grumble about (and...

Clinical: Journals Watch - TIA, CVD risk and influenza.(transient ischemic attack)(cardiovascular diseases)
June 25, 2010... Have you been too busy to read the journals? Dr Louise Newson brings you the latest research. - Patients with TIAs are still not going to emergency departments. Emerg Med J 2010; 27: 364-7 There have been many adverts highlighting FAST...

MedEconomics: Choice of email available to GPs.
June 25, 2010... Rereading messages if you use more than one device can be frustrating. Dr Neil Paul has an answer. There are three main types of email and knowing the differences can help you choose the best for your needs. Colleagues have complained that...

MedEconomics: Why I do benefits tribunal work.(general practitioner Patricia Moultrie )(Occupation overview)
June 25, 2010... Dr Patricia Moultrie uses her medical knowledge and communication skills at appeal hearings. My position as a medical member in the Social Entitlement Chamber sitting on social security appeals is a real judicial appointment. Using my skills...

MedEconomics: Preparing for a dispensing robot.(automated dispensing unit )
June 25, 2010... Temporary disruption to the dispensary should herald an improved service, says Dr Jeremy Phipps. Three months ago, after several years of consideration, we decided to order a dispensing robot for our large dispensing practice. Investing in...

Good Practice: Reconfiguring Services - Pros and cons of vertical integration.
June 25, 2010... Would merging GP, community and in-patient services be a risk or an opportunity? By Dr David Jenner. There has been a lot of debate recently in England over the benefits and risks of integrating services, either vertically or horizontally. ...

Enterprise Awards 2010.
June 25, 2010... - Practice team Winner: Complex care team - Upton Surgery, Worcestershire This practice's 'complex care team' provides a multi-agency approach to supporting patients with acute needs, that saved pounds 148,000 in one year. Other...

Plain Tales from the Surgery.
June 25, 2010... - Essential maintenance An elderly patient came to see me complaining of worsening knee pain. He refused to believe it was due to osteoarthritis despite X-rays confirming this diagnosis. He was frustrated that no analgesics had helped his...

PCT cuts to fund GP commissioning.
June 25, 2010... GPC calls for commissioning salaries for GPs as DoH reveals funding plans. GP commissioning work will be paid for by a share of more than pounds 500 million in PCT and SHA budgets cuts, the DoH has confirmed. In a revised operating...

GP saves pounds 400,000 with dementia service.
June 25, 2010... A GP saved pounds 400,000 in secondary care costs last year with a new service that reduced the diagnosis time for dementia from the national average of three years to just four weeks. Dr Ian Greaves, of Gnosall Surgery in Staffordshire, is...

PCTs ignore call for overseas GP checks.
June 25, 2010... GP investigation shows PCTs are slow to act in wake of Ubani incident. One in six PCTs have failed to set up checks to prevent a repeat of the fatal prescribing error by German locum Dr Daniel Ubani, GP can reveal. A health select...

NSAIDs side-effects warning.
June 25, 2010... Most patients susceptible to side-effects from NSAIDs may not be receiving drugs to prevent adverse reactions, a study shows. A study of patients in the Netherlands showed just 40 per cent of patients prescribed NSAIDs and at risk of...

GP training on fit notes required.
June 25, 2010... Sixty-three per cent of UK companies think GPs should have occupational health training to help them fill out fit notes, the 2010 CBI sickness absence survey has revealed. Nearly half of UK companies want doctors trained to improve their...

Compulsory commissioning may be difficult, report warns.
June 25, 2010... The DoH may need to enable several 'tiers of participation' in commissioning to reflect the fact that many GPs are not keen to take part, a report says. The report, jointly published by the RCGP, the National Association of Primary Care...

ARB slows microalbuminuria onset.
June 25, 2010... European Society of Hypertension Conference 2010 - ARB impact - Salt intake - Doctors accept higher BP. The angiotensin-receptor blocker (ARB) olmesartan delays the development of microalbuminuria in at-risk patients, an international study...

'Above-guideline BP' often ignored.
June 25, 2010... Most doctors across Europe are willing to accept BP levels slightly above guideline limits, a Europe-wide survey of 2,629 doctors suggests. The survey found that the mean systolic BP by which doctors were concerned was 148.8mmHg and half...

Small drop in salt intake will lower BP.
June 25, 2010... Modest, easily achievable reductions in salt intake can significantly lower BP, UK research suggests. Dr Rebecca Suckling, of St George's University of London, and colleagues looked at the effects of reductions in salt intake in patients with...

Conference Briefs: Hypertenion treatment.(Brief article)
June 25, 2010... Starting hypertension patients on combination therapy with a calcium channel blocker and angiotensin-receptor blocker therapy leads to faster reductions in BP, an Italian study has shown. University of Milan researchers showed that, compared...

Conference Briefs: Reductions in BP.(Conference news)
June 25, 2010... A single-pill combination of telmisartan 80mg and amlodipine 10mg provides superior BP reductions to those provided by either therapy used alone without increasing adverse events, research suggests. A study presented by Dr Henry Black of New...

Many GPs will extend out-of-hours role, says Lansley.
June 25, 2010... Making GPs responsible for commissioning out-of-hours care will result in many deciding to play an 'enhanced role' in providing the service, the health secretary has said. GPC chairman Dr Laurence Buckman told GP he agreed this was a...

GP Diary.
June 25, 2010... WALK-THROUGH COLON: LA has drive-through weddings; East Lincolnshire has walk-through colons. While the former seems a little tacky, the latter has the eminently sensible aim of raising awareness of bowel cancer. What better way of doing this...

Primary care access targets scrapped.
June 25, 2010... NHS Reform: Extended hours target to be shaped locally, 48-hour access target to be ditched. Access targets in primary care are to be scrapped as the government looks to boost efficiency savings, a revised NHS operating framework reveals. ...

RCGP backs NICE advice on CVD.(cardiovascular disease )(Brief article)
June 25, 2010... Cutting levels of salt and saturated fat in processed food could save tens of thousands of lives a year in the UK, NICE has said. Although cardiovascular disease (CVD) is largely preventable, it causes over 40,000 people a year to die...

Swine flu 'easement' deal fails to prevent patient survey losses.
June 25, 2010... Low swine flu vaccination figures suggest the deal to ease practice losses in the patient survey may not be effective. To ease pressure on practices struggling with swine flu, a deal was negotiated by the GPC to relax patient access targets...

Swine flu response has failed to work.
June 25, 2010... Swine flu containment measures failed to work as planned and may need to be revised ahead of any future pandemic, the WHO has said. The head of the organisation's global influenza programme, Dr Sylvie Briand, said that the containment...

Independent Nurse: Unions warn against slashing NHS staff pension provision.
June 21, 2010... Unions have warned against any changes to the NHS pension scheme as the government prepares its emergency budget. The RCN has claimed that NHS staff have already been 'very understanding' when their pensions were renegotiated in recent years....

Independent Nurse: Public 'not interested' in health board voting.
June 21, 2010... Doubts have been raised over government plans to roll out elected NHS boards across the UK after poor turn-out and reports of skewed representation in a pilot scheme. RCN Scotland warned that rolling out direct elections for health board...

Independent Nurse: Nurses halve admissions for COPD and save NHS pounds 97,000.
June 21, 2010... Nurses have played a 'crucial central role' in a project which has halved hospital admissions for COPD patients in Norfolk. GP Dr Daryl Freeman presented the results of the project at the International Primary Care Respiratory Group...

Independent Nurse: Number of PCTs 'will fall', says think tank.
June 21, 2010... PCT numbers and staffing levels are likely to be cut as clinicians take on a greater role in commissioning, the King's Fund says. The think tank's chief executive Chris Ham also predicted 'further integration' between GP practices, hospitals...

Independent Nurse: Gout drug found to improve angina.
June 21, 2010... Gout drug allopurinol could be used to treat angina, research suggests. Dr Awsan Noman and colleagues from the University of Dundee compared the effectiveness of allopurinol 600mg a day with placebo at reducing ischaemia in 65 patients with...

Independent Nurse: Insulin training.
June 21, 2010... Online modules on the safer use of insulin have been launched by NHS Diabetes. The training is designed for healthcare professionals and coincides with a National Patient Safety Agency report on safer administration of insulin. NHS Diabetes...

Independent Nurse: RCN backs Lansley.
June 21, 2010... The RCN has backed comments in Andrew Lansley's first speech as health secretary that patients will be at the heart of NHS policy. Dr Peter Carter, RCN chief executive and general secretary said: 'As the healthcare professionals who have the...

Independent Nurse: NHS iphone app.
June 21, 2010... A PCT has become the first to unveil an iPhone application featuring details of health services in its area. NHS Bristol's app can be used to find a GP, NHS dentist and the nearest walk-in centre. As well as contact details, it also gives GPS...

Independent Nurse: Drop in heart attacks.
June 21, 2010... Emergency hospital admissions for heart attacks fell by over 2 per cent in the year after the smoking ban was introduced in England. A team from University of Bath examined emergency hospital admissions in England in patients aged over 18...

Independent Nurse: Diabetes data reveal failure to improve clinical outcomes.
June 21, 2010... Clinicians involved in diabetes care need to ensure they are improving patients' outcomes as well as measuring them, NHS Diabetes has said. NHS Information Centre data released last week showed that greater access to health services for...

Independent Nurse: Vital Statistics - Breast cancer.
June 21, 2010... - 38,000 cases of breast cancer are diagnosed each year - 81% of deaths occur within two years of diagnosis - 8 out of 10 women survive the disease beyond five years Source: National Cancer Intelligence Network conference. ...

Independent Nurse: Journals Watch.
June 21, 2010... - Use ACR to assess diabetes risk Albumin to creatinine ratio (ACR) can be used to assess mortality risk among elderly diabetes patients regardless of their level of kidney function, research suggests. Albuminuria is known to be associated...

Independent Nurse: Vetting scheme to undergo overhaul.
June 21, 2010... Reforms to the vetting process for healthcare staff working with vulnerable adults or children are to be reviewed, after criticism from the RCN. The government has announced it is to halt plans for the Independent Safeguarding Authority (ISA)...

Independent Nurse: 'Freeze public sector pay' say businesses.
June 21, 2010... Public sector wages should be frozen for two years to cut spending, according to businesses. The British Chambers of Commerce (BCC) is making a series of recommendations to the coalition government in advance of its emergency budget on 22...

Independent Nurse: Community reforms 'moving too fast'.
June 21, 2010... Health professionals have 'serious concerns' about the speed at which PCTs are rushing through Transforming Community Services plans set up under the last government. Nurses are worried that their services may be 'swallowed up' by...

Independent Nurse: World Outbreak Information - Week beginning 21 June.
June 21, 2010... INDIA Suspected cases of Japanese encephalitis (JE) have been reported in Bihar this month. Similar cases were reported in Uttar Pradesh in April JE is a viral infection causing a severe flu like illness. It is spread by mosquitoes that bite...

Independent Nurse: Return community nurses closer to GPs.
June 21, 2010... Community nurses should be reintegrated with general practice to bring them back into the heart of primary care teams, according to doctors' leaders. Kent GP Dr Fiona Armstrong warned a local medical committee conference this month that ties...

Independent Nurse: Containment did not stop swine flu spread.
June 21, 2010... Containment measures during the early stages of the swine flu outbreak did not reduce the disease's spread, an HPA report has concluded. The requirement for GPs to take samples from suspected cases also stretched the resources of the regional...

Independent Nurse: News Focus - Dementia strategy is not working.(United Kingdom. National Health Service. Primary Care Trusts)
June 21, 2010... More than a year after its launch, the dementia strategy's failings are becoming clearer, writes Stephen Robinson. England's five-year National Dementia Strategy (NDS), launched in February 2009, pledged to transform the quality of care for...

Independent Nurse: Opinion - Online.
June 21, 2010... All the money spent on sex education and advice on contraception appears to have been wasted if it is now necessary to actually advertise abortion on TV. Direct-entry health visiting is not the way to increase health visitor numbers. Paying...

Independent Nurse: Editorial - Dementia budgets must be ringfenced.(Editorial)
June 21, 2010... Dementia care has not always been given the priority it deserves This was supposed to change, when the government launched England's National Dementia Strategy (NDS) last year. However, findings from a recent survey show many PCTs have failed...

Independent Nurse: Opinion - Keep collaborating in spite of austerity.
June 21, 2010... For the past year, thanks to the generosity of our funders, the Queen's Nursing Institute has been running three sets of practice improvement projects simultaneously. This has given us a wonderful mix of projects, from all over the country,...

Independent Nurse: In My View - Nurses need tailored allergy training.
June 21, 2010... I have just returned from the Allergy Show at London Olympia and was overwhelmed by how many people attended the event looking for help for their allergy problems. These were not just people with hay fever or eczema but desperate families...

Independent Nurse: Clinical - Best practice in otitis externa - Ear care.(Disease/Disorder overview)
June 21, 2010... Patient education and meticulous aural toilet are key to management, says Jayne Allen. Otitis externa is an inflammatory process of the external auditory canal. It affects around 10 per cent of the population at some time in their lives. Peak...

Independent Nurse: Clinical - Understanding the risks of osteoporosis.(Disease/Disorder overview)
June 21, 2010... Prevention measures for osteoporosis should begin in childhood, writes Dr Rachel Pryke. Bone, despite its hard fixed appearance, has constant cell turnover with a balance struck between bone-building osteoblasts and cells called osteoclasts...

Independent Nurse: Clinical - Caring for the diabetic foot.
June 21, 2010... Education of patients and practitioners alike is the key to successful management, writes Maureen Benbow. Diabetic foot ulceration is an increasingly common major public health issue. Loss of sensation in the lower extremities due to gradual...

Independent Nurse: Clinical - Managing schizophrenia: the role of primary care.(Disease/Disorder overview)
June 21, 2010... Annual physical health checks are an important part of managing schizophrenia, say Dr Geetika Gupta and Dr Milind Pant. Schizophrenia is a serious mental illness that causes disordered ideas, beliefs and experiences. It is a frightening and...

Independent Nurse: Clinical Solutions - Perimenopause.(Case study)
June 21, 2010... THE CASE A 47-year-old woman (with an intact uterus) comes to see you complaining of hot flushes and night sweats. She would like treatment, but is concerned about the risks of HRT. Diagnosing perimenopause Perimenopause is the time...

Independent Nurse: Clinical - Ongoing care for patients with HIV.
June 21, 2010... In this guide for the primary care team, Dr Zara Aziz outlines the continuing care and support practitioners should aim to provide. HIV is now considered a chronic condition with increased survivorship and improved quality of life. This has...

Independent Nurse: Clinical Focus - Overactive bladder syndrome.(Disease/Disorder overview)
June 21, 2010... Overall key points - OAB affects some 17 per cent of people aged over 40 in North America and Europe. - The condition can have a devastating effect on physical and psychological wellbeing. - Most patients with OAB can be assessed and...

Independent Nurse: Professional - Avoiding a healthcare time bomb.(United Kingdom. National Health Service)
June 21, 2010... Promote self-care by suggesting a free online NHS MidLifeCheck to patients, writes Dr Michael Dixon. As the UK population both ages and expands, we all know that the level of spending required from the NHS is not sustainable. So it is crucial...

Independent Nurse: Professional - The nurse contribution to out-of-hours care.
June 21, 2010... Nurse teams deliver safe, high-quality out-of-hours care, writes Jane Edwards. In 2006, I joined Birmingham and District General Practice Emergency Rooms (BADGER) as a nurse consultant. I brought with me acute sector experience as a ward...

Independent Nurse: Professional - Nurses and the new government.
June 21, 2010... How will the profession fare under the coalition government's proposed policies? asks Richard Staines. Nurses, in common with all public sector staff, are preparing themselves for a period of change and uncertainty under the...

Independent Nurse: Professional Resources - Worth a look.
June 21, 2010... Health Through Warmth Awareness sessions Npower's Health Through Warmth scheme has re-launched its free awareness sessions to help community workers, district nurses and other healthcare professionals learn more about risks associated with...

Independent Nurse: Professional Resources - In numbers - Abortions by purchaser.
June 21, 2010... Abortions by purchaser, England and Wales, 2000-2009 In 2009, 38 per cent of abortions were performed in NHS hospitals and 56 per cent in approved independent-sector places under NHS contract, making a total of 94 per cent of abortions funded...

Independent Nurse: Professional Resources - Recommended patient resource.
June 21, 2010... What is this? A website launched earlier this month, designed to inform fans about HIV and other STIs during the World Cup in South Africa, where one in five adults is HIV positive. Who developed it? The All Party Parliamentary group on HIV...