GP articles from March 2006

GP archives from March 2006

Exclusive: Budget cuts put GPs off commissioning.(general practitioners)(practice-based commissioning )
March 31, 2006... GPs are being deterred from practice-based commissioning (PBC) by budget restrictions and a lack of control over spending, LMCs and the GPC have warned. LMCs say there is a risk that the 'tipping point' for the success of PBC might not...

Small LDL changes can halve CHD risk.(low density lipoprotein)(coronary heart disease)(Brief article)
March 31, 2006... Lowering LDL levels by as little as 15 per cent could halve CHD risk, even if other risk factors are high, a team of US researchers has claimed. They looked at rates of MI, fatal CHD and coronary revascularisation over 15 years in...

Only safe sex can halt HIV.
March 31, 2006... Even universal access to antiretroviral drugs could not control an HIV epidemic, UK researchers have found. They used a mathematical model to compare different ways of improving access in poor countries. Providing drugs to all patients raised...

Weather in infancy linked to adult BP.
March 31, 2006... The average temperature and rainfall during the first summer of life could partially determine hypertension risk in old age, according to a UK study. Researchers found that diarrhoea and dehydration during infancy make hypertension in...

Asthma is worsened by increased stress.(Brief article)
March 31, 2006... Chronic stress causes asthma exacerbations by reducing the expression of genes that code for receptors for hormones that normally dilate airways, a Canadian study has shown. The researchers carried out the study to find out why asthmatic...

Research brief: Alzheimer's atrophy worse with type-2 diabetes.
March 31, 2006... The brains of type-2 diabetics with Alzheimer's disease age faster than those of non-diabetics with the condition, according to US research. The increased risk of Alzheimer's associated with type-2 diabetes had previously been attributed to...

Research brief: Bowel cancer risk higher in smokers and drinkers.
March 31, 2006... Alcohol, tobacco use and being male are associated with earlier onset of colorectal cancer, according to US research. The records of 161,172 patients with colorectal cancer were analysed to identify risk factors. Alcohol and tobacco users...

Research brief: Antibody drug to protect pancreas in diabetics.
March 31, 2006... A trial to test whether the monoclonal antibody rituximab can preserve pancreas function in type-1 diabetes is to begin in April, researchers from Indiana University in the US have announced. The researchers believe rituximab could also save...

Research brief: Be alert for post-natal anxiety.(Brief article)
March 31, 2006... Women can suffer from anxiety and stress after giving birth, Australian researchers have found. The study included 325 first-time mothers who gave birth between six weeks and six months previously. The researchers said that new mothers should...

Research brief: Smiling can be bad for you.(Brief article)
March 31, 2006... Workers who smile at rude customers in places like airports are at increased risk of depression and heart disease, according to a German study, which found that being polite at all times caused higher stress levels than in those who could...

BUPA uses NHS profits to cut its private fees.(British United Provident Association Ltd.)(national health services)
March 31, 2006... BUPA will use profits from providing services to the NHS to cut insurance premiums for private patients, the company has revealed. This has concerned GPs, who are forced by Choose and Book to offer patients a choice of private hospital if...

Arachnophobia.(hormone cortisol helps reduce fear of spiders)(Brief article)
March 31, 2006... Treatment with the stress hormone cortisol can help arachnophobic patients conquer their fear of spiders, according to a US study. The researchers gave either 10mg oral cortisol or a placebo to 20 arachnophobic patients. Those given cortisol...

Switch ineffective antidepressants.(Brief article)
March 31, 2006... Depressed patients who do not respond to initial SSRI treatment should be offered the choice of additional medication or a different antidepressant, US research has suggested. The study found that one in three depressed patients who did...

Elderly still miss out on medication review.(national health service failed to maintain standards)(Brief article)
March 31, 2006... The NHS is failing to meet the standards set out in the NSF for older people on management of medicines, according to a report by three public-sector watchdogs. The review of the NSF acknowledged that all parts of the NHS were...

NHS Direct plan to help GPs hit quality targets.(national healh service)(General practitioners)
March 31, 2006... GP patients with cardiovascular disease and diabetes are enrolling in a home-care service run by NHS Direct, which believes it will help GPs reach quality targets. The Birmingham pilot is 'precisely the type of localised, patient-focused...

Pre-eclampsia linked to higher lifetime CVD risk.(cardiovascular disease)(Brief article)
March 31, 2006... Women who have an eclamptic pregnancy are still at increased risk of cardiovascular disease (CVD) up to 30 years later, a US study has found. Levels of the inflammatory marker C-reactive protein (CRP), were found to be twice as high in...

GPs urged to stand up against bullying LHBs - Welsh LMCs Conference - Bullying by officials and recruitment.
March 31, 2006... GPs in Wales must stop being gullible and stand up to bullying health boards, the GPC has said. GPC Wales chairman Dr Andrew Dearden told the annual conference of Welsh LMCs near Cardiff this week that there had been a spate of incidents...

Call for 'Welsh factor' to improve retention.(Conference news)(Brief article)
March 31, 2006... A 'Welsh Factor' should be introduced into GP pay to stave off a crisis in GP recruitment and retention, the Welsh conference of LMCs believe. GPC Wales chairman Dr Andrew Dearden backed the idea, saying: 'There is no doubt that the...

'Suspend GMS contract in event of flu pandemic'.(General Medical Services)(Brief article)
March 31, 2006... The GMS contract should be suspended in the event of a flu pandemic, GPC Wales has told the Welsh Assembly in a letter. In addition, it wants elective outpatient hospital appointments cancelled and staff redeployed, patients to be able to...

Fears over free scrips.(free prescriptions in Wales)(Brief article)
March 31, 2006... Free prescriptions in Wales will encourage dependency on GPs, increase GP workload, be expensive and lead to health tourism. That was the verdict of Welsh LMCs representatives who voted overwhelmingly that free prescriptions should be...

Premises money not reaching practices.(Conferences, meetings and seminars of local medical committee)(Brief article)
March 31, 2006... The Welsh LMCs conference passed over a dozen motions deploring the lack of premises money and urged LHBs to engage practices more fully in their decisions. Dr Mike Griffiths of Gwent LMC told the conference that 'barely a third of the money...

BMA urged to take a stance on assisted suicide.(British Medical Association)(Brief article)
March 31, 2006... The Welsh LMCs conference has voted to press the BMA into reviewing its stance on assisted suicide. Dr Bill Harris of Bro Taf LMC proposed the motion. 'There is a service available to my terminally ill cat, but not to a human being,' he said....

'GPs must fight mental health plan'.(Department of Health)
March 31, 2006... The government's Mental Health Bill has been scrapped, the DoH announced last week. Instead existing legislation will be altered to incorporate some of the Bill's controversial plans. The amendments will compromise GPs ethically and...

All newborns to be offered better hearing screen.(Brief article)
March 31, 2006... Every newborn baby in England is to be offered a new hearing screening test. The pounds 20 million programme replaces the infant distraction test that has been used since the 1960s and is estimated to be about four times more cost-effective....

Computer to select patients for survey.(Brief article)
March 31, 2006... Patients who complete surveys worth up to pounds 24,000 per practice in 2006/7 will be chosen at random by computer, the GPC says, as it emerged that three quarters of Britons have never been consulted about NHS services. In future,...

Review queries benefits of spinal manipulation.
March 31, 2006... GPs should continue to refer patients with musculoskeletal problems to chiropractors or osteopaths where necessary, experts say, despite a damning review of the efficacy of such treatments. NICE's draft guidance on stabilisation...

Post-MI care poor in patients on dialysis.(Brief article)
March 31, 2006... Elderly patients on dialysis are likely to receive insufficient cardiovascular care after acute MI, US researchers have found. Mortality was high among elderly dialysis patients who had an MI, the study showed. Over 40 per cent of 902...

H pylori raises all-cause mortality.(Risk factors of Helicobacter pylori)
March 31, 2006... Helicobacter pylori infection could increase a patient's risk of 10-year mortality by up to 46 per cent, UK researchers told the British Society of Gastroenterology conference in Birmingham last week. But they warned that treating...

Health benefits of omega-3 in doubt.(health aspects of Omega 3 fatty acids)(Brief article)
March 31, 2006... Omega-3 fatty acid supplements might not reduce cardiovascular disease (CVD) or have other health benefits after all, according to a meta-analysis carried out by UK researchers. The finding contradicts earlier research which showed clear...

White infants miss BCG.(risk factors of tuberculosis)(BCG vaccination)(Brief article)
March 31, 2006... Greater awareness of the fact that some white children are at risk of TB is necessary to improve poor vaccination rates, UK researchers have said. A study in Wales found that white British children at risk for TB were under-vaccinated...

Police surgeons are awarded 3% annual pay rise.(compensation and benefits of forensic physicians )(Brief article)
March 31, 2006... Rates of pay for forensic physicians across the UK are to rise by 3 per cent in 2006/7, and again by the same amount in 2007/8. More than 1,000 forensic physicians employed directly by police forces across the UK are entitled to the rise....

Budget disappointment for health.(non funding to public health)
March 31, 2006... Chancellor Gordon Brown has been widely criticised for shying away from health issues in his 10th Budget speech. His speech came in the wake of a DoH denial that the health system was in financial crisis, despite service cutbacks and job...

GPC advises caution on commissioning.(directed enhanced service)(General practitioners)(Brief article)
March 31, 2006... Practices should be 'aware of the arrangements pertaining to and implications arising from their involvement in commissioning at any level', the GPC has warned in guidance on the practice-based commissioning directed enhanced service (DES)....

National Audit Office to look at IT care records.(Brief article)
March 31, 2006... Connecting for Health should face further scrutiny from the National Audit Office (NAO), this time focused on the safety of its patient care record system, according to a Conservative MP. The NAO is undertaking a general review of...

HC2006 Informatics Conference: IT chief blames users for crashes.(Brief article)
March 31, 2006... System problems, GP record transfer and IT strategic review. Connecting for Health's chief executive says users are to blame for many of the problems with systems implemented under the IT programme. Richard Granger, also director of...

GP-to-GP data transfer is top of GP wishlist.(General Practitioners)(Brief article)
March 31, 2006... Half of GPs believe that GP-to-GP transfer of electronic patient records and not the DoH's favoured Choose and Book initiative should be Connecting for Health's number-one priority. Rather than attempting to deliver the DoH's choice...

NHS strategy on IT set to be 'refreshed'.(Brief article)
March 31, 2006... Connecting for Health says it is currently working with the DoH on a review of NHS IT strategy, but denies the IT agency itself is undergoing a close review. The IT agency's director of service implementation Richard Jeavons told the...

PCT payout for unfair GP suspension.(Primary Care Trusts)
March 31, 2006... A PCT that unlawfully suspended a GP from its performers' lists might have to pay out more than pounds 80,000 in costs. Waltham Forest PCT faces an additional bill for damages after High Court judge Mr Justice Collins ruled that inclusion...

Behind the headlines: Gene breakthrough for allergies.
March 31, 2006... Researchers have made the first step towards gene therapy for eczema. WHAT IS THE STORY? Scientists have discovered the gene responsible for dry, flaky skin, which predisposes sufferers to eczema and asthma, according to media...

Leader: Stop NHS subsidising private health fees.(Brief article)
March 31, 2006... The conspiracy theorists among us might be right on one score after all. Those who warn of a secret plan to privatise the NHS are beginning to collect at least some credible evidence. First, there were the private treatment centres given...

Leader: Don't blame the user, blame the IT.(Brief article)
March 31, 2006... Next time you can't log on to your NHS email or discover that Choose and Book isn't working, don't sit there muttering about useless computer systems, because it is not a failure of the system. According to Connecting for Health chief...

Opinion: Take advantage of chaperons.
March 31, 2006... A few weeks ago I discussed finding a place called Statin Island in Tierra del Fuego. Well, can you believe it, a few miles to the west of Statin Island is - wait for it - Chaperon Island. Presumably, a few miles further down the coast we'll...

Opinion: Managers waste clinical time.
March 31, 2006... In working out how to reduce the huge NHS deficit we need to concentrate on the role of managers. Let me make myself clear - good managers are worth their weight in gold. The NHS needs good management, constantly and consistently applied. ...

Clinical: Journals watch - Stroke, statins and mental health.
March 31, 2006... Too busy to read the medical journals? Let Dr Raj Thakkar be your guide to the latest findings. NATIONAL GUIDELINES ON BP LOWERING IN STROKE - BMJ 2006;332:617-8 Target BP for post-stroke patients in the UK varies. The British...

Clinical: Sites relating to motor neurone disease.
March 31, 2006... Websites related to this week's Clinical Review selected by Dr Keith Barnard. USE OF RILUZOLE Riluzole is a sodium channel blocker and its use has been shown to be associated with a modest prolongation of survival - which for any...

Clinical: At a glance - Scleritis versus uveitis.(Brief article)(Clinical report)
March 31, 2006... SCLERITIS Discriminatory signs - Very painful deep, boring ache. - Tender eye. - Bluish purple discolouration of the sclera. - Watering of the eye and photosensitivity. - More common in women aged 30s-50s. - Can affect both...

Clinical: The good old days - Catarrh.
March 31, 2006... This is an inflammatory irritation of the mucous membrane lining the air-passages - the nostrils and bronchi. It usually commences in the former and extends to the latter. Catarrh, or 'a cold', as its popular name implies, is generally the...

Clinical: Treat hay fever early for best results.
March 31, 2006... THE BASICS: Early spring is a good time to start hay fever therapy, says Dr Anthony Crockett. Hay fever or seasonal allergic rhinitis is a common allergic disorder characterised by inflammation of the nasal passages. In susceptible...

Clinical: A homoeopathic approach to hay fever.
March 31, 2006... VIEWPOINT: Homoeopathy may be used to treat hay fever, explains Dr Iain McLellan. The idea of being able to use small doses of substances to produce a reactive effect within the body to cure conditions might appear nonsensical,...

Clinical: Simple spirometer has varied options.
March 31, 2006... EQUIPMENT REVIEW: Ease of use is just one of the reasons why the Vitalograph is so valuable, says Dr Bryan Palmer. Recent guidelines and protocols for the diagnosis of asthma and COPD mean that most GP practices possess a spirometer in...

Clinical: Presentation of cystic lesions.
March 31, 2006... GANGLION: Ganglia occur in relation to a joint or tendon sheath and are most commonly seen on the dorsum of the hand, wrist or ankle. Ganglia occur at any age but most commonly appear between the teenage years and the 40s. They are often...

Clinical: Q & A - Malaria, Down's syndrome and use of statins.
March 31, 2006... Our team of experts answer your questions on screening for Down's, malaria and statins. Q: A patient is going to West Africa with work for several weeks. Can he take atovaquone plus proguanil for more than 28 days as prophylaxis? And...

Clinical: Motor neurone disease - part two.
March 31, 2006... THE ESSENTIALS - Average survival is three to five years from symptom onset. - There is no cure, but riluzole modestly prolongs survival. - Symptomatic treatment can improve quality of life. - End-of-life care must be discussed while...

Registrar: A problem shared - Patient unprepared for procedure.
March 31, 2006... Your patient has not followed instructions before a barium enema and has been referred back to you. How do you proceed? THE PROBLEM You've referred a middle-aged male patient with a change of bowel habits for a barium enema. Five...

Registrar: MRCGP exam update - Are herbal medicines safe?
March 31, 2006... Current situation - Legally, herbal products are classified as food supplements and they are widely available from health food shops and chemists. - Worldwide several thousand different plants are being used for medicinal purposes....

Registrar - Pictorial - Case study.(Brief article)
March 31, 2006... THE CASE A 19-year-old woman complaining of vulval soreness presented with worsening vulval soreness and dysuria, but no vaginal discharge after being advised to buy fluconazole by a pharmacist. She was using the Pill, but no barrier...

MedEconomics: GP finance - How to ... offer eight to eight surgeries.
March 31, 2006... There is plenty to consider when making a case for funding longer opening hours, writes Jennifer Taylor. It seems to be widely accepted that patients want their GP practice to offer longer opening hours. The government has promised...

MedEconomics: New business models help GPs compete.
March 31, 2006... Is a GP-owned company better than a co-op or doctors chambers? Carole Slingsby investigates. The aim of setting up a GP-owned organisation or provider body may be to fend off competition from alternative providers, or enable local GPs to...

GP MedEconomics: Guide to GP-owned organisations.
March 31, 2006... Laurence Slavin and Lynne Abbess offer their views on the various models of GP organisation. These summaries will give GPs or practices intending to set up a provider body food for thought about what form of legal entity your...

MedEconomics: GPs must take note of changes to pensions.(general practitioners)
March 31, 2006... 6 April will mean big changes to retirement planning, says Jon Dunckley. On April 6, the current complex web of pensions regulation will be replaced with one new set of 'simplified' rules applying to all pension plans. A-Day, as the...

MedEconomics: READ codes, living wills and taxation.
March 31, 2006... NHS RULES Q: In view of the emphasis being put these days on recording ethnicity, does anybody know which READ codes are going to be the ones used? A: As of 1 April 2006, the DoH has advised that the '16+1 codes' be used (where the...

MedEconomics: Looking good meant I felt better.(diagnosis of diseases)
March 31, 2006... Cancer patients benefit from advice on looking good and a little pampering, as Dr Sian Williams found for herself. I found my lump on the day the bombs hit London. The next day I should have been accompanying my husband to his ex-boss's...

MedEconomics: Save time on your accounting.(general practitioners accounting software)(value added tax)(evaluation of accounting software)
March 31, 2006... This easy-to-use, GP-developed accounting software is of great benefit to GPs, says Dave Dodsworth. Since 1987 two former GPs, Dr Neil Maclean and Dr Ian McNicoll, have been providing a comprehensive accounting package for GP practices....

GP Life: The versatile compact MPV.
March 31, 2006... Flexibility is the key to a compact MPV and this is where the Toyota beats its rivals hands (and seats) down. Toyota's Verso lost its 'Corolla' tag in 2005 and gained a couple of cracking new diesel engines in the process. One of which,...

GP Life: I emigrated to ... Newfoundland, Canada.(General Practitioners life)(Brief article)
March 31, 2006... When my Canadian girlfriend and I married, I set about gaining a foreign physician license to practice in Ontario. Six years and many exams later, it was clear that moving to a province for two years to gain my Canadian College of Family...

GP Life: GP gadget - 15-Minute Charger.
March 31, 2006... Model: Energiser 15-Minute Charger Price: pounds 39.99 Available from: www.dixons.co.uk and www.ebuyer.com

Plain tales from the surgery.
March 31, 2006... USE YOUR BRAINS A concerned female patient of mine recently came in to see me because of tenderness in both her breasts. I took her through to the nurse's room and proceeded to do the usual examination. After finishing, she...

GP Life: A profession dehumanised.
March 31, 2006... Pity the UK medical students, unable to interview for their chosen jobs lest somebody offer them a post because they seem enthusiastic and are known to work hard. Instead, jobs are allocated by computerised questionnaire, in a process...

Independent Nurse: DoH continues to drags its feet over unlicensed Mantoux test tuberculin.(uk Department of HealthServices)
March 31, 2006... The DoH has still not sorted out problems around nurses being unable to prescribe Mantoux TB tests without a doctor's signature. The failure comes as NICE has issued guidance on diagnosing and treating TB, recommending the use of Mantoux...

Independent Nurse: Women with angina need better diagnosis.
March 31, 2006... Angina is as prevalent in women as it is in men but the diagnosis is less frequently confirmed with tests such as angiograms or treadmill exercise electrocardiograms. A UK study of over 100,000 patients aged between 45 and 89 years found...

Independent Nurse: Dual antiplatelet therapy questioned.(Brief article)
March 31, 2006... Using a combination of clopidogrel and aspirin to treat cardiovascular disease in the long-term is no more effective than using aspirin monotherapy, a large study has found. The Clopidogrel for High Atherothrombotic Risk and Ischemic...

Independent Nurse: Journals Watch - Prednisolone may increase risk of pneumonia.(Brief article)
March 31, 2006... A three-year study of 16,788 patients with rheumatoid arthritis found prednisolone increased the risk of pneumonia hospitalisation by 70 per cent overall. Those taking 5mg/day or less had a 40 per cent increased risk. However, leflunomide,...

Independent Nurse: Journals Watch - Aspirin and NSAIDs can increase cardiovascular events.(Brief article)
March 31, 2006... A study of more than 70,000 US women aged between 44 and 69, with no CVD or cancer, found that after 12 years those frequently using NSAIDs had a 44 per cent increase in cardiovascular events while those frequently using paracetamol had a 35...

Independent Nurse: Journals Watch - Hip protectors not effective at preventing fractures.
March 31, 2006... A systematic review of data from trials of 5,135 patients living in the community found no reduction in hip or pelvic fractures in those using hip protectors and compliance with wearing them was poor. The researchers concluded the protectors...

Independent Nurse: Journals Watch - Deadly peanut kisses.(Brief article)
March 31, 2006... Teenagers with a nut allergy should be wary of kissing someone too soon after they have eaten nuts. Research presented at the annual meeting of the American Academy of Allergy Asthma and Immunology in Miami found it takes four hours for...

Independent Nurse: Judicial review to examine UnitedHealth decision.(cases of medical practice)
March 31, 2006... Patients whose practice is set to become amongst the first in the country to be run by a US multinational have won the first round of a legal battle against the move. Healthcare giant UnitedHealth was named by Northern Eastern Derbyshire...

Independent Nurse: Proteins could help cancer treatment.(Brief article)
March 31, 2006... Swedish researchers have discovered that surface cells of the placenta, belonging to the foetus, express and secrete proteins into the blood of a pregnant woman. These proteins fool the mother's white blood cells and prevent her body...

Independent Nurse: Brown promises top pay rise for nurses.
March 31, 2006... Chancellor Gordon Brown has promised nurses a bigger pay rise than other public sector employees. In his 10th budget last week he told parliament that public sector pay settlements would average at 2.25 per cent 'combining fairness in...

Independent Nurse: Vaccination advisory body seeks nurse.(Brief article)
March 31, 2006... The independent committee that advises all UK governments on immunisations and vaccinations is, for the first time, searching for a nurse to join the body. The Joint Committee on Vaccination and Immunisation is looking for either a...

Independent Nurse: What the papers said.(breast cancer research)(Brief article)
March 31, 2006... 'Women with different sized breasts may have greater risk of cancer' DAILY MAIL 'Uneven breasts linked to cancer' THE TIMES 'Asymmetrical breasts linked to higher cancer risk' THE GUARDIAN What did the press say?...

Independent Nurse: PCTs are accused of 'forcing' district nurses into community matron roles.(nurses are forced to work as a community matrons )
March 31, 2006... District nurses are being forced to work as community matrons so the government meets its target for 3,000 of the new-style healthcare worker by March next year, a leading nurse has revealed. Former health secretary John Reid promised...

Independent Nurse: NHS Direct proposes cost cutting measures.
March 31, 2006... NHS Direct looks set to shed hundreds of jobs and close some of its 54 call centres to save costs. The organisation also proposes a recruitment freeze, streamlining management and replacing clinicians with health adviser roles. An...

Independent Nurse: Clinical managers surveyed about skills.(Brief article)
March 31, 2006... The RCN is asking clinical nurse managers how the role is being affected by deficits and PCT reforms. The survey also aims to find out if the skills of nurse managers are being utilised and whether some areas of their work suffers at the...

Independent Nurse: Vital Statistics - HIV-infected drug users.(human immunodeficiency virus)(Brief article)
March 31, 2006... 1.6% of injecting drug users were infected with HIV in 2005 0.9% of injecting drug users were infected in 2002 6 fold increase in the levels of HIV in drug users outside of London since 2002 The Health Protection Agency (HPA) is...