GP articles from May 2011

GP archives from May 2011

Public health plans 'confused and inadequate'.
May 27, 2011... Experts warn House of Commons inquiry of concerns over focus on unproven interventions. The government's public health plans are 'confused and inadequate' and fail to follow the advice of last year's influential Marmot review, experts have...

Report finds major gaps in NHS provision of falls care.
May 27, 2011... NHS services for the prevention and care of falls and fracture are 'inadequate' and routinely fail to deliver satisfactory care, a report has shown. The audit, commissioned by health watchdog the Healthcare Quality Improvement Partnership...

Brief advice cuts insomnia in elderly.
May 27, 2011... Treatment could reduce patients' risk of fracture and cardiovascular disease. Chronic insomnia in elderly patients can be treated by brief behavioural therapy in primary care, potentially reducing hip fractures and cardiovascular events, a...

Women with AF at higher CV risk.
May 27, 2011... Otherwise healthy women who develop AF are at increased risk of dying from cardiovascular (CV) events even when other risk factors are controlled for, researchers have shown. Much of the increased risk resulted from cardiovascular events...

Research Briefs: Less scarring.(Brief article)
May 27, 2011... Scientists have invented a new type of wound dressing that reduces scar tissue formation after surgery. The dressing, developed by researchers at Stanford University, California, lowers the tension of surrounding skin, reducing the size of...

Research Briefs: Mortal countdown.(Brief article)
May 27, 2011... Home-based testing kits to tell you how long you have left to live will be available later this year. The kits, developed by Spanish company Life Length, count repeated DNA sequences in the telomeres of a person's chromosomes. ...

How PCTs have let smokers down.(primary care trust)
May 27, 2011... PCTs could put patients at risk by restricting care and second-guessing NICE advice, writes Stephen Robinson. Efforts to cut tobacco-related illness and death are being undermined by restrictions on drugs to help patients quit and by poor...

MPs urge the scrapping of under-fire IT programme.
May 27, 2011... MPs demand answers after watchdog says billions spent on NHS IT have achieved precious little. MPs have called for the NHS IT programme to be scrapped after a spending watchdog said it offered poor value for money and cost billions of pounds....

NICE chairman backs GP commissioning role.
May 27, 2011... Professor Sir Michael Rawlins says GPs will implement NICE advice more effectively than PCTs. GP consortia will be better at implementing NICE advice than PCTs, but improvements will take years to bear fruit, NICE's chairman believes. ...

Charities to link up with consortia.
May 27, 2011... Charities plan to use increased localism in the NHS to bolster patient involvement in decisions about services. Asthma UK said it was 'vital' for GP consortia to involve patients in designing care and that charities can help link patients...

King's Fund wants manager cull targets scrapped by DoH.
May 27, 2011... Health secretary defends plan to cut manager numbers and pledges to put clinicians in charge. DoH plans to cut NHS administration costs by 33 per cent and manager numbers by 45 per cent are 'arbitrary' and should be scrapped, the King's Fund...

Bid to cut missed GP appointments.
May 27, 2011... A GP consortium in Sheffield has launched a campaign to cut missed appointments. Nationally, 13.5 million GP appointments are missed annually, at an estimated cost to the NHS of pounds 180 million. Central Sheffield GP Consortium carried...

GP ONLINE.COM: A round-up of the best from GP's website this week.
May 27, 2011... - NHS reform timeline View our brand-new, interactive NHS reform timeline to see the progress of the Health Bill since it was published last July. gponline.com/commissioning - Personal finance for GPs As our five-part series comes to...

Opinion: Ballot box.
May 27, 2011... 57% of GPs do not think that practices should provide more out-of-hours services to cut the cost of urgent care Source: GP -------------------- Did you find this article useful? Why not subscribe to the magazine? Please call 08451 55 73...

Opinion: Your say online.
May 27, 2011... PCTs must pay consortia the promised pounds 2 per patient development funding It is depressing that both clusters who request PCT management support and PCTs who offer it as part-payment are allowed to. What is the point of reform if the old...

Opinion: The little GPs with our fingers in the dyke.
May 27, 2011... It's deja-vu all over again; what goes around comes around, and only the names have changed. Twenty years ago, the Tories called it GP fundholding, now they call it GP consortia, which they obviously think sounds a bit posher, but is actually...

Opinion: Mourning the days of whalebone before Lycra.(Viewpoint essay)
May 27, 2011... The birth rate is at an all time low, and Ivy reminds me of the real reason. Ivy's emphysema is unmitigated by mountains of inhalers, oceans of steroids and a pulmonary rehab team with the patience of Job. Today she arrives coughing the kind...

Editorial: PCTs must prioritise smoking-cessation bids.(Editorial)
May 27, 2011... Does your primary care organisation incentivise your practice through a local enhanced service to record smokeless tobacco use among patients? If not, it's not alone, because this week GP reveals exclusively that just five of 120 PCTs hold...

Opinion: Practice management can make a difference.(Viewpoint essay)
May 27, 2011... Two apparently unconnected events have made a great impression upon me. One of my patients was taken ill on holiday and was admitted to the local hospital. The treatment he received couldn't be faulted, especially the nursing. A member of...

Clinical: Journals Watch - Rheumatoid arthritis and NSAIDs.(nonsteroidal anti-inflammatory agents)
May 27, 2011... Not had time to read the journals? Let Dr Simon Hunter bring you up to date with the latest research. - Joint destruction in rheumatoid arthritis Ann Rheum Dis 2011; 70: 733-9 Rheumatoid arthritis (RA) comprises synovitis, joint damage...

Clinical: The basics - Depression in primary care.
May 27, 2011... Manage depression using a stepped care approach depending on severity, says Dr Raj Thakkar. In 2000, a WHO study concluded that depression was the top non-fatal disease and the fourth ranked disease overall globally. Prevalence has...

Clinical: Migraine and vascular disease.
May 27, 2011... The association between migraine and vascular disease has long been recognised, says David Kernick. Approximately 15 per cent of the population suffer with migraine. The pathogenesis of migraine is poorly understood but the condition is...

Clinical: Red flag symptoms - Vomiting in adults.
May 27, 2011... A focused history and clinical examination should identify the cause, says Dr Harry Brown. - Haematemesis - Clinical signs of dehydration - Electrolyte disturbances or anaemia - Weight loss - A distended abdomen or signs of peritonitis -...

Education: Consultation skills - How best to work with children.
May 27, 2011... Communication between colleagues can optimise a GP's relationship with a child. Paediatrics is a core element of general practice. I am fortunate to have recently concluded a six-month paediatric rotation as part of my GP ST2 year in a busy...

Education: Book Review - CSA revision notes for the MRCGP.(Book review)
May 27, 2011... This book is a priceless resource for CSA candidates in the run up to the exam, says Dr Hamed Khan. Most CSA books are designed for candidates to role play common scenarios. In contrast, this text seems more suitable for personal study,...

MedEconomics: How to ... Avoid allegations of age discrimination.
May 27, 2011... The MDU's Dr Wendy Pugh has advice for GPs on equality legislation due to come into force next year. GPs have always had an ethical duty to avoid discriminating against a patient on the grounds of age, but there has not previously been an...

MedEconomics: Raising your practice's profile.
May 27, 2011... Sue Broome has suggestions for marketing the services you offer to patients and commissioners. Depending on what happens as a result of health secretary Andrew Lansley's listening exercise, the Health and Social Care Bill could still...

MedEconomics: Reduce the expense of CCTV protection.(closed circuit television)
May 27, 2011... Dr Neil Paul says GPs can save money by using IP cameras connected via cable or WiFi to the surgery's IT system. Do your receptionists feel safe while working? Has your surgery ever been broken into? We are all used to seeing CCTV clips on...

MedEconomics: Personal Finance - Inflation-beating savings return.
May 27, 2011... Get a move on if you want to invest in the government's new index-linked certificates, says Danny Cox. GP savers everywhere can rejoice. The government announced on 12 May that National Savings and Investments (NS&I) five-year...

Commissioning: Leadership support - Mentoring aid for GP commissioners.(general practitioners)
May 27, 2011... Dr Steve Blades points out the advantages to GPs who are unaccustomed to the pressures of lead roles. There is widespread recognition that GPs with leading roles in consortia will have significant development needs, but how can they be...

Commissioning: Viewpoint - Go for sophisticated pathways analysis.(Viewpoint essay)
May 27, 2011... Tom Mulhern urges commissioners to mind the gap between simplistic pathway data and actual patient experience. If GP consortia are to be effective commissioners, they must ensure their healthcare IT lets them make 'apples with apples'...

Plain Tales from the Surgery.(Brief article)
May 27, 2011... A very tasty procedure I was pleasantly surprised when I recently came across a letter stating a patient of mine successfully had a 'culinary angiogram'. Yum. Dr Diljit Singh Bhatia, Ashford, Kent Stand up for infections A patient...

PCT cost-cutting breaches NHS rules.
May 27, 2011... NHS constitution ignored as PCTs limit stop-smoking drugs and cut funding. PCTs are breaching the NHS constitution and may damage patients' health by blocking GP prescribing of smoking cessation drugs, a GP investigation reveals. Figures...

CQC registration may hit GP services.
May 27, 2011... GPC says GPs will have to take time off to complete onerous registration. GP leaders have hit out at 'unrealistic expectations' for GP registration with the Care Quality Commission (CQC), warning that the heavy workload will undermine patient...

Paracetamol doses 'too low'.
May 27, 2011... One in 10 paracetamol prescriptions for children are for too low a dose of the drug, researchers have found. The risk that children would be prescribed too low a dose rose with age, but younger children were also at risk of being prescribed...

CQC plans changes to GP registration.
May 27, 2011... The Care Quality Commission (CQC) has written to the DoH proposing changes to plans for GP registration, amid warnings that it will struggle to cope. But the CQC has confirmed it will not alter the deadline for all GP practices to register...

LMCs to debate boycott of CQC.
May 27, 2011... GPs will debate whether to boycott registration with the Care Quality Commission (CQC) at the annual conference of LMCs in London next month. They will also vote on whether the GPC should ballot GPs to ask if they wish to take part in GP...

Lords May Not See Health Bill until the Autumn
May 27, 2011... Liberal Democrats plan to veto regulator's role in promoting competition throughout the NHS. The Health Bill is unlikely to reach the House of Lords until September after Liberal Democrats pledged to veto plans for the regulator Monitor to...

GPs must ask patients to fill out 'yellow card' reports.
May 27, 2011... Patients must be encouraged to describe the side-effects of medicines themselves and report them on the MHRA's yellow cards, researchers say. A team led by Professor Tony Avery of Nottingham University Medical School looked at more than...

150-year landmark practice.
May 27, 2011... A Surrey practice has celebrated 150 years as a continuous GP partnership. The Kingston-upon-Thames practice was set up in 1861 by Dr Edward Shirtliff, who qualified in the year of the 1858 Medical Act that established the modern concept of a...

Half of consortia may be excluding sessional GPs.
May 27, 2011... GPC leaders warn that sessional GPs are entitled to take part in formation of GP consortia. More than half of emerging consortia are excluding sessional GPs or barring them from standing in board elections, GP leaders have said. GPC...

GP Diary.
May 27, 2011... TYPEFACE OF EVIL Analysing PCT strategy documents is an everyday joy at GP, and sifting through reams of jargon is tough enough. So Diary did not take kindly to NHS South Gloucestershire's decision to publish its 101-page 'strategic plan' for...

Clinical: Case Study - A curious case of ice cube eating.(Case study)
May 20, 2011... A very rare condition that is easy to treat. Sometimes we encounter a patient with a strange symptom that is ignored by the standard medical textbooks. Recently, I was presented with such a patient, whose rare symptom I had read about but had...

Education: Consultation Skills - Evaluating your consultations.
May 20, 2011... Analysing your patterns of behaviour can identify strengths and weaknesses, writes Dr Peter Tate. So much has been written on this topic that perhaps it is time to get back to the bedrock. I know there are consultations we all find...

Education: Pictorial Case Study.
May 20, 2011... The case This 69-year-old obese diabetic man presented to the surgery with a long history of a rash affecting his groin. The rash was present bilaterally and extended onto his upper thighs and scrotum. It was occasionally itchy but most of...

MedEconomics: Practice Management - Take eight steps to great teamwork.
May 20, 2011... Fiona Dalziel has advice for GPs on the best ways to motivate individual practice staff to pull together. A practice team that works well is vital, especially when facing new challenges and major change. Follow these steps to make sure your...

MedEconomics: Our practice is a social enterprise.
May 20, 2011... Like John Lewis Partnership staff, our staff members each own part of the business. Back in 2003, and following pressure from local residents, the then PCT decided to make use of the newly conceived PCT medical services (PCTMS) contract to...

MedEconomics: Review - How artists depict ill health.(Book review)
May 20, 2011... Dr Jeremy Phipps is impressed by this paperback from the Getty museum but wishes the images were bigger. Medicine in Art is a beautiful book. It is filled with annotated works of art demonstrating and explaining the imagery of illness and...

MedEconomics: Ask the experts - Premises and pensions.
May 20, 2011... Q. Premises scheme cancellation Our six-GP partnership has been planning to build a new medical centre The PCT had agreed to pay notional rent, but warned us verbally last autumn that financial constraints could compromise the project. In...

MedEconomics: Dealing with a problem GP partner.
May 20, 2011... Will your partnership deed's wording protect the business if a partner is expelled? The presence of an unsatisfactory GP partner can cause insurmountable damage to the practice as a business. So it is essential to include an appropriate...

Commissioning: Informatics - Robust data underpins pathfinder.
May 20, 2011... NHS Bexley's focus on patient data analytics aids consortium development, says Dr Sid Deshmukh. Evidence suggests that, armed with appropriate information management tools, GPs are well placed to deliver the key aims of the NHS reforms. ...

Commissioning: Viewpoint - Independent sector can bridge the gap.
May 20, 2011... Consider roles for non-NHS providers in delivering NHS care closer to home, Sarah Bricknell urges GPs. Bringing more healthcare services closer to patients' homes via GP surgeries will be an essential element in protecting the NHS over the...

Plain tales from the surgery.
May 20, 2011... - The unworldly wise web My dislike for patients bringing me print outs from websites during the busy surgery reached a new height recently. A woman came with pages of information about gangrene and she was puzzled why I was not arranging...

Let GPs decide when to enforce competition.
May 20, 2011... Monitor should not be allowed to dictate how consortia commission services, says NHS Alliance. GP consortia must be free to decide when to use competition to help them commission services and not be dictated to by Monitor, the NHS Alliance...

PCT clusters must not lose local focus.
May 20, 2011... PCT clusters will have to work hard to maintain good relationships with GP consortia, a senior NHS manager has warned. NHS Confederation PCT Network director David Stout said that clustering will have many positive implications, but could...

GPs urged to train nurses to start prescribing.
May 20, 2011... Study backs nurses to prescribe appropriately and finds patients accept non-medical prescriber roles. More GPs should train practice nursing staff to prescribe, according to a DoH-funded study. Nurse prescribing is working well in primary...

'Industrial strength' data is vital for GP commissioners.
May 20, 2011... NAPC Conference - Expert warns against poor commissioning - Relationships with secondary care take time. Without access to 'industrial-strength' information, clinical commissioning will be a 'hobby for amateurs' that brings limited change, a...

No quick fixes to building relationships with hospitals.
May 20, 2011... Having a secondary care representative on a consortium board does not guarantee strong relationships with hospitals, a senior GP has warned. Speaking at the National Association of Primary Care event, Dr Luke Twelves, a GP and founder of...

OTC drug addiction often tied to illegal drug use.
May 20, 2011... National Treatment Agency for Substance Misuse reports on the extent of OTC drug misuse. Addiction to prescription and over-the-counter (OTC) medicines is linked to illegal drug use in the majority of cases, a DoH-commissioned report has...

Travel-related infections on the rise.
May 20, 2011... Cases of dengue fever and chikungunya imported to the UK rose sharply last year, Health Protection Agency (HPA) figures have revealed. Dengue fever and chikungunya are both mosquito-borne infections for which no vaccines are available. The...

GPs must focus on quality during pause in reform.(General practice)(National Institute for Clinical Excellence)
May 20, 2011... NICE Conference - Dr Clare Gerada on work during Health Bill 'pause' - Quality standard warning from NICE. General practice must focus on providing patient-centred care while uncertainty around the future of the Health Bill continues, the...

NICE faces 'challenge' to prepare consortia targets.
May 20, 2011... Producing all 150 NICE quality standards in time for them to be used to determine consortia's quality premiums will be 'challenging', NICE has said. NICE's quality standards seek to define the gold standard of care for a range of conditions....

Will changes save the Health Bill?
May 20, 2011... GPs fear changes could make the NHS reforms worse if commissioning plans are dumbed down. Susie Sell reports. As recently as March, the Health Bill seemed to be cruising through the House of Commons at breakneck speed. Despite concerns...

SHAs to manage implementation of NHS reform.
May 20, 2011... SHAs will determine which organisations are 'best fit' to take on roles as PCTs are broken up. SHAs' final act will be to oversee the transfer of public health from PCTs to local authorities, and of commissioning to GP consortia, the DoH has...

Carers save NHS pounds 119 billion a year.
May 20, 2011... Carers save the NHS pounds 119 billion a year - roughly equivalent to annual government spending on the entire health service, a charity has revealed. The figure, calculated by Carers UK and the University of Leeds, shows the possible cost of...

ARB may help block muscle wasting in elderly patients.
May 20, 2011... Mice study finds losartan prevents sarcopenia, which affects more than 40 per cent of people aged over 80. The angiotensin-receptor blocker (ARB) losartan could prevent muscle wasting in elderly patients, a US study suggests. Sarcopenia,...

Plan to speed up access to new medicines is shelved.
May 20, 2011... Government plans to speed up access to new drugs have been put on hold. The MHRA said ministers had decided 'not to progress' the proposed Earlier Access to Medicines Scheme. The decision had been taken, the agency said, because of 'the...

Behind the Headlines: Are breastfed babies better behaved?
May 20, 2011... Breastfed children are more likely to be well behaved, according to newspaper reports. A UK study showed that children breastfed for at least four months as babies were 30 per cent less likely to exhibit a range of behavioural problems when...

GPONLINE.COM: A round-up of the best from GP's website this week.
May 20, 2011... - Personal finance for GPs As our five-part series comes to an end, find an archive of all the latest articles on personal finance online in our Medeconomics section. gponline.com /medeconomics - CPD Organiser on GPonline.com Save...

Opinion: Ballot Box.
May 20, 2011... 65% of GPs think Andrew Lansley should be sacked if the Health Bill is watered down. Source: GP. -------------------- Did you find this article useful? Why not subscribe to the magazine? Please call 08451 55 73 55 for more information or...

Opinion: Your say online.(Column)
May 20, 2011... Falling GP morale puts reforms at risk GPs are vital to the NHS. So don't hack GPs off, or the nation and the nation's health will be considerably worse off than before. Mind you, I can't see GP consortia really understanding what...

Opinion: GPs have turned breaking bad news into an art.
May 20, 2011... Breaking bad news and then getting the blame for it is all part of the tapestry of general practice, though over the years I've become quite good at it; as Francois de La Rochefoucauld said: 'We all have strength enough to bear the troubles of...

Opinion: Hairy times on the slippery slope to addiction.
May 20, 2011... Every addict must at some point have said: 'Just once, what's the harm.' Reader, I have joined their ranks. I am a waxaholic. How did this happen? I blame the youth of today. The tendency of younger people to remove all body hair in a kind of...

Editorial: Don't let PCTs undermine GP commissioning.(Editorial)
May 20, 2011... In all but a few shining pockets of the NHS, GPs' relationship with primary care organisations has never been plain sailing. In England, PCTs have entered what looks like the final stages of their existence with clear instructions that GPs,...

Opinion: History suggests GPs could be more open-minded.
May 20, 2011... This year is the 40th anniversary of the founding of St. Ann's Hospice in Heald Green, Greater Manchester. As well as being a cause for commemoration it is also a reminder that our profession is considerably less open-minded than we like to...

Clinical - Journals Watch: Menorrhagia and heart failure.
May 20, 2011... Not had time to read the journals? Let Dr Bryan Palmer bring you up to date on the latest research. - Cost effective treatments for menorrhagia BMJ 2011; 342: d2202 What is the most cost-effective NHS treatment for menorrhagia? This...

Clinical Review: Acromegaly.
May 20, 2011... Contributed by Dr Raghava Reddy, consultant endocrinologist, Stafford Hospital and Professor John Wass, professor of endocrinology, Churchill Hospital, University of Oxford. Section 1: Epidemiology and aetiology Acromegaly is a slowly...

Clinical: Red Flag Symptoms - Eye pain.
May 20, 2011... A clinical history and examination will usually elicit the diagnosis, says Dr Mehul Mathukia. - Vomiting, halos around light - Signs of systemic infection (fevers, chills, etc) - Decreased visual acuity - Proptosis There are many...

Clinical: Anabolic steroids.(Drug overview)
May 20, 2011... Users would benefit from healthcare advice, says Dr Euan Lawson. Anabolic steroids are a group of drugs with similar actions to endogenous testosterone that have performance enhancing effects Strictly speaking they should be referred to as...

Clinical: Haematology - Disseminated intravascular coagulation.(Disease/Disorder overview)
May 20, 2011... This life-threatening condition has many triggers. Coagulation is a normal response to injury. Clot formation is finely regulated to achieve appropriate haemostatic control through a balance of coagulant, anticoagulant, fibrinolytic and...

Clinical: The basics - The management of gallstones.(Disease/Disorder overview)
May 20, 2011... How to manage gallstones depends whether the condition is acute or chronic, says Dr Lizzie Croton. Gallstones are calculi formed in the gallbladder by the accretion of bile components. They may remain in the gallbladder or pass into other...

NICE targets drive up CQC costs for GPs.
May 20, 2011... Extra standards to push true cost of CQC registration beyond basic pounds 1,000 fee. Care Quality Commission (CQC) registration will cost GPs far more than the pounds 1,000 annual fee as practices take on extra work and staff to hit tough...

David Cameron: Health Bill will drive integration.
May 20, 2011... Prime minister pledges Health Bill will do more to stop private firms 'cherry-picking' services. Prime minister David Cameron has said key parts of the Health Bill will be updated to encourage integration in the NHS and ensure private...

Experts provide clear Pill advice.(Brief article)
May 20, 2011... Clearer and more consistent advice for women who miss contraceptive pill doses has been issued by the Faculty of Sexual and Reproductive Healthcare (FSRH). The new guidelines advise that, if one active pill is missed, there is no need to take...