GP articles from May 2012

GP archives from May 2012

Opinion: I Treat All of My Patients without Fear or Favour
May 30, 2012... 'Could you do me a favour?' asked Joe, leaning in close with a conspiratorial air, even more shifty than usual, which is saying a lot; Harry Lime could have taken lessons. I leaned back in reciprocal fashion, our little pas de deux a...

Opinion: The Council's Refuse Service Is Really Rubbish
May 30, 2012... I am again moaning on the phone to Mrs Refuse at the council about the difficulty of organising life around work. To take you back a step in the saga of the refuse collection, which I know you are already finding utterly gripping, they did...

Clinical: Journals Watch - Hip Dislocation and Diabetes
May 30, 2012... Too busy to read all of the journals? Let Dr Suzanne Hunter update you on the latest research. Selective screening for congenital hip dislocation - Arch Dis Child 2012; 97: 423-9 Universal ultrasound screening for congenital dislocation of...

Clinical: The Basics - Fungal Nail Disease
May 30, 2012... In most cases, patients who have onychomycosis will require systemic treatment, writes Dr Nigel Stollery. Fungal nail infections affect 6-8% of the population. Fingernails can be infected, but toenail infections are more common. ...

Clinical Review: Non-Alcoholic Fatty Liver Disease
May 30, 2012... Contributed by Rebeca Carter, Angelina Mouralidarane, Dr Junpei Soeda and Dr Jude Oben, University College London, Royal Free Hospital, London, and Dr Shuvra Ray, Guy's and St Thomas' Hospital, London. Section 1: Epidemiology and aetiology ...

Clinical: Case Study - Identifying the Cause of a Swollen Arm
May 30, 2012... A subclavian vein thrombosis indicated a diagnosis of Paget-Schroetter syndrome. A 31-year-old man had a one-week history of heaviness and swelling in his right arm. He had been to casualty and had received antibiotics and NSAIDs, and the...

MedEconomics: How to ... Cope with GP Partners' Retirement
May 30, 2012... Katharine Mellor considers what the practice needs to do when a partner decides that it is time to go. When a GP principal decides to retire, putting the necessary arrangements in place can take time. Practices should ensure that they plan...

MedEconomics: Viewpoint - Cockroaches and Regional HAs
May 30, 2012... What do they have in common? Paul Corrigan says they are the only likely nuclear holocaust survivors. I must right away offer an acknowledgment to the author of this joke, which comes from Nigel Edwards, who worked for the NHS Confederation...

MedEconomics: Tax Nuggets - Childcare Vouchers for Practice Staff
May 30, 2012... Help is available with childcare costs if the practice sets up its own childcare voucher scheme, says Russell Finn. Childcare vouchers enable practice employees to pay for childcare out of their pre-tax pay, thereby saving money on their...

Plain Tales from the Surgery
May 30, 2012... - Playing fast and loose Our nurse has recently started carrying out blood glucose and lipid checks. During one consultation a patient became slightly agitated when asked whether she had fasted. Having asked the nurse to repeat the...

GP Premises Conference: Rent Frozen as PCTs Toughen Premises Stance
May 30, 2012... Practices that fail to comply with minimum standards on premises are increasingly facing freezes to notional rent, an expert has warned. Rent reimbursement rates rose by just 6% in the three years to 2011, compared with 12.8% in the three...

Capital Funding Shortage for GP Premises
May 30, 2012... GPs are struggling to secure capital funding for premises development and this situation looks unlikely to change soon, a leading solicitor has warned. Partner at Hempsons solicitors Lynne Abbess told the GP premises conference that banks and...

Merger Warning for GP Practices
May 30, 2012... GPs are being warned by premises experts to keep their eyes open for merger opportunities to fit with the prevailing 'bigger is better' NHS ethos. Speaking at the GP premises conference, partner at Hempsons solicitors Lynne Abbess said the DH...

DH Warns on Implications of Competition Rules
May 30, 2012... Plans for AQP procurement regulations leave CCGs open to legal challenge from private firms. Procurement rules could make provider contracts worthless and allow private companies to launch legal challenges against clinical commissioning...

GP Training Plans 'Lacking in Detail'
May 30, 2012... DH plans to reform training of GPs and other health workers lack crucial detail, MPs have warned. The House of Commons health select committee said the establishment of Health Education England (HEE) and Local Education and Training Boards...

Practices Must Provide Online Booking by 2015
May 30, 2012... GPs are given deadline by DH information strategy as GPC stresses need for patient safeguards. Practices must provide online booking for appointments by 2015 in a bid to end the '8am rush', the DH has said. The DH's information strategy,...

Patients Given Choice of Where to Have Blood Tests
May 30, 2012... NHS patients will be able to choose when and where they receive common diagnostic and monitoring tests, including blood tests and heart scans, under DH plans. GPs will be expected to advise patients on possible options under the new...

Latest Clinical Research: Sleep Apnoea Treatment May Reduce Risk of Hypertension
May 30, 2012... Treating obstructive sleep apnoea with breathing equipment may prevent hypertension, a study has found, although other research suggests it may have no effect. Continuous positive airway pressure (CPAP) therapy was found to reduce the chance...

NICE Looks to Future as an Era Ends
May 30, 2012... NICE chairman Sir Michael Rawlins steps down next year. Tom Moberly hears how he sees the institute's future. NICE chairman Sir Michael Rawlins is a man with his eyes on the future. Having led NICE since its formation in 1999, he will step...

Opinion: Your Say Online
May 30, 2012... Health secretary says GPs have 'ethical duty' to save NHS costs - Our public also has a duty not to abuse and misuse health services. We are overlooking the fact that much of NHS funding goes into those who play up the free healthcare system....

Editorial: Charging Patients Would Divide the Profession
May 30, 2012... GPs at this year's LMCs conference were pretty fed up. Income is falling, workloads are rising, pensions are being cut, an 'overly bureaucratic' system of revalidation starts this year and, in England, Care Quality Commission registration and...

Opinion: Integrated Patient Records Can Save My Time, Funds and Sanity
May 30, 2012... Today is Saturday, and as usual, I've just spent four hours extra at the surgery, finishing off the week's paperwork. (Professor Grant, take note.) The task is becoming increasingly irksome because so much of it is unproductive. Many incoming...

LMC Fears as Final 212 CCGs Revealed
May 30, 2012... DH officials publish details of England's new CCGs but GP doubts remain. GP leaders warned that clinical commissioning groups (CCGs) must listen to LMCs and behave democratically, as DH officials set out plans for 212 of the groups across...

Collapse in Morale Means NHS 'Could Run out of GPs'
May 30, 2012... The NHS risks running out of GPs as the profession faces rising workload but no investment at a time of uncertainty, the GPC chairman has warned. Speaking at the LMCs conference in Liverpool last week, Dr Laurence Buckman warned that GPs'...

LMCs Conference 2012: GMC Has 'Shirked Responsibility' over Revalidation
May 30, 2012... GP leaders have accused the GMC of 'shirking its responsibilities' and demanded it develops a standard appraisal system with the BMA which will be accepted for revalidation. GPs at the LMCs conference in Liverpool last week unanimously backed...

LMCs Conference 2012: LMCs Demand Freeze on 'Arduous' QOF
May 30, 2012... QOF 'box-ticking' is now so arduous it interferes with GPs' ability to deliver traditional primary care, LMCs have said. Delegates at the LMCs conference demanded no QOF changes for two years 'to accommodate the changes to commissioning'. ...

LMCs Conference 2012: Conference Briefs
May 30, 2012... Fraud claim. Hospitals that overcharge for care should be viewed as committing 'fraud' and failing to tackle the issue will 'kill' GP commissioning, an LMC has warned. Avon LMC called on the GPC to act over what it called a 'crazy' situation...

LMCs Conference 2012: Let GPs Charge for Services NHS Will Not Offer, LMCs Say
May 30, 2012... GPs should be allowed to charge their patients private fees to provide treatment not funded by the NHS, LMCs have said. LMCs narrowly backed a motion calling on the GPC to negotiate a change to the GMS contract to let patients receive...

GP Diary
May 30, 2012... - TWITS AND TWATS The appraisal and revalidation saga was an ever-present theme at the LMCs annual conference in Liverpool last week. Northern Ireland chairman Dr Tom Black proposed a solution. He suggested doctors with above average skill...

Clinical: Conditions affecting hands.
May 23, 2012... Dupuytren's contracture This man has quite severe Dupuytren's contracture causing this fixed flexion deformity. He was referred for orthopaedic assessment. In more severe cases like this, the surgery is harder and the problem may recur. Cases...

MedEconomics: Viewpoint - Cockroaches and regional HAs.
May 23, 2012... What do they have in common? Paul Corrigan says they are the only likely nuclear holocaust survivors. I must right away offer an acknowledgment to the author of this joke, which comes from Nigel Edwards, who worked for the NHS Confederation...

MedEconomics: Tax nuggets - Childcare vouchers for practice staff.
May 23, 2012... Help is available with childcare costs if the practice sets up its own childcare voucher scheme, says Russell Finn. Childcare vouchers enable practice employees to pay for childcare out of their pre-tax pay, thereby saving money on their...

Clinical: The basics - Antenatal viral infections.
May 23, 2012... Dr Suneeta Kochhar describes how common viral infections may manifest during pregnancy. Antenatal viral infections can be transmitted transplacentally, as well as perinatally from infected blood or vaginal secretions. More mother-to-child...

MedEconomics: How to ... Cut errors on prescription forms.
May 23, 2012... Dr Jeremy Phipps has 10 top tips on avoiding mistakes in the prescriptions you give to patients. GPs made the national newspapers at the start of this month but not for the best of reasons. The Prevalence and Causes of Prescribing Errors in...

Opinion: Make the most of this technological age.(Viewpoint essay)
May 23, 2012... Knowledge is power; I was senior house officer in a neonatal ward when a new-fangled state-of-the-art monitoring device was delivered. I was the only one on the ward at the time, and when the rep showed me how to work it, I became the de...

Opinion: GP patients lack both guilt and insight.
May 23, 2012... Doctors are the worst patients, lacking both guilt and insight. Two weeks post op I am a bit unwell. There is a sizzling sound as a passing moth, attracted over from south of the Thames by the obvious heat source, lands on me and dies. The...

Clinical: Journals Watch - Thyroid cancer and pre-eclampsia.
May 23, 2012... Not had the time to read the journals? Let Dr Sally Hope bring you up to date on the latest research. Low-dose radioiodine in thyroid cancer - N Engl J Med 2012; 366: 1674-85 The incidence of thyroid cancer has tripled from 2.7 to 7.7 per...

Plain Tales from the Surgery.
May 23, 2012... - Stalling the inevitable Following what the patient considered to be an unsatisfactory consultation, she demanded to talk to the practice manager. Our conversation went as follows: irate patient: 'I would not see that doctor again if I...

Clinical Review: Asthma in children.
May 23, 2012... Contributed by Dr Atul Gupta, consultant in paediatric respiratory medicine, and Dr Madeleine Barnett, specialist trainee in paediatrics, King's College Hospital, London. Section 1: Epidemiology and aetiology Asthma is a disease of the...

MedEconomics: In a nutshell - The ethics of clinical trials.
May 23, 2012... Professor Rodger Charlton explains what GPs need to know about the role of research ethical committees in protecting patients who take part in trials. You may not be involved in research, but GPs need to know a little about clinical trials....

PCTs ignore cancer scan warning.
May 23, 2012... Despite repeated warnings, PCTs have failed to invest to improve cancer outcomes. Stephen Robinson reports. England's cancer survival rates risk falling further behind the rest of Europe because PCTs are failing to invest in diagnostic...

Lansley quizzed on nurse CCG role.
May 23, 2012... Nurses demanded assurances from health secretary Andrew Lansley that he would keep promises to ensure they were represented on clinical commissioning groups. At a question and answer session with Mr Lansley at the Royal College of Nursing...

NI GPs close to superannuation deal.
May 23, 2012... Talks continue on funding top-up amid accountancy cost concerns. GPs in Northern Ireland could be set to receive superannuation payments worth tens of thousands of pounds after a three-year delay. But Northern Ireland GPC (NIGPC) is...

GP audits could unearth two million COPD patients.
May 23, 2012... GPs should carry out audits of patient records to help identify two million people with undiagnosed COPD, the DH has said. The advice is included in a companion document to the outcomes strategy for COPD and asthma for England, which the DH...

Opinion: Ballot Box.
May 23, 2012... Take part in our daily polls at GPonline.com. Results from recent polls include: Are you planning to vote for industrial action on pensions? No 14% Yes 86% Source: GP. -------------------- Did you find this article useful? Why...

Standards are slipping, not being maintained.(Brief article)
May 23, 2012... Sir Ian Carruthers said that the NHS surplus was increasing but standards were being maintained (GP, 9 May). I am sorry, but this is just not true: services are being cut and standards reduced and clinical outcomes are worsening. We used to...

We are working as one to make prescribing safer.
May 23, 2012... The GMC study on prescribing errors reveals just how complex prescribing decisions are (GP, 9 May). As a former GP, I know all too well that there are times when we need to balance one risk against another - this is often not evident when...

Latest Clinical Research: Protein discovery may speed pancreatic cancer diagnosis.
May 23, 2012... Pancreatic cancer could be identified earlier and new treatments developed sooner, following the discovery of a protein that plays a key part in the spread of the disease. San Diego School of Medicine researchers in the US found the...

Benefits of extra education found.(Brief article)
May 23, 2012... One additional year of education cuts the risk of dying from all causes after middle age, data obtained from 1.2m people in Sweden have shown. Between 1949 and 1962, Sweden introduced an extra year of schooling for children in some areas. Dr...

Research Brief: Cheaper immunisation.
May 23, 2012... Vaccines could be developed faster and more cheaply using laboratory-based tests which have been shown to replicate human immune responses, US researchers believe (Disruptive Science and Technology Online 2012). -------------------- Did...

Research Brief: Appropriate diet.(Brief article)
May 23, 2012... Smartphone apps could help overweight children lose weight, US research suggests. Findings presented at the European Congress on Obesity this month found 83% of children who used an app lost at least 3kg. -------------------- Did you find...

GPs urged to publish information on outcomes.
May 23, 2012... Royal College of Surgeons president challenges practices to publish data about GPs' performance. Data showing individual GPs' impact on patient outcomes should be published and could feed into revalidation, the president of the Royal College...

Partner must be responsible for CQC standards, says GPC.
May 23, 2012... CQC GPC advice says partners must be CQC 'registered manager'. GP partners, not practice managers, should register themselves legally responsible for complying with Care Quality Commission (CQC) standards, the BMA has said. As part of...

First GPs to learn date for revalidation by December.
May 23, 2012... Responsible officers will become the first doctors to undergo revalidation from later this year. GPs will begin to receive letters from 3 December this year setting dates for their revalidation, the GMC has said. Responsible officers...

Legal threat over DH risk register.(Department of Health)(Brief article)
May 23, 2012... Health secretary Andrew Lansley could face a judicial review over his decision to block publication of the transitional risk register on the Health Act. Neither Labour former shadow health secretary John Healey nor the Information...

Editorial: PCTs must invest more in tests for cancer.(Editorial)
May 23, 2012... If England were to achieve cancer survival rates at the European average, then 5,000 lives would be saved every year. The figure jumps to 10,000 if England's performance were to achieve cancer survival rates at the European best. So says the...

Opinion: Collaboration is the key to the perfect prescription.
May 23, 2012... Currently one in 20 GP prescriptions contains an error. Part of the solution is for all NHS prescribing to be conducted from a centralised, web-based database: this means only one place to create prescriptions and only one place to look them up....

Opinion: Inside Commissioning.(Brief article)
May 23, 2012... The latest thinking on redesigning healthcare Early results have shown emergency COPD admissions have already decreased 18%.CCGs partnering with the pharmaceutical industry might be unusual but the results in Nottinghamshire appear to be a...

Opinion: From the Editors.(Health Act)(Brief article)
May 23, 2012... The battle to have the risk register published has been an interesting story to cover but Labour should now draw a line under that particular report and let it gather dust. With a coalition government still at the helm and a Health Act now...

Opinion: Money Talks.(payments for general practitioners)(Brief article)
May 23, 2012... So what should GPs be doing now? When you get your June payments, check the seniority levels that have been paid, you may need to look carefully to find if any adjustments have been made. You might also want to review the expected profits you...

PCTs fail to invest in extra cancer tests.
May 23, 2012... GP investigation shows 50% of PCTs have not invested to boost cancer tests. Half of PCTs are failing to invest in extra cancer tests despite long waiting times, putting plans to improve NHS cancer outcomes at risk. An investigation by GP...

'LMCs must warn of damaging impact of NHS reform'.
May 23, 2012... GPs must use the 2012 UK LMCs conference this week to urge ministers to halt NHS reform, GPC chairman Dr Laurence Buckman has told GP. Speaking ahead of the conference in Liverpool on 22 and 23 May, Dr Buckman said: 'I'd like conference to...

Nice Conference 2012: Lansley: GPs have 'ethical duty to cut costs'.(Conference news)
May 23, 2012... GPs have an 'ethical duty' to reduce NHS costs and must be transparent about how they spend taxpayers' money, health secretary Andrew Lansley has said. It is 'imperative' for GPs and clinical commissioning groups (CCGs) to consider how...

NICE plans first advice on comorbidities.
May 23, 2012... NICE is to develop its first ever advice to help GPs manage comorbidities, and will work on patient-specific decision support tools, its chairman has said. At the NICE annual conference, Professor Sir Michael Rawlins said incorporating...

Conference briefs: Par for the course.(golf by generlal practitioners)(Conference news)(Brief article)
May 23, 2012... NHS Commissioning Board chairman Professor Malcolm Grant has been rebuked for suggesting that GPs 'playing golf' was leading to patients being unnecessarily admitted to hospital. In a discussion about the importance of the NHS addressing the...

Conference briefs: Pricing drugs.(Conference news)
May 23, 2012... Proposals to reform drug prices to reflect value to patients are simply 'rhetoric', health economist Professor James Raftery of Southampton University believes. Speaking at a forum on value-based pricing, he said: 'My fear is we will have...

Conference briefs: Followng guidance.(medical law)(Conference news)(Brief article)
May 23, 2012... Uptake of NICE guidance needs to be more systematically assessed, the institute's chairman Professor Sir Michael Rawlins believes. 'I want to see a more formal system for tracking the uptake of our guidance,' he said. Sir Michael suggested...

GPs could be excluded from action on pension changes.
May 23, 2012... Low ballot turnout among individual specialties could see them left out of industrial action this summer. GPs could be left out of industrial action on pensions if they do not vote in high enough numbers, a BMA council member has warned. ...

NCB secures pounds 35m funding increase.(NHS Commissioning Board)(National Health Service)(Brief article)
May 23, 2012... An extra pounds 35m has been added to the NHS Commissioning Board's (NCB) running costs, largely to cover additional staff, a report shows. The total 2013/14 budget for NCB running costs rose from the pounds 492m agreed at its February board...

June deadline for practices to set plans for flu campaign.
May 16, 2012... DH targets higher jab uptake after last year's poor rate. GPs in England have been set a 15 June deadline to provide detailed flu vaccination plans under a DH bid to improve coverage this winter. In a letter to the NHS, England's CMO Dame...

Opinion: Machines may change, but the theory doesn't.
May 16, 2012... When I was a junior doctor in a rural hospital, the local community had been fundraising for years for an ultrasound scanner, which back in the early eighties was the very latest thing. Eventually, after innumerable guest teas and raffles and...

Opinion: The patients who return when they're better.(Viewpoint essay)
May 16, 2012... When people get better they tend not to come back - so when they do we are sometimes puzzled (or even alarmed, as when Mrs Fester turned up with the fruit cake to thank us for trying after she drowned the maggots in her legs). The day when...

Clinical: Journals Watch - Antenatal screening and diphtheria.(Report)
May 16, 2012... Too busy to read all of the journals? Let Dr Jonathan Holliday update you on the latest research. - Antenatal screening for trisomy 21 and 18 Am J Obstet Gynecol 2012; 206(4): 322e1-e5 The purpose of this study was to assess the...

Clinical: Red Flag Symptoms - Pitting oedema.(Report)
May 16, 2012... This condition can develop secondary to increased venous pressure. - Young age, children - Unilateral leg oedema - Rapid onset oedema - Shortness of breath - Chest pain, tachypnoea or haemoptysis - Hepatomegaly, jaundice or...

Clinical: Clinical Review - Ovarian cancer.
May 16, 2012... Section 1. Epidemiology and aetiology Ovarian cancer is the most lethal of the gynaecological malignancies, with approximately 6,500 women diagnosed annually in the UK. Most women will initially respond to therapy but ultimately relapse,...

Clinical: The Basics - Scrotal pain.(Report)
May 16, 2012... Some causes of scrotal pain may need urgent referral, writes Dr Lizzie Croton. Scrotal pain may be acute, subacute or chronic (lasting more than three months). The patient may complain of pain in one or both testicles or in surrounding...

MedEconomics: Medico-Legal - Always audit significant events.
May 16, 2012... Auditing critical events is crucial to avoid claims and improve patient safety, says Dr Pallavi Bradshaw. Significant event audits (SEAs) should be an integral part of modern clinical practice, but the experience of the Medical Protection...

MedEconomics: Tax nuggets - GPs' pensions annual allowance.
May 16, 2012... Russell Finn explains how to work out if you are above or below the annual allowance limit. GPs can obtain tax relief on the payments they make into the NHS Pension Scheme (NHSPS) and other pension plans each year up to a limit. Under the...

MedEconomics: Ask the Experts - Unfair dismissal claims and pension calculator.
May 16, 2012... Q: PREGNANT EMPLOYEE DISMISSAL We employed a staff member on a month's trial period (which she scraped through) but after employing her for eight months we have concluded that her performance really isn't up to the standard required -...

Research gap hits GP diagnosis of polymyalgia.
May 16, 2012... Care for rheumatic disorder GPs see on average five times a year hit by shortage of clinical evidence. Early diagnosis of the most common inflammatory rheumatic disorder seen by GPs is being hindered by a lack of primary care research, an...

GP Diary.
May 16, 2012... MEET MY FRIEND Users of social networking sites use their more attractive friends to make new pals, researchers believe. Scientists found that volunteers thought a person more likeable as a potential friend when linked to good-looking...

GPs urged to help patients plan their end-of-life care.
May 16, 2012... Third of GPs have never discussed patients' plans. GPs have been urged to do more to ensure patients' end-of-life wishes are respected, after a poll found more than a third had never initiated talks with patients about end-of-life care. ...

Viewpoint GPs must talk about end-of-life care.
May 16, 2012... 2012 has been a momentous year for general practice for two reasons: the Health Act mandates the formation of GP commissioning groups, and GP training is being extended to four years. Both of these are extremely relevant to end-of-life care...

Latest Clinical Research: Meningitis vaccine may prevent 90% of infections.
May 16, 2012... Around 90% of meningitis cases could be prevented by a vaccine shown to be safe and effective at producing immune responses in an international study. The vaccine protects against meningococcal serogroup B, which causes meningitis and...