GP articles from November 2009, page 3

GP archives from November 2009

QOF changes agreed under swine flu deal.
November 13, 2009... At least eight indicators and 28 points will be allocated to new indicators for the 2011/12 QOF, the GPC has revealed. Under the deal with NHS Employers for swine flu pay, which included the suspension of QOF changes for 2010/11, the GPC has...

Should health and social care join?(United Kingdom. National Health Service. Primary Care Trusts)
November 13, 2009... After more than a decade of Labour, plans for closer links with social care are back on the NHS agenda. Nick Bostock reports. Nowhere is the cyclical nature of the debate around health policy more evident than in the toing and froing over how...

Opinion: Memo to registrars: always beware the Friend.
November 6, 2009... 'Can I bring a Friend in?' said Mrs Magee, a shy and self-effacing lady. 'Of course,' I said grandly, suspecting a 'woman's problem', but when the Friend entered the surgery I knew I had made a big mistake. The Friend was a large lady with...

Opinion: Parallels with a reptilian world.
November 6, 2009... Watching David Attenborough with my mouth open, I am struck by the parallels between the reptilian world and ours. First on was the toad-eating tarantula, a creature so Tolkienish it sent my daughter screaming from the room. It lies in wait,...

Clinical: Journals Watch - OA, bariatric surgery and physiotherapy. .(Report)
November 6, 2009... Too busy to read all the journals? Let Dr Alison Glenesk keep you up to date with the latest research. Intra-articular corticosteroids for OA - J Am Acad Orthop Surg 2009; 17: 638-46 This was a systematic review of papers on...

Clinical: Clinical solutions - Subclinical hypothyroidism.
November 6, 2009... The case Lab results have been received for a 57-year-old woman who was tested following her new diagnosis of type-2 diabetes. She has no history or symptoms of thyroid disease. She has an elevated TSH level of 5.6mU/l and a normal FT4. ...

Clinical: Recurrent aphthous ulceration.(Disease/Disorder overview)
November 6, 2009... Mr Anish Shah outlines the features and treatment of this common oral mucosal condition. Recurrent aphthous ulceration (RAU, or aphthous stomatitis) is the most common oral mucosal condition. It affects up to a quarter of the population....

Clinical: Paediatric medicine - Investigating delayed puberty.(Disease/Disorder overview)
November 6, 2009... Often simple reassurance is all that is needed but be aware of signs to investigate. The timing of the start and subsequent milestones of normal puberty has a wide range, therefore it is important to appreciate the considerable variability in...

Clinical: Clinical Review - Obesity.(Disease/Disorder overview)
November 6, 2009... Contributed by Dr Bhandari Sumer Aditya, consultant physician, and Professor John PH Wilding, professor of medicine and honorary consultant physician, University of Liverpool, University Hospital Aintree, Liverpool. Section 1: Aetiology and...

Clinical: Red flag symptoms - Numbness.
November 6, 2009... Causes of numbness vary from benign to life-threatening, says Dr Mehul Mathukia - Loss of control of limb movement - Confusion or loss of consciousness - Slurred speech - Change in vision - Loss of bladder or bowel control -...

Clinical: Investigating headaches.
November 6, 2009... Headache as a presenting symptom may merit further investigation to exclude the possibility of serious pathology. Patients who present with headache invariably think that they need glasses, have high BP or have a tumour. Headache presenting...

Education: Medico-legal - Managing the non-concordant patient.
November 6, 2009... Achieve better compliance by engaging with problem patients, says medico-legal adviser Dr Richard Stacey. Doctors' primary concern is to do their best for their patients. All practices will, however, have a cohort of patients whose autonomous...

Education: Book Review - The new DRCOG examination.(Diploma of the Royal College of Obstetricians and Gynaecologists)(Book review)
November 6, 2009... The format of the DRCOG may have changed but a good set of sample questions is still essential for revision, by Dr Katrina Ford. This recently published study guide for the new DRCOG (Diploma of the Royal College of Obstetricians and...

Education: Journals club - Aspirin for primary prevention.
November 6, 2009... Curriculum statement 15.1 Cardiovascular problem Key trials - A significant number of patients prescribed aspirin as antithrombotic therapy have major adverse vascular-related events each year (N Engl J Med 2005; 353: 2373-83). - One...

MedEconomics: How to ... Change employment contracts.
November 6, 2009... Rayner Jones explains the legalities practices need to take into account when altering staff contracts. While many believe the worst of the recession may be over, practices still face difficult times. If reducing costs is important, one...

MedEconomics: Ask the experts - Tax-efficiency and early retirement.(United Kingdom. National Health Service)
November 6, 2009... Q: TAX-EFFICIENT INVESTING I would like to invest in the stock market now that it has picked up. I am 53 and want to know a good way to do this without paying too much tax. A: Currently the most tax efficient investments are individual...

MedEconomics: GPSI dermatology scheme a success.(physician Victoria Chamberlain)
November 6, 2009... How a service in Exeter is bridging the divide between primary and secondary care. Dr Victoria Chamberlain's dermatology GPSI clinic at the Heavitree Health Centre in Exeter is an excellent example of successful collaboration between primary...

MedEconomics: In a nutshell... drug company gifts.
November 6, 2009... The MDU's Dr Emma Cuzner explains the rules on pharmaceutical industry sponsorship and gifts. In a nutshell A quick guide to issues affecting GPs Doctors sometimes ask the MDU how they can ensure that any gifts or sponsorship offered by...

MedEconomics: Practice motoring - Drive smartly on home visits.(SmartForTwo)
November 6, 2009... The SmartForTwo fits into parking spaces other cars can't reach, reports Dr Stefan Cembrowicz. The world's tiniest car diesel engine throbs away lustily like a miniature London bus in the latest Smart. The SmartForTwo CDi is spacious...

Dispensing: Management - The role of the GP dispensing lead.
November 6, 2009... Active input from a GP can improve the running of the dispensary, writes Dr Jeremy Phipps. Although dispensary managers play a vital part in running a practice dispensary, there remains a role for a GP. This may simply involve being the...

Plain Tales from the Surgery.
November 6, 2009... - Nice but dim I am an undergraduate tutor with some excellent students... all except one lad. He scores 10/10 for enthusiasm and effort but 1/10 for knowledge. He's a really likeable chap but is lost among the brightest in his year...

Exclusive: One third of PCTs diverting GMS pay.
November 6, 2009... GP investigation reveals 2008/9 GP pay used for scorecards and Darzi centres. More than a third of PCTs have failed to spend their share of a pounds 50 million investment package meant for practices as part of the 2008/9 pay deal, a GP...

Burnham ditches RCGP for US trip.(Royal College of General Practitioners)(United Kingdom. National Health Service)(health secretary Andy Burnham )(health minister Mike O'Brien )(Conference news)(Brief article)
November 6, 2009... Health secretary Andy Burnham has pulled out of a planned appearance at the RCGP conference in Glasgow this week in favour of a visit to the US. The let-down comes less than a month after he withdrew from speaking at the NHS Alliance...

Swine flu jab delivery plans leave practices struggling.
November 6, 2009... Many practices will have less than a month to vaccinate at-risk patients, although little or no notice is being given of when swine flu jabs will arrive. Some practices will not receive vaccines until late November, the DoH has said. But last...

MPs to debate regulations for CQC despite criticisms.(Care Quality Commission)(Law overview)(Brief article)
November 6, 2009... Legislation on the regulation of healthcare providers by the Care Quality Commission (CQC) has passed before parliament for approval, despite concerns from the BMA, the RCGP, and the King's Fund. In response to a DoH consultation on the...

Practices face rise in swine flu calls.
November 6, 2009... Swine flu - Heavy workload looms as details of jab targets are revealed by DoH and BMA. Practices are facing a sharp rise in calls from patients affected by swine flu, just as the heavy workload of the vaccination campaign looms. Details...

Exclusive: RCGP sets tough revalidation target.
November 6, 2009... 12,000 GPs to be revalidated in first year as system goes live in April 2011. The RCGP is aiming to revalidate 12,000 GPs in the first year of the new system. There are 56,000 GPs earmarked to be revalidated in five years, starting in...

GP Diary.
November 6, 2009... No flies on Norm Lib Dem soothsayer Norman Lamb has turned his penetrating insight to public health, pronouncing sagely that 'obesity is a massive public health crisis'. His solution? 'Looking at new approaches like incentives to get people off...

Men 'unaware' of diabetes risk.
November 6, 2009... Men are twice as likely as women to have undiagnosed diabetes, UK research shows. Researchers examined 6,739 patients aged 52-79. In total, 9.1 per cent of the participants had diabetes. In 22 per cent of men, the condition was previously...

Complaint settled over media coverage of GP pay.
November 6, 2009... An investigation into the Daily Mail's coverage of GP pay by the Press Complaints Commission has resulted in the newspaper publishing a letter by two GPs. GPC chairman Dr Laurence Buckman and Surrey GP Dr Nicholas Down were unhappy with an...

QMAS overhaul feeds target culture.
November 6, 2009... Performance - Monitoring to expand as QMAS replacement will assess LESs and DESs. GPs fear plans to broaden the remit of the IT system that calculates QOF pay will fuel the rise of a 'target-driven culture' in general practice. The DoH and...

QOF exception reporting falls to its lowest rate.
November 6, 2009... Greater stability of indicators may have helped to reduce exception reporting rates, experts say. Exception reporting rates for England have fallen to the lowest level since the new GMS contract was introduced. However, reporting rates for...

MHRA issues warning over patient data research.
November 6, 2009... Research Access to database of GP patient information by unauthorised research teams puts confidentiality at risk. Patient confidentiality could be compromised by researchers gaining unauthorised access to the general practice research...

NICE urges rapid referral for suspected meningitis.
November 6, 2009... Emergency hospital referral for suspected meningitis has been backed by NICE. NICE said that children and young people with suspected meningitis or meningococcal septicaemia should be transferred to secondary care as an emergency by calling...

HRT 'reduces mortality risk in 50s'.
November 6, 2009... Menopause - Study of past research data suggests HRT risk overstated in younger women. HRT reduces mortality in women in their mid-50s, an analysis of data from 16,000 women has shown. Dr Shelley Salpeter and colleagues at Santa Clara...

CT scans 'help predict COPD'.
November 6, 2009... CT scans can be used to identify smokers likely to develop COPD, Canadian researchers believe. A team from the University of British Columbia in Vancouver examined 143 men and women taking part in cancer screening trials. Researchers measured...

Research briefs.(Report)(Brief article)
November 6, 2009... Longer immunity - Immunity to whooping cough lasts at least 30 years on average, a new study based on incidence data suggests Researchers at the University of Georgia, US, used data from England and Wales before and after pertussis vaccination...

Additional practices win share of cash for training upgrade.
November 6, 2009... 800 practices to share pounds 100 million to upgrade training. More than 800 practices have received cash to upgrade their facilities for training from a pounds 100 million DoH fund. The fund was originally tar-geted at 600 practices, with...

Exercise delays diabetes onset by up to 10 years.
November 6, 2009... Development of type-2 diabe-tes can be delayed by at least 10 years by lifestyle interventions and metformin treatment, US research has shown. Researchers from George Washington University in Maryland, followed 2,766 patients who had...

NICE backs blood clot combination.(United Kingdom. National Institute for Clinical Excellence)(Brief article)
November 6, 2009... NICE has approved the use of the antiplatelet drug prasugrel in combination with aspirin as an option for preventing blood clots in patients with acute coronary syndromes. The final guidance, published last week, recommends that patients...

Welsh revalidation model may win backing for a UK roll-out.
November 6, 2009... Revalidation GMC 'provisional blessing' for appraisal system. Wales looks set to lead the way into revalidation after the GMC gave its provisional blessing to the country's appraisal and clinical governance systems. The GMC said the Welsh...

GPs face early requests for licence numbers.
November 6, 2009... GPs are being asked for GMC licence numbers, which have not yet been issued, when they issue a medical certificate of cause of death (MCCD). The request from local registrars of births, marriages and deaths anticipates 16 November, when the...

Scouts rescue swine flu programme.
November 6, 2009... A troop of 30 girl and boy Scouts beat the postal strike for one of Bristol's largest practices, which needed to call up patients for their swine flu jab. Scouts hand-delivered 2,500 letters to high-risk under-65s, earning their troop a handsome...

How the next GMC leader sees GPs.(United Kingdom. National Health Service)
November 6, 2009... Interview - King's Fund boss Niall Dickson becomes GMC chief executive in January. He talks exclusively to GP. Q: Is it important to be able to always see the same doctor? A: For most of us, at some time I suspect it will be important -...

Evidence database accredits 20% of guidelines.
November 6, 2009... Guidance from branches of NICE and SIGN handed reliability kitemark by NHS Evidence website. One in five guidelines accessi-ble through the NHS Evidence website now carries the site's accreditation kitemark. Three organisations won...

GP caution urged on referral details.
November 6, 2009... GPs must beware the potential pitfall of disclosing unrelated medical conditions when pro-viding patient referrals, accord-ing to the Medical and Dental Defence Union of Scotland (MDDUS). The issue was highlighted in a recent call to the...

Behind the Headlines: Will HPV jab change sexual behaviour?
November 6, 2009... Having the HPV jab to protect against cervical cancer could make girls more promiscuous, media reports suggest. The findings come from the first survey to focus on girls' views of the vaccine rather than responses from their parents. ...

Where did the 2008/9 GMS cash go?(British Medical Association General Practitioner Committee)(United Kingdom. National Health Service. Primary Care Trusts)
November 6, 2009... Much of a pounds 50 million fund for improving access to services has never actually reached GPs. Tom Ireland reports. When the GPC negotiated an additional pounds 50 million in funding for access as part of the 2008/9 pay deal for England,...

Healthcarerepublic.com: A round-up of the best from GP's website this week.
November 6, 2009... - GP goes daily for RCGP A team from GP will be producing three daily editions of GP at this week's RCGP conference in Glasgow. View our coverage, featuring video interviews with the main speakers at the confer-ence, including Scotland's...

Opinion: Ballot box.
November 6, 2009... 64% of GPs do not think they should take back 24-hour responsibility. 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...

Opinion: Your say online ... www.healthcarerepublic.com/forums.
November 6, 2009... Tories to end UK GP contract and write new one - I support the idea of having commissioning in the hands of GPs, who could employ a business manager and staff to deal with these issues, as GPs know best their patients' needs. - Control of...

Editorial: DoH must get tougher with its weak managers.(Editorial)
November 6, 2009... When is a 1.5 per cent pay increase not a 1.5 per cent increase? It's a question GPs in England might well ask themselves after reading the results of this week's GP investigation into where the pounds 105 million extra primary care funding...

Opinion: Standards must be worth setting and keeping.
November 6, 2009... As I wrote a couple of weeks ago, the DoH is considering abandoning its requirement to achieve information management and technology directed enhanced service accreditation before uploading patient summaries to the spine. Not only is this...

Independent Nurse: Practice nurse job satisfaction high but pay concerns remain.
November 2, 2009... Three quarters of practice nurses are on old or locally negotiated pay scales, an RCN survey has found. A total of 26 per cent are now on Agenda for Change (AfC) pay bands, while 51 per cent remain on clinical grades and 23 per cent have...

Independent Nurse: Tories commit to overhaul of GMS contract.
November 2, 2009... Contractual arrangements that govern how practices operate and the targets they must hit may be set for a radical overhaul whichever party wins the next general election. Shadow health secretary Andrew Lansley has confirmed there will be a...

Independent Nurse: Warning issued on impact of patient control over budgets.
November 2, 2009... Giving patients in England control of their own budgets will 'damage the NHS', public sector union Unison has warned. The DoH is piloting personal health budgets intended to give patients more control over how money is spent on their care....

Independent Nurse: Exercise can delay diabetes by 10 years.
November 2, 2009... Onset of type-2 diabetes can be delayed by at least 10 years by lifestyle interventions and metformin treatment, a US study shows. Researchers from George Washington University, Maryland, followed 2,766 patients who had taken part in a...

Independent Nurse: Tool 'doubles' nurse time with patients.
November 2, 2009... Community nurses may be able to nearly double the time spent with patients by implementing ways of working set out in a new toolkit. The NHS Institute for Innovation and Improvement has published the toolkit as part of its 'productive...

Independent Nurse: News in brief.
November 2, 2009... Workforce: MSPs should challenge Scottish cabinet secretary Nicola Sturgeon not to cut the future nursing workforce, according to the RCN It says that the 2010/11 draft health budget, which Ms Sturgeon was quizzed about last week by the Scottish...

Independent Nurse: Diabetes care 'benefits from transfer to practice nurses'.
November 2, 2009... Transferring care of diabetes patients from GPs to practice nurses can improve blood glucose control, a Dutch study has suggested. Researchers from the University Medical Centre in Utrecht examined outcomes in 397 patients whose care was...

Independent Nurse: Vital Statistics - Diabetes.
November 2, 2009... - 285 million people worldwide now live with diabetes - 435 million people are expected to have the condition 20 years from now - 85-95% of diabetics have type-2 diabetes Updated guidance on self-monitoring of blood glucose, pregnancy...

Independent Nurse: Journals Watch.
November 2, 2009... - Parents' tumours harm children Several serious conditions of childhood may be the result of testicular tumours affecting older fathers, an Oxford University study suggests Researchers examined the impact of small testicular tumours and...

Independent Nurse: NICE urges caution on antidepressants.
November 2, 2009... Clinicians should not routinely prescribe antidepressants for long periods, or to treat mild depression, NICE has warned. Updated guidance published this week says prescribers should only consider the drugs for patients with moderate or...

Independent Nurse: All children could receive swine flu jab.
November 2, 2009... The Joint Committee on Vaccination and Immunisation (JCVI) is considering whether all children should receive the swine flu jab, as the DoH warns almost one in three children could catch the virus this winter. Currently, only children with...

Independent Nurse: NMC urges employers to test language.
November 2, 2009... The NMC has abandoned efforts to persuade the EU to allow it to language-test nurses, and will now focus on encouraging employers to do so themselves. A 2005 EU directive on the recognition of professional qualifications enabled the free...

Independent Nurse: World Outbreak Information - Week beginning 2 November.
November 2, 2009... Philippines The country's department of health has reported a high incidence of leptospirosis in the Metro Manila region following severe flooding. Over 1,000 cases have been recorded including 89 deaths. Leptospirosis is transmitted by...

Independent Nurse: Wales to regulate health support staff.
November 2, 2009... The RCN has welcomed a decision by the Welsh Assembly to make Wales the first part of the UK to regulate healthcare support workers (HCSWs). Edwina Hart, the Welsh health minister, has agreed to implement both a code of conduct for HCSWs and...

Independent Nurse: Discharge summaries 'too late to be useful'.
November 2, 2009... Nearly half of PCTs report that GP practices do not receive hospital discharge summaries in time for them to be of any use, a Care Quality Commission (CQC) report reveals. The report calls on PCTs to assess whether hospitals send the right...

Independent Nurse: COPD combination therapy questioned.
November 2, 2009... Adding long-acting beta-agonists (LABAs) to corticosteroid therapy for COPD does not appear to offer additional benefits, Dutch research has suggested. The findings go against a recent analysis of the TORCH trial, which found combination...

Independent Nurse: Primary asthma care 'could save pounds 4.5m'.
November 2, 2009... PCTs could save up to pounds 4.5 million in unnecessary hospital admissions if they commissioned more effective preventive care from GP practices, data from Asthma UK suggest. The charity examined emergency hospital admissions, comparing PCT...

Independent Nurse: 'Goody effect' boosts cervical screening.
November 2, 2009... The number of eligible women aged 25 to 64 who attended cervical screening in England rose by almost 12 per cent in the last year, NHS Information Centre data reveal. A total of 3.6 million women were screened in 2008/9, up from 3.2 million...

Independent Nurse: News Focus - Is health visiting set for a revival?(Survey)
November 2, 2009... As an RCN survey confirms the low morale of health visitors, Nick Bostock asks whether there is hope of better news. Competition for most-neglected-profession-in-the-NHS status has probably been red hot since 1948. But the way health visiting...

Independent Nurse: Your opinion - Online ..
November 2, 2009... Having worked as an external consultant to a London PCT, I was shocked at the low number of health visitors. It placed extremely vulnerable children at risk, not to mention the staff who were expected to take on ridiculous caseloads. The...

Independent Nurse: Opinion - Swine flu jab demands a balancing act.
November 2, 2009... Nurses in surgeries and clinics have to balance the informality and trust that comes from a long-term relationship with patients and their families with the need to maintain professionalism. Now they will be questioned, with real urgency, by...

Independent Nurse: In My View - Services must build young people's trust.
November 2, 2009... Working directly with young people involves dealing with the sensitive health-related issues that arise, be it sexual health, emotional problems, alcohol and substance misuse - or simply bad skin. Young people often find it difficult to ask...

Independent Nurse: Editorial - Learning lessons from happy practice nurses.(Editorial)
November 2, 2009... The latest RCN employment survey is a mixed bag. The report paints a depressing picture of life for health visitors and district nurses, the two groups most likely to feel under too much pressure. Things are distinctly more positive for...

Independent Nurse: Clinical - Tackling threadworms.(Disease/Disorder overview)
November 2, 2009... Hygiene measures are important to break the cycle of infection, writes Jane Stevenson. Threadworm (Enterobius vermicularis) infection is the most common helminthic infection in the UK,1 affecting up to half of children at some point.2...

Independent Nurse: Clinical - Managing acute cough in children.(Disease/Disorder overview)
November 2, 2009... Children with a cough require thorough clinical review. Dr Atul Gupta and Professor Andrew Bush explain. Cough is an important protective reflex, enabling airway secretions to be cleared. It is one of the most common presenting symptoms in...

Independent Nurse: Clinical Focus - Open angle glaucoma.(Disease/Disorder overview)
November 2, 2009... Overall key points - Glaucoma is the world's most significant cause of preventable, irreversible blindness. - Early glaucoma usually has no symptoms; the other eye compensates. - Treatment aims to prevent progressive loss of visual...

Independent Nurse: Clinical - Dealing with a thumb injury.(Case study)
November 2, 2009... Involving the patient in treatment decisions can promote concordance, writes Penny Lovatt. Jacob, aged 11, attended the minor injuries unit with his mother, having had a tyre fall onto his right thumb while rolling it around the garden The...

Independent Nurse: Clinical - Finding the right emollient.(Drug overview)
November 2, 2009... Working with the patient to ensure the selection of an emollient that is suitable for them is vital, writes Dr Nigel Stollery. Emollients, or moisturisers as they are often more commonly known, are an essential and often under-used part of...

Independent Nurse: Clinical - Monitoring child growth.
November 2, 2009... New WHO child growth charts have been adopted in the UK, covering the period from birth to four years. Rosie Dodds explains. Following international recognition that growth charts for infants did not reflect the physiologically normal growth...

Independent Nurse: Clinical - Understanding psoriasis.
November 2, 2009... Psoriasis is a common but complex condition with potentially serious co-morbidities, writes Julie Van Onselen. Psoriasis is a common chronic skin disease that affects 1.5 per cent of the UK population. It affects both sexes equally, the mean...

Independent Nurse: Professional - Using references in academic writing.
November 2, 2009... Reference with care or you could be marked down or even accused of plagiarism, writes Paul Cornforth. When writing academic essays, you must include references and a bibliography to acknowledge allusions made to other people's work Produce...