GP articles from November 2009

GP archives from November 2009

Opinion: What goes around, comes around.
November 27, 2009... 'Eey, lad,' said the old gastric parietal cell (was that a little tear in his eye, a catch in his voice?). 'When I was your age, them mucosal fields was full of helicobacter, as far as the eye could see; but tell that to young folk nowadays, and...

Opinion: Why PCT targets and patients do not mix.
November 27, 2009... There is nothing worse than a PCT target to interrupt a simple patient encounter. No longer can we say: 'Mrs Jones, your BP may be elevated, but you're a 102, and you have come this far without me. Take my advice now, and get as far from me as...

Clinical: Journals Watch - Renal surgery, obesity and diabetes.(Report)
November 27, 2009... Too busy to read the journals? Let Dr Louise Newson keep you up to date with the latest research. Medical treatment better for renal artery stenosis - N Engl J Med 2009; 361: 1953-62 Many patients with atherosclerotic renovascular disease...

Clinical: Substance misuse - Minimising the risks of injecting.(Drug overview)
November 27, 2009... Dr Meg Thomas sets out health promotion strategies to help patients who are drug users. Intravenous drug (IVD) users have a mortality rate up to 24 times that of the general population and suffer significant morbidity.1 The health of users...

Clinical: GPs well placed to talk about balanced diet.
November 27, 2009... Diet and weight can be difficult topics to broach with patients. Dr Frankie Phillips explains how to start. While any number of self-styled 'experts' - and some genuine ones - are on hand to give advice on nutrition, diet and lifestyle, GPs...

Clinical: Clinical Review - Abdominal pain in pregnancy.
November 27, 2009... By Mr Bright Gyampoh, senior specialist registrar, Mr Antonios V Antoniou, consultant gynaecologist and obstetrician, and Mr Nilesh Agarwal, specialist registrar, Newham University Hospital, London. Section 1: Incidence and diagnosis ...

Clinical: Practice dilemma - Emotional blackmail for a sickness certificate.
November 27, 2009... The Dilemma - A man comes to see you in clinic requesting a sick note for swine flu. He states he had the illness two weeks ago and has since recovered. Mr Jones says he did not contact the surgery as he did not want to bother you and that if he...

Education: The days that changed our lives.(Royal College of General Practitioners)(general practitioners David Royal, Mark Clayson and Lisa Horman)
November 27, 2009... We reveal this year's winners of our Being a GP writing competition, in association with the RCGP. 1st prize - When listening is the best medicine, by Dr David Royal I had just finished my vocational training scheme, had joined a local...

MmedEconomics: Careers - Female GPs scale the heights.(Barbara Hakin from United Kingdom. National Health Service. Primary Care Trusts)(Occupation overview)
November 27, 2009... Fiona Barr meets two role models for ambitious female GPs keen to make an impact in the NHS. Women entrants to medicine, and to general practice in particular, are now outnumbering men, yet there are few female doctors in the profession's top...

MedEconomics: Ask the experts - Car purchase, premises and 24-hour retirement.
November 27, 2009... Q: CAR PURCHASE I am a GP partner and would like to know what is the most tax-efficient way of purchasing a new car. Also, how can we claim for depreciation on the sale of the old car? If you buy a car that you use for practice work, you...

MedEconomics: In a nutshell ... Staff party tax rules.
November 27, 2009... Make sure practice staff do not pay tax on the cost of the annual Christmas bash, writes Simon Pointon. In a nutshell - A quick guide to issues affecting GPs The season of goodwill can soon turn sour if GPs fail to pay attention to tax...

Dispensing: Practice development - Investing in deblistering devices.
November 27, 2009... Dr Jeremy Phipps reviews the options for removing drugs from blister packs. Dispensers placing tablets into monitored dose systems often suffer sore thumbs as a result of pushing tablets out of their packs. This may sound trivial, but for...

Plain Tales from the Surgery.
November 27, 2009... - Feeding frenzy A mother of a nine-month-old child asked for an urgent home visit, complaining that 'the child had not been feeding for two days and was unwell'. At the house I found a happy, plump child on the floor with a mouthful of...

General practice 'on course for 70% female workforce'.
November 27, 2009... Workforce - Dame Carol Black warns part-time work more costly. General practice is set to become 70 per cent female, according to national director for health and work Dame Carol Black. Most GPs will be women by 2013, a two-year study by...

Pre-eclampsia thyroid risk uncovered.
November 27, 2009... GPs should monitor for hypothyroidism in women who have had pre-eclampsia, US researchers have said. Two studies have found women with pre-eclampsia face increased hypothyroidism risk during and after pregnancy, and that this risk can last...

PCTs handed national tool to monitor practice results.
November 27, 2009... NAPC Conference - Performance tool PBC rebels Tony Blair. PCTs can now performance-manage practices against 101 indicators for which data are available nationally, thanks to a new comparative tool. It will enable PCTs to aggregate and...

GPs urged to 'rebel' against management interference.
November 27, 2009... Practices should 'rebel' against PCTs that hold them back on practice-based commissioning (PBC), according to the DoH. Cambridgeshire GP Dr Chris Grant, a former professional executive committee chairman, said PBC was 'almost impossible' for...

Tory plans 'too daring for Blair'.(United Kingdom. National Health Service)(adviser Matthew Swindells)(Conference news)(Brief article)
November 27, 2009... Tory health policy is 'what Blair would have done if he had had the nerve', according to a former DoH adviser. Matthew Swindells, former adviser to Patricia Hewitt when she was health secretary and now managing director (health) of...

Research briefs.(Report)
November 27, 2009... Burns - Human embryonic stem cells could be used to produce temporary skin while burns patients await skin grafts, according to research (The Lancet Online 2009). Preventing dementia - US research suggests those with poor oral hygiene are...

Osteoporosis tool assists screening in primary care.
November 27, 2009... Fractures - Algorithm data based on two million UK patients. More patients at risk of osteoporosis could be identified in primary care with the aid of two new fracture risk algorithms, UK researchers say. The QFractureScores for estimating...

Drug may reverse Down's cognitive deficit.
November 27, 2009... Cognitive deficits in adult patients with Down's syndrome could be reversed by treatment targeting the noradrenaline system, a US study has suggested. It found that administration of a pro-noradrenaline drug, called L-DOPS, reversed...

GP leaders call for drive to 'self care'.
November 27, 2009... NHS reform Funding concerns may provide 'trigger' for patients to learn to self treat. GPs and other practice staff should encourage patients to 'self care' to cut NHS spending on treatment of minor illnesses, say experts. The Proprietary...

Study finds statins reduce CV events in healthy women.(Conference news)
November 27, 2009... Taking statins could cut the risk of cardiovascular events among healthy women who do not have any signs of established heart disease, according to the latest sub-analysis of the JUPITER trial. The findings, presented last week at the annual...

Genes impeding spread of bird flu.
November 27, 2009... Bird flu has so far failed to cause a pandemic because at least two simultaneous genetic mutations in the virus are required before it can be transmitted readily from human to human, latest research suggests. At present, H5 viruses can only...

Scots defend essence of GP role.(Ken Lawton from Royal College of General Practitioners)
November 27, 2009... General practice north of the border is 'vibrant', RCGP Scotland chairman Dr Ken Lawton tells Colin Cooper. Ten years since devolution, and GPs in Scotland are now facing a markedly different future to that of their colleagues in England,...

Healthcare republic.com: A round-up of the best from GP's website this week.(Royal College of General Practitioners)
November 27, 2009... GP Enterprise Awards GP launched the 2010 Enterprise Awards earlier this month. The awards aim to highlight innovative ideas that other practices can easily replicate. For full details on how to enter and an entry form visit health...

Opinion: Ballot box.
November 27, 2009... 74% of GPs think two-thirds of PCTs should be scrapped. Source: Healthcare Republic -------------------- Did you find this article useful? Why not subscribe to the magazine? Please call 08451 55 73 55 for more information or visit...

Opinion: Your say online ... www.healthcarerepublic.com/forums.
November 27, 2009... NHS Constitution could undermine GPs' judgment - As GPs we should be left to access and make our own patient-based judgment as to whether that patient will handle information without panicking, otherwise breaking the news will cause more...

Editorial: It is GPs who will rescue the NHS.(Editorial)
November 27, 2009... Congratulations. If you didn't already know it, you will play a vital role in the future of the NHS. Speaker after speaker at the National Association of Primary Care's (NAPC) conference in Birmingham last week said that primary care would be...

Opinion: Limits of statistics can be easily figured out.
November 27, 2009... The incidence of Clostridium difficile in hospitals may be far greater than thought because current testing methods miss 20-80 per cent of cases. New, more accurate tests could be introduced - but hospital managers are worried an apparent rise...

Under-fives must wait for swine flu jab.
November 27, 2009... GPC warns of 'massive workload' as it attempts to negotiate deal for under-fives. The expansion of the swine flu vaccination programme to children under five will not start until the New Year and will create a 'massive workload' for...

GPs face five-figure remediation bills.
November 27, 2009... Revalidation - GPC warns doctors will quit as deaneries call for GPs to fund remediation. GPs could be forced to pay five-figure sums for their own remediation if problems are identified during revalidation, the GPC has warned. Some...

GPC warning on swine flu advice.
November 27, 2009... The GPC has urged the flu czar to clarify DoH advice on swine flu jabs, after evidence that midwives have been reluctant to vaccinate pregnant women. Ian Dalton, DoH national director for flu resilience, was asked by the GPC to ensure a...

New breed of uber-GPs to lead primary care in UK.(Royal College of General Practitioners)(Conference news)(Brief article)
November 27, 2009... A former chairman of the RCGP has called for a new breed of 'uber-GP' to lead primary care and safeguard the future of personal doctoring. Professor Mayur Lakhani said these GPs would need to display clinical excellence, a caring approach and...

GP enterprise award winners.(Awards list)
November 27, 2009... Wigan GPs Dr Shikha Pitalia and Dr Sanjay Pitalia were guests at the RCGP's annual general meeting last week as the overall winners of the GP Enterprise Awards 2009. They were presented with the MDU Enterprise Award and a cheque for pounds 4,000...

DoH plans 20 per cent hospital admission cuts.
November 27, 2009... Commissioning - Speculation that cash spent on running PCTs and SHAs could be diverted to 'revitalise PBC'. Hospitals could be forced to cut admissions by 20 per cent if they want to run community services, the NHS chief executive says. ...

GP Diary.
November 27, 2009... Reality TV - 'Medical procedures must be researched for accuracy, so why can Holby City and Casualty not reflect the work and practices of a 'real' hospital?' asks Antony Sumara, chief executive of Mid Staffordshire NHS Foundation Trust, tutting...

Swine flu plans help flood-hit practices cope.
November 27, 2009... GPs 'worked all weekend' to offer co-ordinated response to once-in-a-millennium Cumbrian floods. Buddying-up plans developed to cope with swine flu have helped maintain services in practices hit by the flooding in Cumbria, GP can reveal. ...

Depression link to child asthma.
November 27, 2009... Maternal depression may be an independent risk factor for exacerbated symptoms in children with asthma, a US study shows. It found morbidity in children with asthma was linked to the frequency of depressive symptoms in their mothers. The...

Smoking and weight loss 'best together'.
November 27, 2009... Starting a weight-loss diet and smoking cessation simultaneously may boost success in both, US researchers say. The finding goes against current guidelines which recommend patients try to quit smoking before attempting weight-loss. A...

Independent Nurse: RCN statement gives backing to advanced nurse regulation.
November 23, 2009... An RCN statement on advanced nursing practice launched last week said there was a 'compelling case' for regulation and standardisation of roles. The statement says: 'The RCN believes there are compelling grounds for the regulation and...

Independent Nurse: Antibiotic campaign scrapped over 'confusion'.
November 23, 2009... The DoH has scrapped its antibiotic awareness campaign for 2009/10 amid fears it would put patients off taking antivirals. A DoH spokesman said: 'We are not running our usual national press campaign this year because research showed the...

Independent Nurse: News in brief.
November 23, 2009... SELF CARE Practice nurses and GPs should encourage patients to 'self care' to reduce demands on the NHS for the treatment of minor illnesses, say experts. The Proprietary Association of Great Britain (PAGB) estimates that self-care for minor...

Independent Nurse: Acute trusts may be handed control of community services.
November 23, 2009... Acute trusts could be allowed to run community services if they can show 20 per cent cuts in admissions, the NHS chief executive has said. David Nicholson said a decision on whether PCTs had to outsource community services would be made early...

Independent Nurse: H1N1 to be added to seasonal flu jab.
November 23, 2009... Swine flu is set to be added to next year's seasonal flu vaccine after the DoH confirmed the current strain is expected to re-emerge in future flu seasons. Each year, the WHO selects strains known to be circulating for inclusion in the winter...

Independent Nurse: Drug error legal advice expected.
November 23, 2009... The Crown Prosecution Service (CPS) is to publish guidance early next year to prevent one-off dispensing errors being treated automatically as a criminal matter. Concerns over existing laws on dispensing errors were raised when a community...

Independent Nurse: Statins could benefit healthy women, say US researchers.
November 23, 2009... Taking statins could cut the risk of cardiovascular events among healthy women with no signs of established heart disease, the latest sub-analysis of the JUPITER trial shows. The findings, presented at the annual American Heart Association...

Independent Nurse: Vital Statistics - Teenage contraception.
November 23, 2009... 57% of teenagers believe only five to eight types of contraception exist; in fact, there are 15 69% of teenagers see clinicians as the most trusted source of information on contraception 56% of teenagers feel comfortable discussing...

Independent Nurse: Journals Watch.
November 23, 2009... Statin side-effects listed Memory loss, sexual dysfunction and depression are to be added to the side-effects listed in product information for all statins. An MHRA review identified side-effects believed to represent a class effect of...

Independent Nurse: Fall in assaults on NHS staff is 'tiny'.
November 23, 2009... The rate of assaults on NHS staff in England is still too high despite a slight fall in 2008/9, NHS leaders say. A total of 54,758 assaults on NHS staff occurred in 2008/9, 1,235 fewer than the year before. Some 3,472 of them were against...

Independent Nurse: RCN issues warning over recession.
November 23, 2009... The recession could be the greatest threat to nursing and patient care in living memory, the RCN has warned. A report by the college this month highlights five key issues that jeopardised patient care following previous downturns, including...

Independent Nurse: Nurse degrees 'could undermine care'.
November 23, 2009... Plans to ensure all new nurses are educated to degree level from 2013 could damage the profession, nursing leaders have warned. From 2013, the minimum entry-level requirement for nurses will be a three-year degree, the DoH has said. Details...

Independent Nurse: NHS failing to move work out of hospital.
November 23, 2009... PCTs are failing to transfer care from hospitals into community settings, an Audit Commission report shows. The report, More For Less, says there has been 'no shift from hospitals to care closer to home in the community; either in terms of...

Independent Nurse: Chlamydia screening wastes pounds 40m a year.
November 23, 2009... Up to pounds 40 million of NHS funding will be wasted this year if chlamydia screening services in England do not improve, the National Audit Office (NAO) has warned. Fragmented implementation of the programme across PCTs has been...

Independent Nurse: World Outbreak Information - Week beginning 23 November.
November 23, 2009... Thailand An outbreak of cholera has been reported following floods in the south of the country near the Malaysian border this month. More than 400 cases were reported to the WHO in 2008. Cholera is spread by contaminated food and water. It is...

Independent Nurse: News Focus - Should health and social care merge?(United Kingdom. National Health Service. Primary Care Trusts)(Report)
November 23, 2009... Financial troubles in the health service have brought joint working plans to the fore again. Nick Bostock reports. Nowhere is the cyclical nature of the debate around health policy more evident than in the to-ing and fro-ing over how exactly...

Independent Nurse: Opinion - Online.
November 23, 2009... Health visitors visit; that shouldn't change. Some vulnerable people don't attend clinics and can only be reached through home visiting. Some of the most valuable health education is done one-to-one in the home. All public sector pay is too...

Independent Nurse: Editorial - Perverse incentives prevent shift in care.(Editorial)
November 23, 2009... One of this government's key health policies has been to move care out of hospitals and into the community. The consensus is that this would encourage joint working between primary and secondary care, which would in turn lead to cost savings...

Independent Nurse: Opinion - Onus on us to prove worth of our services.
November 23, 2009... Why have we taken so long to think seriously about ways of measuring the quality of nursing care in the home? For years, we have delivered, measured and judged community services on the basis of how many people are involved (headcount) or how...

Independent Nurse: In My View - No room for complacency on asthma care.
November 23, 2009... There is complacency about asthma - complacency that the NHS cannot afford. It is illustrated by the disappointing news that a third of PCTs have no respiratory leads and fewer than half have used disease management tools to analyse emergency...

Independent Nurse: Clinical - Understanding haemochromatosis - Iron metabolism.(Disease/Disorder overview)
November 23, 2009... This genetic disorder is more common than previously realised, says Barry Hill. The iron overload disorder genetic haemochromatosis (GH) is a hereditary condition that causes the body to absorb excessive amounts of dietary iron. Iron is then...

Independent Nurse: Clinical Focus - Benign prostatic hyperplasia.(Disease/Disorder overview)
November 23, 2009... Overall key points - Half of 50-year-olds and 70 per cent of 70-year-olds have historical changes of BPH in their prostates. - A full urological history is important when assessing the patient. - The amount of 'bother' caused and the...

Independent Nurse: Clinical - Chronic cough in children.
November 23, 2009... Cough may be the first sign of a serious disorder, write Dr Atul Gupta and Professor Andrew Bush. Chronic cough is a common presenting symptom in children, although most will have no serious underlying cause. If the severity or frequency of...

Independent Nurse: Clinical - Ensuring access to cardiac rehabilitation.
November 23, 2009... Participation in cardiac rehabilitation is lower than expected, but many patients can benefit, writes Jill Ridley. CVD is the most common cause of premature deaths in the UK, causing more than one in every three deaths.1 However, more and...

Independent Nurse: Clinical - CVD - Case Study.
November 23, 2009... The routine review of a patient with CVD who is receiving treatment for secondary prevention is described by Amber Cornforth. Secondary prevention in CVD should incorporate pharmacological management, risk reduction and health promotion....

Independent Nurse: Clinical - Dressing minor wounds.
November 23, 2009... The principles of wound care relating to trauma wounds that are often seen in primary care are outlined by Jackie Stephen-Haynes. Trauma wounds are defined as 'wounds caused by injury';1 they range from minor abrasions to lacerations and...

Independent Nurse: Professional - The assisted suicide debate.
November 23, 2009... Calls to legalise assisted suicide are growing louder, writes Julie Griffiths. Within the past 18 months, several high profile cases have catapulted assisted suicide into the headlines, prompting impassioned public debate over its rights and...

Independent Nurse: Professional - Promoting patient participation.(United Kingdom. National Health Service)(British Medical Association)(Royal College of General Practitioners)(Patient Participation Groups)(National Association of Patient Participation)
November 23, 2009... Encourage patients to get involved in health promotion and other activities, writes Benny Harston. Several years ago, the practice in which I work as an advanced nurse practitioner (ANP) decided that much of the information we were sharing...

Independent Nurse: Professional - Nursing with compassion.
November 23, 2009... Procedures and interventions should never take precedence over patients, write Claire Chambers and Elaine Ryder. Compassion is the essence of caring, and therefore the essence of nursing, and yet it is not always the central focus of nursing...

Independent Nurse: Professional Resources - Worth a look.
November 23, 2009... NHS Evidence Ethnicity and health The NHS Evidence Collection (Ethnicity and Health), formerly known as the Specialist Library for Ethnicity and Health, was updated in October Topics now prioritised are childhood obesity; cancer; mental...

Independent Nurse: Professional - In numbers - Contraception in Wales.
November 23, 2009... NHS community contraceptive services in Wales, 2008/9 Just under 40,000 women and 3,800 men attended clinics for contraceptive services. A total of 46 per cent of the women attending clinics were in the 20-34 age group in 2008/9 (top chart)....

Independent Nurse: Professional - Recommended patient resource.
November 23, 2009... What is this? A self-assessment tool for people with Parkinson's disease. Patients track their condition daily by assessing their performance of a regular activity. They do this at two points in a day (at their best and their worst) and note...

Independent Nurse: Professional - Policy digest.
November 23, 2009... Report on the Standing Commission on Carers 2007-2009. What is this document? Published on 20 October, this is the first annual report of the Standing Commission on Carers, an independent advisory body providing expert advice to ministers and...

Independent Nurse: Professional - Career Profile - Ann Francis, Luton, Bedfordshire.
November 23, 2009... - Why did you become a nurse? As a healthcare assistant, I was a support worker for a health visiting team. I enjoyed it but longed for more involvement with families I supported so underwent nurse training. - How has your career developed...

Independent Nurse: Professional - Practical prescribing.
November 23, 2009... Molly Courtenay helps resolve everyday issues for nurse prescribers. I am undertaking the non-medical prescribing programme and am unclear about unlicensed medicines and off-label prescribing. Can I prescribe an unlicensed medicine or...

Opinion: The problem with mentioning side effects.
November 20, 2009... Joe had an unlovely and suspicious disposition; he felt that the whole world was against him. This, of course, was palpably untrue, it was only his hometown and the surrounding network of villages and countryside that considered him...

Opinion: The latest adventure of Polly Clinic and Pooh.
November 20, 2009... Pooh and Eeyore were sitting in the Hundred Acre Wood when Owl brought the spreadsheet. It was eight o'clock and the children had gone, but they still had to deal with the mess Tigger had made when he bounced over to Piglet shouting that...

Clinical: Journals Watch - Varicose veins, suicide and AAA.(Abdominal aortic aneurysm)(Report)
November 20, 2009... Too busy to read all the journals? Let Dr Katrina Ford keep you up to date with the latest research. Recovery after varicose vein surgery Br J Surg 2009; 96: 1262-7 Ultrasound-guided foam sclerotherapy (UGFS) is a minimally invasive...

Clinical: Drug misuse - The risks of intravenous drug use.(Drug overview)
November 20, 2009... In the first of this new series looking at the management of patients who misuse drugs, Dr Meg Thomas identifies the specific health risks associated with drugs that are injected. It is estimated that 0.4 per cent of the UK population...

Clinical: The basics - Irritable bowel syndrome.(Disease/Disorder overview)
November 20, 2009... Lifestyle modification is often the best method of managing the relapsing condition of irritable bowel syndrome. IBS is a chronic, relapsing and often lifelong disorder. The term refers to a heterogenous group of abdominal symptoms for which...

Clinical: Clinical Review - Autistic spectrum disorders.(Disease/Disorder overview)(Case study)
November 20, 2009... Section 1: Epidemiology and aetiology Autistic spectrum disorders (ASD), including Asperger's syndrome, are complex developmental disorders, behaviourally defined and characterised by abnormal social interaction and communication, with...

Clinical: Red Flag Symptoms - Blurred vision.(Disease/Disorder overview)
November 20, 2009... Basic examinations can be undertaken to make a diagnosis, writes Dr Mehul Mathukia. Sudden change in vision - Eye pain - Visual field defect - HIV/AIDS or other immunosuppressive disorder - Pre-existing systemic disorder ...

Clinical: Malposition of the eyelids and lashes.
November 20, 2009... Pseudostrabismus The epicanthic fold is a semi-lunar skin fold that runs from the medial part of the eyebrow towards the lower lid. It tends to obscure the inner canthus making the nose appear broader. In the Chinese, Japanese and in Down's...

Education: GP Training - Mentoring to help achieve goals.(United Kingdom. National Health Service)
November 20, 2009... Mentoring is a tool for reflection rather than a time for advice or counselling, explains Dr Linda Miller. Broadly speaking, mentoring is an opportunity for an individual to reflect on an issue and consider their options for action. The...