GP articles from October 2006

GP archives from October 2006

GPC calls for a boycott of access DES.(General Practitioners Committee, directed enhanced service)
October 27, 2006... The GPC is telling practices in England to consider dropping the directed enhanced service (DES) for access, worth pounds 12,000 to an average practice, after a dispute with the DoH. Practices taking part are already likely to have...

... while DoH offers only 1.5% rise.(Department of Health, General Medical Services)(Brief article)
October 27, 2006... The DoH is refusing to agree even inflationary uplifts to the GMS contract for 2007/8 without additional work and efficiency savings, say GP leaders. In written evidence to the Doctors' and Dentists' Review Body (DDRB), the GPC accused...

Reversibility test is helpful in COPD.(Chronic Obstructive Pulmonary Disease)(Brief article)
October 27, 2006... Inclusion of reversibility testing in the COPD quality domain has been supported by UK research that showed one patient in five has reversible airflow obstruction. The study involved 1,508 smokers or ex-smokers over 40 with respiratory...

Gene could be key to Crohn's.(Brief article)
October 27, 2006... A mutation in a gene that affects a key inflammatory pathway could explain why Crohn's disease is inherited, US research has suggested. Researchers looked at 300,000 single nucleotide polymorphisms (SNPs) noted in people with Crohn's and...

Plasma jab lessens pain in tennis elbow.(Brief article)
October 27, 2006... A single injection of a concentrated solution of blood platelets could one day replace surgery in the treatment of severe tennis elbow, claim US researchers. They found that injecting platelet-rich plasma (PRP) into the elbow of patients...

Statins can stabilise fall in lung function.(Brief article)
October 27, 2006... Statins could help prevent and stabilise lung diseases in smokers, says a US study presented at the 72nd annual international scientific assembly of the American College of Chest Physicians in Salt Lake City this week. It included 182...

Research Brief: Vegetables sustain memory.(Brief article)
October 27, 2006... A high intake of vegetables, but not fruit, could stave off cognitive decline in old age, a US study claimed. It included 3,718 people aged 65 years and older who gave diet details and took two cognitive tests over six years. The rate of...

Research Brief: Lung exercises reduce pneumonia risk.(Brief article)
October 27, 2006... Patients who do breathing exercises before heart surgery are less likely to develop pneumonia afterwards, according to Dutch researchers. They assigned 279 coronary artery bypass graft patients to be given preoperative inspiratory muscle...

Research Brief: Pharmacy and physiotherapy best for knee pain.(Brief article)
October 27, 2006... Pharmacy review or physiotherapy are both successful approaches for reducing knee pain in older adults, according to a UK study. It included 325 adults aged 55 years or over with knee pain from 15 practices in North Staffordshire. They...

Research Brief: High BMI associated with low cognitive scores.(body mass index)(Brief article)
October 27, 2006... A high BMI in middle age is associated with accelerated cognitive decline, according to French researchers. The study of 2,223 people aged 32 to 62 years assessed medical, psychosocial and environmental factors, as well as cognitive function....

'Add PAD indicator to the quality framework'.(peripheral arterial disease)
October 27, 2006... GPs have called for guidance on peripheral arterial disease (PAD) issued by SIGN to be extended UK-wide and for it to be added to the quality framework. Currently there are no guidelines for the management of PAD in the other UK...

Jazzed up.(Patrick Byrne's fund raising events for charities)(Brief article)
October 27, 2006... Huntingdon GP Dr Patrick Byrne assembled a jazz band for a ball to raise funds for a children's charity. Dr Byrne and his band filled the dance floor with a succession of crowd-pleasers including Glenn Miller's In the Mood. Fellow GP Dr Mike...

DoH may impose pension cuts.(Department of Health, general practitioners)(Brief article)
October 27, 2006... GP leaders have rejected a DoH proposal to cut the value of the GMS contract pension deal agreed in 2003, but fear ministers could impose it anyway. Dynamisation factors based on the rate of growth of GP income are used to uprate...

PPIs may not reduce cancer risks.(proton pump inhibitors)(Brief article)
October 27, 2006... Long-term pharmacological gastric acid suppression may not reduce the risk of oesophageal cancer in patients with reflux disease, UK data has suggested. Comparison of 809 cases of newly diagnosed oesophageal or gastric cancer with 10,000...

Enhanced service cuts forced in aftermath of PCT mergers.(primary care trusts)(Brief article)
October 27, 2006... Enhanced services are being cut because of PCT reorganisation, GP leaders are warning. They fear the new larger PCTs which took over this month will see amalgamations of former trusts as a chance to cut local enhanced services (LESs) or...

Death blamed on out-of-hours IT.(Camdoic was blamed for Penny Campbell death)
October 27, 2006... Out-of-hours IT systems will come under DoH scrutiny in the coming weeks after they were implicated in a recent death. North London out-of-hours provider Camidoc has launched a joint review with its four commissioning PCTs into the...

GP training in practice cut back by six months.(general practitioners)
October 27, 2006... GP educators are dismayed at the 'sudden withdrawal' across the UK of plans to allow GP registrars to spend 18 months training in general practice. Course organisers heard Dr Arthur Hibble, chairman of the committee of GP educators...

Good practice guide sent to every practice.(General Medical Council)(Brief article)
October 27, 2006... The GMC has launched its new version of 'Good Medical Practice' and is sending posters to every GP practice in the UK to advertise it. Central to the guidance is a renewed focus on giving patients more of a voice in their treatment....

Choose and Book referrals near 1.5 million.(Brief article)
October 27, 2006... Almost 1.5 million referrals have been made through Choose and Book, the DoH said last week. Health minister Lord Warner said that 85 per cent of GP practices now used the system. 'A million bookings since introduction in 2004 is a real...

Healthcare funding review to be revisited.(general practitioners using websites for practice)(Brief article)
October 27, 2006... Sir Derek Wanless is to revisit his 2002 review for the Treasury looking at the funding of healthcare. The former NatWest Group chief executive will look at progress on his funding recommendations which led to the Chancellor's decision...

MASTA travel study days for nurses.
October 27, 2006... MASTA travel clinics are running study days for practice nurses on travel vaccinations. The next study day will be on 10 November 2006 and will be held at the Royal College of Physicians in London. For more information, go to www.masta.org.

Screen young women for chlamydia yearly.
October 27, 2006... Annual chlamydia screening should be offered to all women aged 16 to 24, with six-month re-screens for those with a positive test result, UK experts have said. The results of an 18-month prospective study of 1,971 women in England have...

Online: Live links at healthcarerepublic.com.(chlamydia)(Brief article)
October 27, 2006... Screening recommendations: - Women aged 16-24 should undergo annual chlamydia testing. - Women with a positive result should be retested at six months, sooner if their partner is untreated or new. - Women should be tested for...

Online: PCTs to slash referrals in pounds 2bn savings plan.(primary care trusts)(Brief article)
October 27, 2006... GPs fear DoH plans for efficiency savings, worth up to pounds 2.2 billion, will restrict referral options. The DoH has drafted a series of indicators that allow trusts to compare their efficiency. Trusts are expected to save cash by...

Online: Smokers face 'unfair' delays to elective surgery.(Brief article)
October 27, 2006... Plans to order patients to attend smoking cessation clinics before elective surgery are inappropriate and unfair, say GPs. Norfolk PCT, which has a pounds 50 million deficit, is planning to take smokers off waiting lists for procedures...

'CMO's report likely to demoralise profession'.
October 27, 2006... The GMC's longest-serving council member has launched a stinging attack on the CMO Sir Liam Donaldson's review of medical regulation. In an independent response to each of the CMO's 44 recommendations in 'Good Doctors Safer Patients',...

Diabetes patients to be prescribed information.
October 27, 2006... GPs must prescribe patients with information as well as medicines to aid understanding of long-term conditions, experts have said. MPs have passed an early day motion to improve information provision for people with type 1 and type 2...

GPSI clinics do not cut costs or waiting times.(general practitioners with special interests)(Brief article)
October 27, 2006... The DoH's own research has thrown doubt on the clinical and cost effectiveness of GPSIs. The research coincides with last week's announcement of 30 pilots to shift six specialities, including rheumatology and dermatology, out of...

Behind the headlines: Does eating fish cause birth risk?
October 27, 2006... Mercury in fish might increase a woman's chances of giving birth prematurely. What is the story? Eating too much fish during pregnancy could increase the risk of giving birth prematurely, according to media reports. The papers...

GPs unwilling to follow DoH road map.(general practitioners, Department of Health)
October 27, 2006... Proposed changes to the GMS contract have provoked opposition from. GP leaders. Nick Bostock reports. Much of the terrain for this year's GMS contract negotiations was set out in a White Paper implementation 'road map' published last...

Opinion: Death waited eagerly for me.(Column)
October 27, 2006... House calls aren't always fun, especially at a spooky time like Halloween. The cottage was deep in the woods. As usual, on calls where the welcome is uncertain, I parked facing away from the house and on a down-slope, and left the engine...

Opinion: All the patients want is agreement.(Column)
October 27, 2006... Mrs Gimlet subjected me to the piercing stare she keeps for the lower classes and demanded to know how anyone in their right mind could possibly think she would want to take antibiotics for such a minor inconvenience as a suppurating leg...

Opinion: Editorial - DoH will not win with back-door pay cuts.(Department of Health)(Editorial)
October 27, 2006... The government's target for inflation is 2 per cent and it is currently running at around 2.5 per cent. So in order simply to be running to stay still in terms of income, lifestyle,paying the mortgage and so on, everyone in the UK is looking...

Opinion: Chris Lancelot on ... A really independent NHS.(Column)
October 27, 2006... Quite independently, Gordon Brown and David Cameron have suggested releasing the NHS from direct political control. At first this looks like an excellent idea - the NHS would no longer be a political football. But will removing the NHS one...

Clinical: Journals Watch - Sudden death, weight loss and CVD.
October 27, 2006... Running short of time to read the journals? Let Dr Alison Glenesk share the latest findings with you. Avoiding sudden death in athletes JAMA 2006; 296: 1,593-601 This is a very timely study, following the death of yet another of...

Clinical: Understanding eGFR calculations.(epidermal growth factor receptors)
October 27, 2006... Measuring eGFR has enhanced the diagnosis of renal disease, say Dr Donal O'Donoghue and Dr Ian Wilkinson. Chronic kidney disease (CKD) is endemic in the UK population with around 2.9 million people in CKD stages III to V (moderate kidney...

Clinical: Equipment Review - A table to keep the waiting kids happy.(WMS Play Table )(Product/service evaluation)
October 27, 2006... The WMS Play Table has brought peace to the waiting room, says Dr Gwen Lewis. Our surgery has recently become even more of a paradise for the younger members of our practice population. It now offers as much fun as the local Early...

Clinical: Sites on systemic lupus erythematosus.
October 27, 2006... Websites relating to this week's Clinical Review selected by Dr Keith Barnard. MANAGEMENT OF SLE This offering is much better than it looks - I do wish this online journal would abandon its format of a long narrow column down the...

Clinical: Complementary Therapy - Data on yoga doesn't always stand up.
October 27, 2006... There are health benefits to yoga, but research is weak, says Professor Edzard Ernst. The ancient Indian practice of yoga includes stretching, breathing exercises and meditation. Indian symbols dating from 3000BC indicate it already...

Clinical: Systemic lupus erythematosus.
October 27, 2006... Contributed by Dr David P D'Cruz, consultant rheumatologist, the Louise Coote Lupus Unit, St Thomas' Hospital, South London. 1. AETIOLOGY AND EPIDEMIOLOGY Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder with a...

Clinical Q&A: Psychosis and loss of libido.
October 27, 2006... Our experts answer queries on the transport of a disturbed patient and lack of libido. What should be the first-line treatment by a GP who is treating acute psychosis of unknown origin when sedation is required to transport the patient...

Clinical: Viewpoint - How to bring anxiety levels under control.(Viewpoint essay)
October 27, 2006... Managing unmet needs is the key to resolving anxiety, say Ivan Tyrrell and Denise Winn. All forms of anxiety arise because people's essential physical or emotional needs are not being met or our innate resources to help us meet those...

Registrar: A problem shared - An elderly long-distance runner.
October 27, 2006... A 72-year-old man wants to run a half-marathon. How should you advise him? THE PROBLEM A 72-year-old man comes to your surgery and says that he wants to run a half-marathon in six months' time. The last time he was seen was the...

Registrar: MRCGP Exam Update - Urinary incontinence.
October 27, 2006... Current situation? - Urinary incontinence affects one woman in three but is underdiagnosed and undertreated. - Continence services in the UK are scattered and varied. - A questionnaire survey showed that more than 70 per cent of...

Registrar: Pictorial case study.(Brief article)
October 27, 2006... The case A 55-year-old woman presented because she was concerned about the appearance of swelling in some of her fingers. She had also noticed discomfort at times which was worse in cold weather and stiffness in those swollen joints. ...

Registrar: All you need to know online.(Website overview)(Brief article)
October 27, 2006... WEBSITE www.healthcarerepublic.com This new offering from Haymarket Medical brings together all its medical titles aimed at primary care. The registrar section contains useful educational and clinical articles which will be...

Registrar: Jargon Buster - The Improvement Foundation.(Brief article)
October 27, 2006... What is it? Headed by GP Sir John Oldham, the Improvement Foundation is a public service improvement team, with 11 centres across England. It was formerly the National Primary Care Development Team (NPDT). What is its purpose? ...

Registrar: How to ... write a referral letter.(Brief article)
October 27, 2006... - Keep it simple The amount of information required depends on the problem. A simple problem such as a skin lesion needs less information. - Personal information Introduce the patient to the consultant, giving their age and...

MedEconomics: GP Finance - How to ... learn and benefit from GP research.(general practitioners)
October 27, 2006... Research projects enhance learning in your practice and funding covers the costs. According to the RCGP, 5 to 10 per cent of GPs are involved in leading a primary care research project and a further 15 to 20 per cent collaborate on...

MedEconomics: Supplies, tendering and a roof problem.
October 27, 2006... INDUSTRIAL ACTION The recent industrial action by the staff of NHS Logistics made me wonder what the position would be if, for example, we ran out of medical supplies because deliveries had been interrupted for reasons beyond our...

MedEconomics: Rules on putting GP practices out to tender.(general practitioners)
October 27, 2006... PCTs often put contracts out to tender when this is not legally required, says Dr James Kingsland. Putting primary care services out to tender is controversial, especially when local GPs' bids fail and a private sector organisation wins...

MedEconomics: Primary Care in Europe - How our European neighbours run their GP practices.
October 27, 2006... Twelve weeks of touring enabled Dr Gerald Michael to chart the state of primary care across Europe This summer, at the age of 70, I retired from my post as a GP principal, and set off on a 12-week tour of Europe, asking English-speaking...

MedEconomics: What patients think of self-care.
October 27, 2006... Professor Ruth Chambers looks at patients' attitudes to self-management. Patients in general have always been interested in boosting their health. The problem is that they may not know what to do for the best. They may lack...

GP Life: A classy BMW convertible.(BMW 630i Convertible)(Product/service evaluation)
October 27, 2006... It sat on the forecourt waiting for me, oozing presence. From any angle, the 630i convertible seduced, and I was looking forward to the long journeys I had planned to give it a good test run. In the usual BMW way, the soft top maintains...

GP Life: Classical CD of the month.(Tales of Opera)(Sound recording review)(Brief article)
October 27, 2006... Name: Tales of Opera Composer: Various Artists: Simon Keenlyside (baritone), Munich Radio Orchestra Conductor: Ulf Schirmer Label: Sony Classical The many fans of this intelligent, lithe-voiced baritone will need no reminding of...

GP Life: Save up to 50% off a city break.
October 27, 2006... Do you fancy a spot of retail therapy in the run-up to Christmas, or a relaxing weekend away once it is all over? Why not treat yourself to a city break and also to a little urban luxury? We have teamed up with Hotel Connexions to offer a...

GP Life: Need to know ... online auction helper www.auctionstealer.co.uk.
October 27, 2006... Dr Steven Livingston has discovered a website that will give you the edge in a bidding war in an eBay auction. Have you ever been pipped at the post for an item on eBay? With 30 seconds to go on the auction you feel confident that the...

Plain tales from the surgery.
October 27, 2006... MUM'S THE WORD A 23-year-old woman, who had been my patient since she was three years old, came to see me in tears. She told me that her marriage was in difficulty, and she was struggling to find a solution. She didn't want time off...

Independent Nurse: NMC to relax standard of proof in fitness to practise cases.(Nursing and Midwifery Council)(Brief article)
October 27, 2006... The NMC has agreed that fitness to practise cases should no longer be judged by the criminal standard of proof of 'beyond reasonable doubt'. Instead, as recommended in a DoH review of non-medical regulation, the civil standard of proof -...

Independent Nurse: DoH workshops will debate health visitor role.(Brief article)
October 27, 2006... The government is setting up a working party and regional workshops to debate the future role and contribution of health visitors. The move was announced by health secretary Patricia Hewitt at the CPHVA annual conference in Harrogate last...

Independent Nurse: Prescribing key for new PA role.(physicians' assistants)(Brief article)
October 27, 2006... The term medical care practitioner has been ditched in favour of physician assistant (PA), according to a government document on the curriculum and competencies of the new role. The document, put together by the Royal College of...

Independent Nurse: Lifestyle indicators considered for QOF.(Quality and Outcomes Framework )(Brief article)
October 27, 2006... Smoking, obesity and alcohol indicators are being considered for the quality framework for 2008/9 as the DoH looks at how 'health and well-being outcomes' can be incorporated into the GMS contract. Dr David Colin-Thome, the DoH's national...

Independent Nurse: Drugs may cause harm in otitis media.(antihistamines)(Brief article)
October 27, 2006... Children with persistent middle ear infections are more likely to be harmed than helped by treatment with antihistamines, according to a Cochrane review. The review looked at 15 trials including 1,516 children suffering otitis media with...

Independent Nurse: News in brief - Pay.(Brief article)
October 27, 2006... The RCN and other nursing unions have refused to publish their evidence to the independent pay review because the DoH has delayed issuing its evidence. It is believed a scrutiny committee from the Treasury department has caused the...

Independent Nurse: News in brief - Healthy living.(Brief article)
October 27, 2006... A free, online coaching programme has been launched to help tackle obesity. The programme, created by medical and behavioural change experts, helps professionals and patients identify eating behaviours and the physical, emotional and...

Independent Nurse: News in brief - Email.(National Health Service introduced email service only for nurses)(Brief article)
October 27, 2006... A hotline has been set up for nurses to register their NHSmail email account. The email service has been approved by the DoH and the BMA as a method of transmitting patient information. Once nurses have an NHSmail account, their address will...

Independent Nurse: News in brief - Cholesterol.(rosuvastatin helps in cholesterol reduction)(Brief article)
October 27, 2006... Data presented at the Primary Care Cardiovascular Society meeting in Newcastle has found that 10mg of rosuvastatin may be an effective second-line treatment for high cholesterol. Data from over 100 GP practices across the UK found that 81 per...

Independent Nurse: News in brief - Travel health.(Brief article)
October 27, 2006... MASTA will hold its next study day for health professionals on 10 November at the Royal College of Physicians in London and will cover a range of travel issues including tick borne encephalitis, skin conditions affecting travellers and...

Independent Nurse: Care closer to home - DoH research doubtful about the effectiveness of GPSIs.(general practitioners with special interests, Department of Health)(Brief article)
October 27, 2006... The DoH's own research has thrown doubt on the clinical and cost-effectiveness of GPs with special interests (GPSIs). The research was published ahead of health minister Lord Warner's announcement of 30 pilots to shift six specialities...

Independent Nurse: Vital statistics - Gonorrhoea.
October 27, 2006... 21.7% of gonorrhoea sufferers are resistant to ciprofloxacin 17.9% are resistant to penicillin 16.2% increase in antibiotic resistance amongst homosexual men Source: Health Protection Agency.

Independent Nurse: Journals Watch - Metformin link to B12 deficiency.(Brief article)
October 27, 2006... Patients taking metformin have almost three times the risk of suffering vitamin B12 deficiency, according to a Hong Kong study. Researchers compared 155 patients with diabetes mellitus and vitamin B12 deficiency with 310 matched controls....

Independent Nurse: Journals Watch - Soy milk formula does not reduce allergies in babies.(Brief article)
October 27, 2006... A Cochrane review looked at trials in which infants were given a soy milk formula compared with those receiving cows milk. They found both groups had a similar risk of developing allergic conditions such as asthma, eczema or rhinitis....

Independent Nurse: Journals Watch - PCTs limiting anti-TNF drugs.(tumour necrosis factor)(Brief article)
October 27, 2006... A questionnaire sent to 509 consultant rheumatologists in the UK has found that, despite NICE approval of anti-TNF therapy for rheumatoid arthritis, 46 per cent reported they were limited in their prescribing of the drugs. The most common...

Independent Nurse: Journals Watch - LSD disrupts alcoholism.(Brief article)
October 27, 2006... Canadian researchers followed up a group of alcoholics who took a single large dose of LSD in the 1960s as part of a study and reported it had made them view their alcoholic behaviour differently. Participants said the treatment had helped...

Independent Nurse: DoH invests in pilot social enterprises.(Department of Health)(Brief article)
October 27, 2006... The DoH has announced it will invest pounds 1 million to support 10 to 15 social enterprise pathfinder schemes. It is currently recruiting for possible projects (IN, 25 September) and is circulating an application pack that asks how...

Independent Nurse: Information packs to help self-care.(Brief article)
October 27, 2006... The DoH is piloting 'information prescriptions' until the end of 2007. Health minister Rosie Winterton said the pilots would initially apply to cancer and mental health. She said patients, on average, remembered only 10 per cent of a...

Independent Nurse: Call to accredit sponsored CPD.(continuing professional development)
October 27, 2006... All nursing continuing professional development (CPD) for nurses should be accredited by either a nursing organisation or academic institution, according to the International Council of Nurses. The federation of national nursing...

Independent Nurse: World Outbreak Information - Week beginning 23 Oct.(cases of Chikungunya fever )(Brief article)
October 27, 2006... INDIA Over 100,000 cases of Chikungunya fever are suspected in several regions. Delhi has also reported a high incidence of dengue. Both diseases are transmitted by daytime biting mosquitoes. There are no vaccines. IVORY COAST ...

Independent Nurse: Self-care does not reduce arthritic pain.(self-management programme )(Brief article)
October 27, 2006... Self-management programmes for people with osteoarthritis do not reduce pain, or the number of visits patients make to their local practice, according to a London-based study. The study involved 812 patients with osteoarthritis in their...

Independent Nurse: Applicants sought for QNI awards.(Queen's Nursing Institute )(Brief article)
October 27, 2006... Community nurses are being encouraged to enter the Queen's Nursing Institute (QNI) annual awards for innovative and creative community nursing practice. Winning projects will receive up to pounds 7,500 in funding for a year as well as...

Independent Nurse: News focus - Integrating health and social care.
October 27, 2006... As PCTs struggle to integrate health and social care, Judy Sands finds that nurses could be the key to making this happen. This last round of PCT mergers was, according to ministers, prompted by the need to ensure PCT and local government...

Independent Nurse: News focus - Will a tariff change care?
October 27, 2006... The DoH is investigating a community care tariff. Judy Sands looks at the possible impact. Nurses currently attempting to set up their own businesses repeatedly say the most difficult and time-consuming part is obtaining data to...

Independent Nurse: Editorial - PCTs must invest to improve public health.(child obesity have risen from 9.9 per cent in 1995 to 14.3 per cent )(primary care trust)(Editorial)
October 27, 2006... It's official. Britain is now the fattest country in Europe. And being overweight or obese is rapidly becoming the norm, with 60 per cent of women and two-thirds of men falling into these categories. These figures, which come from the...

Independent Nurse: Opinion - Do we have too many specialist nurses?
October 27, 2006... Have we gone too far with specialism? This is a difficult time for specialist nurses, with many facing the threat of redundancy or redeployment in light of financial deficits. I am not suggesting this is the right way forward, but I do think...