GP articles from October 2007

GP archives from October 2007

Independent Nurse: Exclusive - Revalidation plans for nurses not due until the end of 2008.
October 29, 2007... Revalidation for nurses is unlikely to be in place before 2009 according to insiders. Following the relaunch of the Knowledge and Skills Framework (KSF), NHS Employers director Alistair Henderson, admitted they were a long way off the...

Independent Nurse: Sexual health education standards considered.
October 29, 2007... Standards for sexual health education for practice nurses are being considered by the Royal College of Obstetricians and Gynaecology following reports that there is a lack of sexual health provision in primary care. An all-party...

Independent Nurse: Lower targets needed to cut CHD.
October 29, 2007... Quality framework targets for cholesterol must be lowered further if the QOF is to prevent secondary CHD claim experts. The call follows UK research that shows current CHD quality indicators have failed to reduce the number of hospital...

Independent Nurse: Flu jab does not affect hospital admissions.
October 29, 2007... Vaccinating the over-65s for flu does not appear to reduce winter hospital admission rates according to a Health Protection Agency (HPA) commissioned study. The study authors have urged the government to consider investing in alternative...

Independent Nurse: Pfizer withdraws its inhaled insulin.
October 29, 2007... The inhaled insulin product Exubera is being withdrawn by manufacturer Pfizer for commercial reasons. A Pfizer spokesman said the product had failed to gain the acceptance of patients and clinicians and investment was unwarranted. ...

Independent Nurse: Mental Health.
October 29, 2007... The amount of money PCTs spend on community mental health teams (CMHTs) has dropped in the past five years despite a government commitment to shift more care into the community. A national DoH survey of investment in mental health shows...

Independent Nurse: Queen's nurses.
October 29, 2007... The first nurses in 40 years to be awarded the title of Queen's Nurse were presented with their awards by England's chief nursing officer Christine Beasley this month. The Queen's Nursing Institute revived the title earlier this year as an...

Independent Nurse: Medicines management.
October 29, 2007... The NMC has published a new document called 'Standards for Medicines Management', which covers controlled drugs, delegation and administering medication from a remote prescription

Independent Nurse: Abortion.
October 29, 2007... The RCN has called for nurses to be allowed to perform terminations in the early stages of pregnancy. Dr Peter Carter, RCN general secretary, has made a written submission to the Commons select committee on science and technology, which...

Independent Nurse: Public Health.
October 29, 2007... NICE has produced new guidance on behaviour change to help patients lead healthier lives. It recommends that clinicians should explain lifestyle changes in terms of easy steps made over time, provide coping strategies to help patients deal...

Independent Nurse: Standardised education needed to deliver care closer to home.
October 29, 2007... Specialist nurses will need regulation and standardised education if the government's plans to shift care closer to home are to be realised, according to a report of specialty sub-groups. The sub-groups, made up of clinical experts, were...

Independent Nurse: Vital Statistics - Patient choice.
October 29, 2007... 4% drop in patients being offered a choice of hospital between March and May 2007 7% fall in patients being offered the 'choosing your hospital' booklet 1% increase in patients aware of hospital choice before attending a GP surgery...

Independent Nurse: Journals Watch.
October 29, 2007... A third of patients use dry powder inhalers incorrectly Observation of 224 patients using dry powder inhalers has shown that 32 per cent make at least one essential error US researchers told delegates at the annual scientific assembly of...

Independent Nurse: DoH backtracks on points for hours swap.
October 29, 2007... The DoH appears to have backtracked on its plan to swap 60 clinical QOF points for extended hours, now saying that services will be commissioned locally. The BMA's GP Committee and NHS Employers are in negotiation about whether extended...

Independent Nurse: Half of practices have had staff withdrawn.
October 29, 2007... Nearly half of all UK practices have had their attached community nursing staff withdrawn in the last year. The figures from the BMA's national survey of GP opinion also found that 49 per cent of the 7,340 respondents had had their...

Independent Nurse: Public health cash spent on debts.
October 29, 2007... Just two thirds of the money allocated for Choosing Health has been spent on public health programmes according to new figures. A survey of PCT directors of public health in England found half of all PCTs had spent 80 per cent of their...

Independent Nurse: Injury claims were wrongly assessed.
October 29, 2007... Nurses who were injured at work between 1985 and 1998 may have had their injury benefits claim wrongly rejected or received an incorrect pay-out the government has announced. Health minister Ben Bradshaw said a decision by the Pensions...

Independent Nurse: Tool kit to help nurses gain training funding.
October 29, 2007... A free tool kit has been published to assist nurses struggling to find funding for training and continuing professional development. The Education for Health resource includes a business case designed to convince employers of the economic...

Independent Nurse: World Outbreak Information - Week beginning 29 October.
October 29, 2007... US Eastern equine encephalitis has been reported by health sources in a European traveller returning from the north east coast this month. There is no vaccine for this rare viral disease, which is transmitted by mosquitoes. Travellers...

Independent Nurse: News focus - DoH and unions renew efforts on KSF.(Knowledge and Skills Framework of United Kingdom. National Health Service)(United Kingdom. Department of Health)
October 29, 2007... A year after missing its original deadline, Nick Bostock reports on the progress of the Knowledge and Skills Framework. In April 2006, an optimistic Patricia Hewitt claimed that the Knowledge and Skills Framework (KSF) would be in place...

Independent Nurse: News focus - Nurses demand leading role in PBC.
October 29, 2007... Nurses' have a unique understanding of patients' needs but many are excluded from commissioning, reports Nick Bostock. Practice-based commissioning (PBC) has been trumpeted as a panacea for many NHS ills. Ministers initially hoped it...

Independent Nurse: Editorial - It's time to ring-fence public health funds.(Editorial)
October 29, 2007... According to the Foresight report, a government inquiry into obesity published earlier this month, 60 per cent of men, 50 per cent of women and 26 per cent of children and young people will be obese by 2050. Incidence of type-2 diabetes...

Independent Nurse: Opinion - Infection control is everyone's business.
October 29, 2007... The past few weeks have been a difficult time for the NHS with regard to healthcare-associated infections (HAIs). The pictures of overcrowded wards and filthy sinks and commodes were terrible. Nurses have also been on the radio saying how...

Independent Nurse: Opinion - We must not ignore ADHD's effect on wellbeing.
October 29, 2007... There are many treatments for ADHD, but few address its impact on children's wellbeing, says Lisa Mangle. Attention deficit hyperactivity disorder (ADHD) is the most common childhood-onset neuro-developmental condition. It affects...

Independent Nurse: What the papers said - Is drink damaging the middle classes?
October 29, 2007... The Brits are well known for enjoying a tipple, but if proof were needed that our relationship with alcohol was starting to become a problem one only needed to look at the papers over the past two weeks. First off, the 'shocking extent of...

Independent Nurse: Clinical - Preventing threadworms.
October 29, 2007... Hand hygiene is the key to beating threadworms, says Janet Blake. Around 40 per cent of children under the age of 10 are likely to have threadworms at some stage,1 which means that threadworms are at least as common as head lice. Yet...

Independent Nurse: Clinical - At a glance - Differential diagnosis - Pemphigus vs pemphigoid.
October 29, 2007... Pemphigus Discriminatory signs - Affects middle-aged patients. - Blisters over scalp, face, back and chest. - Oral lesions occur in 50 per cent of patients. - The blisters break down readily. - Erosions heal slowly. - Nikolsky's...

Independent Nurse: Clinical - Disease prevention - Developments in travel health medicine.
October 29, 2007... Being up-to-date in travel health medicine is vital. Sandra Grieve reviews some recent changes in practice. Statistics show travel abroad by UK residents is on the rise.1 The availability and speed of travel, and increasing numbers of...

Independent Nurse: Clinical CVD - Managing cardiometabolic risk.
October 29, 2007... Nurse-led clinics can target cardiometabolic risk factors effectively, says Jacqueline Cleator. There is a pressing need to develop successful strategies for reducing patients' cardiovascular and metabolic (cardiometabolic) risk. Even a...

Independent Nurse: Clinical Focus - Advances in .(Disease/Disorder overview)
October 29, 2007... Overall key points - Insulin injections have been the mainstay of treatment for type-1 diabetes, allowing survival. - Non-invasive testing would be a useful advance for patients and may be possible in five years. - Continuous...

Independent Nurse: Clinical - At a glance - Differential diagnosis - Pterygium vs pinguecula.
October 29, 2007... Pterygium Discriminatory signs - White or pink fibrovascular growth. - Triangular patch of hypertrophied bulbar subconjunctival tissue, extending from the inner canthus to the border of the cornea or beyond, with apex pointing...

Independent Nurse: Clinical - Prescribing - Evaluating statin safety.
October 29, 2007... Providing patients with evidence-based advice on the safety of medicines is essential, says Alison Turner. Statins are first-line therapy for reducing cholesterol in patients at high risk of CVD and are used by millions of people...

Independent Nurse: Professional - Going it alone.
October 29, 2007... Becoming self-employed can be a scary prospect but, as Julie Griffiths discovers, nurses have a lot to gain. Gone are the days when the only option for nurses working in primary care was employment by a GP practice or PCT. With...

Independent Nurse: Professional - Resources - Worth a look.
October 29, 2007... Travel health study day Nurses are invited to attend MASTA's travel medicine study day, which takes place on 30 November at the Royal College of Physicians. It will highlight the latest resources for travel health professionals and...

Independent Nurse: Professional - Resources - In numbers - Trends in consultation rates.
October 29, 2007... Published in July, the final report of Trends in Consultation Rates in General Practice 1995-1996 shows that, in England in 1995, 77 per cent of the consultations recorded were undertaken by GPs, 21 per cent by nurses and 2 per cent by other...

Independent Nurse: Professional - Resources - Recommended patient resource.
October 29, 2007... Nutrition in Cancer website www.nutritionincancer.co.uk Why has the site been launched? To help cancer patients combat eating problems and unintentional weight loss during their illness. It has been developed by Nutricia, leaders in...

Independent Nurse: Professional - Resources - Policy digest.
October 29, 2007... National Evaluation of Partnerships for Older People Projects: Interim report of progress. What is this document? An interim report of an ongoing evaluation of the national Partnerships for Older People Projects (POPP) programme,...

Independent Nurse: Professional - Workplace - Career profile - Steve Willis, South Manchester.
October 29, 2007... - Why did you become a nurse? It was the result of a natural career progression after working in the NHS in a variety of jobs. I started as a porter in 1977, moving into maintenance and socialising within the nursing fraternity. I...

Independent Nurse: Professional - Workplace - Q&A: How can I deal with angry patients?
October 29, 2007... Q: A patient recently became angry during a consultation. I didn't handle it well and would like some advice on how to deal with similar incidents in future. A: The first step is prevention: try to reduce the causes of anger by...

Exclusive: GPs 'happiest in Europe' on pay.
October 26, 2007... GPs in the UK are among the most worried in Europe about the future of their profession, despite being the happiest with their current method of pay. A total of 399 GPs from the UK, France, Italy, Germany and Spain took part in a poll...

Extended hours may be enhanced service.(Brief article)
October 26, 2007... The DoH appears to have backtracked on its plan to swap 60 clinical quality points for extended hours, saying now that services will be commissioned locally. The GPC and NHS Employers are in negotiation about whether extended hours...

Damaged nerves could be repaired with fat cells.
October 26, 2007... Peripheral nerve damage could be fixed by creating artificial nerves from fat cells, claim UK scientists. In a study in rats, the researchers were able to create Schwann cells - neuroglial cells of the peripheral nervous system - from...

Ibuprofen slows lung decline in CF patients.
October 26, 2007... High-dose ibuprofen can slow the rate of lung decline in children with cystic fibrosis, according to a Cochrane review. The updated review supports the theory that long-term high-dose treatment with the anti-inflammatory drug can slow...

Research Briefs.
October 26, 2007... - A third of inhalers are used incorrectly One in three patients with asthma or COPD misuses their inhaler, US research suggests. Observation of 224 patients using dry powder inhalers showed that 32 per cent made at least one essential...

How will access plans affect GPs?
October 26, 2007... As the government focuses on extending surgery hours, some doctors tell Judy Sands it is time to tackle the issue. Improving access to GP services appears to have replaced hospital waiting lists as the government's health issue of the...

Behind the Headlines: Do statins work years after use?
October 26, 2007... Media reports claim that statins have a long-lasting effect. Sanjay Tanday investigates. - What is the story? People who take statins are protected against heart disease and premature death years after they stop taking them, media...

PCTs underspend by pounds 95m on public health.
October 26, 2007... Financial weakness is still the main reason for poor PCT performance, according to the Healthcare Commission. However, the second annual check found that performance was improving, with 29 per cent of PCTs' use of resources scored as...

Letter: Evening surgeries will pay less than minimum wage.
October 26, 2007... Dear Editor I was interested to read about the bid to swap 60 quality points for extended hours (GP, 12 October). I work as a rural GP in a two-handed practice. If we were to provide two-hour surgeries one evening per week and two hours...

Letter: Music choice was as confused as DoH policy.
October 26, 2007... Dear Editor Health secretary Alan Johnson's selections on Radio Four's Desert Island Discs were mostly very hard on the ear (GP, 12 October). How anybody can pick something as depressing as Death in Venice as a classical choice is...

Letter: Who songs would suit Mr Johnson's playlist.
October 26, 2007... Dear Editor Following your front-page item on Alan Johnson's choice of castaway records, I would like to suggest general practice's choice for him would be The Who's song 'Won't Get Fooled Again', from their greatest album Who's Next...

Letter: Pointless IT Spine will cause rise in litigation.
October 26, 2007... Dear Editor Our PCT is trying to bulldoze us into adopting a new, Spine-friendly IT system. But how many patients have died or been adversely affected because the treating clinician was unable to access their records? Surely, if...

Letter: Government should let us know what it wants.
October 26, 2007... Dear Editor The government should be explicit about what it wants from GPs: should we stop working during the day and open in the mornings and evenings, like the out-of-hours service? Or would it simply prefer slavery? How will GPs...

Opinion: Your Say Online.(Brief article)
October 26, 2007... Extended opening for pounds 6,000 It will cost the small practice the same, if not more (as all receptionists are on very part-time hours), to run the service. We only get 57p of the pound per point to cover this and only have one...

Opinion: Mud and the joy of rural practice.(Editorial)(Personal account)
October 26, 2007... Satellite navigation is one of those inventions that, like Viagra, does not disappoint. I used it this year while driving on the freeways of Los Angeles (SatNav, that is, not Viagra, although I'm not knocking the idea; in LA anything in...

Opinion: Wield a mighty pen for what's right.(Viewpoint essay)(Brief article)
October 26, 2007... The Gardasil debate comes suddenly to the fore, when the parents of a teenage friend on the edge of her first relationship are refused it by their practice on the basis that the PCT have asked them not to prescribe it yet. Essex have...

Editorial: 'What could GPs do with pounds 95 million?'.(Editorial)
October 26, 2007... How much fun is a regular diet of obesity, worsening sexual health and alcohol abuse? National newspaper readers could probably answer that, because tabloids and broadsheets alike have been filled with revelations, including how the...

Opinion: Chris Lancelot on... Hospital infections increase.
October 26, 2007... Following the 90 deaths from C difficile at Maidstone Hospital, two things were inevitable: the CEO would resign, and the secretary of state for health would wring his hands. He also announced that ward sisters would be making quarterly...

Opinion: Journals watch - AMD, obesity and sexual health.(Age-related macular degeneration)
October 26, 2007... No time to read the journals? Let Dr Gwen Lewis guide you through the highlights. Prevention of macular degeneration - BMJ, 2007; 335: 755-9 Age-related macular degeneration (AMD) is the main cause of severe visual loss in people...

Clinical: At a Glance - Juvenile plantar dermatosis versus pitted keratolysis.
October 26, 2007... Juvenile plantar dermatosis Clinical features - Occurs in children, usually between the ages of seven and 14. - Affects the soles of the feet. - Shiny, glazed appearance. - Skin becomes cracked and scaly. - Children complain of...

Clinical: Be prepared for the start of flu season.(Disease/Disorder overview)
October 26, 2007... The basics - Flu mortality can be as high as one in 125 for elderly patients, says Dr Taqi Hashmi. There are three basic types of influenza: A, B and C. Type A is the most pathogenic, influenza B is exclusively human, while A and C can...

Clinical: Emergency contraception and teens.
October 26, 2007... Emergency contraception requests from under-16s need issues of competence to be considered says Dr Sarah Gray. Joanne, who is 15, has come with her friend to ask for the 'morning after Pill'. She has not been seen at the surgery for...

Clinical: Congenital abnormalities of the eye.
October 26, 2007... Blocked nasolacrimal duct Dacryostenosis, or blocked nasolacrimal duct, is when the tear duct is blocked at birth due to incomplete development of the nasolacrimal duct. Some patients have teary eyes. The eye itself appears normal,...

Clinical Review: Raised haematocrit.(Disease/Disorder overview)(Clinical report)
October 26, 2007... 1. Aetiology Blood consists of red cells, white cells and platelets suspended in liquid plasma. If the blood is allowed to separate into cellular and liquid phases then the cellular phase is in the range of 37 to 54 per cent of the...

Clinical: Diabetic dyslipidaemia explained.
October 26, 2007... Understanding diabetic dyslipidaemia is key to effective treatment, says Dr Brian Crichton. Diabetic dyslipidaemia is characterised by a predominance of small, dense LDL cholesterol (LDL-C), low HDL-C and raised triglyceride (TG) levels....

Registrar: The Condensed Curriculum Guide - Gaining the essential knowledge.
October 26, 2007... In our final extract from The Condensed Curriculum Guide, Dr Ben Riley and Dr Jayne Haynes explain the curriculum statements. The curriculum statements spell out how a GP's generic skills and expertise, referred to as the six core...

MedEconomics: How to... cope effectively with 'heartsinks'.(Viewpoint essay)
October 26, 2007... Finding ways to deal with difficult patients can avoid misdiagnoses, reports Jennifer Taylor. A heartsink patient is anyone who makes you think 'oh no' when you see their name on the list of patients with an appointment to see you,...

MedEconomics: NHS pension changes and seniority pay.
October 26, 2007... NHS Pension Changes I shall be 60 in December 2007 when I hope to draw my NHS pension and return to work full-time. However I am uncertain whether to do this on my birthday or to wait until April 2008 to gain the full pension benefits...

MedEconomics: Stumbling blocks to extended access.
October 26, 2007... Lunchtime and evening opening may bring more problems than it solves, warns Dr Kevin McConville. I was intrigued by Leeds GP Dr Pablo Millares Martin's idea that GPs can simultaneously reduce working hours and offer patients evening...

MedEconomics: PCT scheme takes recycling burden.
October 26, 2007... Confidential GP waste is securely recycled in a free PCT service, reports Fiona Barr. Central and East Cheshire PCT covers 54 practices and almost half a million patients and wanted to reduce its reliance on paper to ensure GP practices...

MedEconomics: New NHS pension changes.
October 26, 2007... Contributions will rise steeply for some GPs but it is not all bad news, writes Valerie Martin. To say that GPs were 'dismayed' by the higher cost of the revised NHS Pension Scheme is an understatement of their reaction to the final...

GP Life: Bedding down flowers for winter.
October 26, 2007... Propagate and prepare now for flowering both indoors and next year, says Dr Jonathan Holliday. Here is an interesting one: propagation by root cuttings. My problem is that my Acanthus are well established and not only seed themselves but...

GP Life: Last chance to WIN a pounds 300 hamper.
October 26, 2007... As winter approaches and we turn our attention to evenings indoors, what better than being able to produce some gastronomic goodies at the drop of a hat? Take delivery of one of our two giveaway hampers, and the goodies are yours. ...

GP Life: GP recipe Lemon sole for a light autumnal lunch.(Recipe)
October 26, 2007... With autumn one thinks of root vegetables and more robust flavours, even with a delicate fish. This very simple yet seasonal preparation would make a great dish for a light lunch served with some salad. - Chris Duckham is a GP in Tongue...

GP Life: Luxury Blackpool hotel at half price.
October 26, 2007... The historic Paramount Imperial, the most famous hotel in Blackpool, occupies a prime location with impressive sea views and now you can enjoy a luxurious break there and save 58 per cent with a special offer from GP newspaper. You will...

Plain Tales from the Surgery.(Brief article)
October 26, 2007... Accent on bowels I was doing an out-of-hours shift in Glasgow on a wet Saturday evening when a man in his twenties turned up presenting with lower abdominal and groin pains. During the consultation I asked him how his bowels were....

Why extended hours were no solution for us.
October 26, 2007... Extended hours were a disaster for Dr Kevin McConville's practice in Buckhaven, Fife. His practice, with four-and-a-half full-time-equivalent partners and a salaried GP, tried staggered surgeries but abandoned them. 'Seeing patients...

Talks on fairer prevalence pay.
October 26, 2007... The calculation for determining prevalence pay weighting is being re-examined, after some practices that focus on specific types of patients, were found to have skewed achievement pay. Practices are intended to earn more for quality...

Practices 'bullied' into longer opening hours.
October 26, 2007... Practices are being pressurised to open extended hours without payment, according to the GPC. PCTs are also using PMS contract reviews to insert extended hours into contracts. Current discussions between the GPC and NHS Employers may...

Concern over IUD use in women with cancer.
October 26, 2007... The contraceptive coil Mirena (levonorgestrel) should not be given to women with progesterone-dependent cancers, according to a health minister. Answering a question about the safety of the IUD in the House of Commons last week, public...

QOF targets 'do not reduce CHD'.
October 26, 2007... Quality framework targets for cholesterol must be lowered further if the framework is to prevent secondary CHD, claim experts. The call follows UK research that shows current CHD quality indicators have failed to reduce the number of...

GPs shun summary records pilot.
October 26, 2007... The government is facing a battle to convince GPs to sign up to its summary care records plans in Bolton, Lancashire, one of four pilot areas testing out the initiative. Bolton LMC surveyed the town's 169 GPs and, of the 98 respondents,...

EMEA advice on rosiglitazone.
October 26, 2007... The prescribing information for the type-2 diabetes drug rosiglitazone should be updated to include safety warnings, the European Medicines Agency (EMEA) has announced. The benefits of using rosiglitazone were found to outweigh the...

Long-term benefit of exercise in OA for months.
October 26, 2007... Exercise programmes for osteoarthritis (OA) patients can improve function for up to six months, UK research has shown. The study focused on 418 people recruited from primary care. All were aged over 50 and had reported knee pain for more...

News in brief.(United Kingdom. Department of Health reports rise in life expectancy alongwith obesity in public health report)(lesser patients in UK opt for outpatient services)(patient care techniciansto be evaluated on clinical engagement)(Report)
October 26, 2007... Life expectancy up despite rise in obesity The latest Health Profile for England shows that life expectancy continues to increase, with early deaths from circulatory disease and cancer falling. But the DoH also reports a rise in obesity,...