GP articles from September 2006

GP archives from September 2006

DoH to double APMS sites by Christmas.(alternative provider medical services)(department of health)
September 29, 2006... EXCLUSIVE The number of under-doctored areas which are being targeted with APMS contracts could double by the end of the year, GP has learnt. The DoH is currently helping service procurement in the 30 most deprived PCTs, but the...

RCGP to push accreditation scheme ahead.(Royal College of General Practitioners)(practice accreditation scheme in the offing)(Brief article)
September 29, 2006... The RCGP is to push ahead with a practice accreditation scheme, despite fierce opposition when it was announced. The idea was put forward in June but was shelved following fears it would be 'misused as a star rating or league table...

NICE obesity advice is 'not appropriate'.(National Institute for Clinical Excellence)
September 29, 2006... The draft NICE guideline on obesity has been criticised by a UK expert for supporting bariatric surgery in under-16s. Dr David Haslam, the clinical director of the National Obesity Forum and a GP in Hertfordshire, criticised the guideline...

Ocular cells cultured on contact lens.
September 29, 2006... Human ocular epithelial cells have been cultured on the surface of contact lenses by Australian scientists. The breakthrough could improve treatment for patients with limbal stem cell deficiency and avoid the risks associated with...

Maternal smoking link to infant allergy.
September 29, 2006... Smoking during pregnancy affects the innate immune system in addition to the respiratory system of the foetus, Australian research has shown. The finding could partly explain why children born to mothers who smoked in pregnancy are at...

Binge drinking speeds up progression of HIV.(human immunodeficiency virus)(Brief article)
September 29, 2006... Chronic binge drinking could accelerate the progression of HIV to AIDS, US research in monkeys has suggested. For the study, 16 rhesus macaques were given alcohol through an intragastric catheter for four consecutive days per week to...

Research Brief: Motivation key to quitting smoking.(Brief article)
September 29, 2006... Motivational interviewing is more than five times as effective as anti-smoking advice at helping patients to quit smoking, Spanish research has shown. Twenty-two smokers assigned anti-smoking advice or motivational interviews were assessed at...

Research Brief: Exercise can slow, not prevent OA.(osteoarthritis)(Brief article)
September 29, 2006... Strengthening exercises for the quadriceps can slow progression in patients with osteoarthritis (OA), US research has shown. For 30 months, 174 OA patients attended a strength training or, as a control, a range-of-motion regimen for 30...

Research Brief: Early statins use boosts benefits.(Brief article)
September 29, 2006... Early intensive treatment with statins in patients with acute coronary syndromes can reduce the risk of cardiovascular death, unstable angina and revascularisation by just under 20 per cent, US researchers have found. A systematic review of...

Research Brief: Cider is the healthy option.(Brief article)
September 29, 2006... A glass of cider a day could keep stroke, heart disease and even cancer away, UK scientists suspect. Cider apples contain high levels of phenolic, an antioxidant that has been linked to protection against these diseases. Researchers at...

Hitting his targets.(Dr Mo Dewji to participate in Volkswagen Masters tournament)(Brief article)
September 29, 2006... Dr Mo Dewji is going to South Africa in November to represent the UK and attempt to win prestigious international amateur golf championship the Volkswagen Masters. The Buckinghamshire GP, who is also the clinical director for primary care...

Access targets do not reflect patient priorities.(Brief article)
September 29, 2006... The DoH's emphasis on 24- or 48-hour access targets is too simplistic, a large study of patients' preferences has found. Some patients are prepared to forgo rapid access in favour of a GP of their own choice or a convenient appointment....

Brown proposes an independent board to run NHS.(Gordon Brown)(Brief article)
September 29, 2006... The BMA is sceptical about chancellor Gordon Brown's plan for an independent board to run the NHS day to day. Mr Brown has asked health experts to examine plans to devolve power in the public services to keep ministers at arm's length....

GPC to submit case for inflationary rise.(general practitioner committee)(Brief article)
September 29, 2006... The GPC is to ask the Review Body for an inflationary pay rise for GPs in 2007/8. It will be the first time the body has been asked to rule on core GP income since 2001. Previously, the GPC and NHS Employers were able to agree funding as...

More security fears hit Choice system.(Brief article)
September 29, 2006... Confidential passwords used by patients to book hospital appointments through Choose and Book can be viewed by NHS staff with smartcards anywhere in England, GP can reveal. Michael Maxwell, a practice manager in Manchester, told GP he had...

HPV vaccine to be available in weeks.(human papillomavirus)(Brief article)
September 29, 2006... One of the two cervical cancer vaccines under development has received a European-wide product licence, and is set for a UK launch in the next few weeks. The licence approves the use of Gardasil in boys and girls aged nine to 15 years,...

NICE guidance sets treatment targets for anaemia in CKD.(National Institute for Clinical Excellence)(chronic kidney disease)(Brief article)
September 29, 2006... GPs are likely to find themselves monitoring all chronic kidney disease (CKD) patients for anaemia following the publication of final NICE guidance. The guideline on anaemia management in patients with CKD sets targets for haemoglobin...

Stroke assessments help long-term care.
September 29, 2006... The success of GPs in managing chronic disease such as diabetes has sparked the development of a pilot primary care model for long-term care of stroke patients. A structured system developed by researchers was found to address three...

Delay changes to training by one year, says BMA.(Modernising Medical Careers specialist training programmes)(British Medical Association)(Brief article)
September 29, 2006... Changes to doctors' training should be put on hold for a year in England, Wales and Northern Ireland to avoid a medical skills drain, according to the BMA. The new Modernising Medical Careers specialist training programmes for junior...

NHS reforms will force GP practices to close.(National Health Service)(general practitioners)(Brief article)
September 29, 2006... The closure of some GP practices is an 'unavoidable consequence' of the current NHS policy reforms, according to the Confederation of British Industry (CBI). Its report claims that opponents of reform are 'out of touch' with the public...

Roving records.(technology to help doctors access patients records away from workspot)(Brief article)
September 29, 2006... Kent GP Dr Manpreet Pujara is to trial software that will allow GPs to access patient records remotely via a BlackBerry. Dr Pujara, chairman of the EMIS national user group, said existing solutions allowed GPs to download patient records...

Genetics GPSIs boost appropriate referrals.(general practitioner with specialist interest)
September 29, 2006... The first audit of the value of introducing GPSIs in genetics has shown a huge increase in 'appropriate' referrals to the genetics service for families with a history of cancer. Ten GPSI posts in genetics were established as a pilot...

News in Brief: Stark warning over hidden health dangers in food.(Food4Thought campaign)(Brief article)
September 29, 2006... A striking image is at the centre of a British Heart Foundation campaign saying half the UK's children are 'drinking' almost five litres of cooking oil every year as a result of eating a packet of crisps a day. It is part of the Food4Thought...

News in Brief: Trusts urged to drop parking charges for patients.(BMA Wales starts campaign)(Brief article)
September 29, 2006... BMA Wales has launched a campaign to persuade trusts to drop hospital parking charges for patients. Dr Tony Calland, chairman of the BMA's Welsh Council, called charges 'taxing the sick by the back door'. Gwent Healthcare NHS Trust had an...

News in Brief: GPs offered progress report on NHS IT.(National Health Services Informaton Technology)(general practitioners)(Connecting for Health organises sessions)(Brief article)
September 29, 2006... Connecting for Health is running a series of 'engagement forums' to update GPs and practice managers on progress with the NHS IT programme. One session is planned in each of the 10 SHA areas, with places offered on a first-come-first-served...

News in Brief: Charity stages accredited course on stroke care.(caring for people affected by stroke)(Brief article)
September 29, 2006... The Stroke Association is running a course called 'Caring for People Affected by Stroke' which has NVQ 2/3 validation in health and social care. The one-day course covers physical needs, swallowing, communication and psychological effects. It...

Check for new symptoms of GORD.(gastro-oesophageal reflux disease)
September 29, 2006... Sleep disturbance, chest pain, cough and laryngitis should be added to heartburn and regurgitation as symptoms of gastro-oesophageal reflux disease (GORD), according to GP specialists. Roger Jones, professor of primary care at Guy's and...

'Dire' warning over revalidation plans.(General Practitioners Committee cautions physicians)(Brief article)
September 29, 2006... GPs have been warned of 'dire implications' if the CMO for England's plans for a more stringent revalidation regime are implemented as they stand, according to the GPC. Sir Liam Donaldson's proposals in 'Good Doctors, Safer Patients'...

Call to incentivise diabetes detection.(Brief article)
September 29, 2006... Recommendations for GPs to detect 90 per cent of diabetes cases are useless without an incentive, according to GPs with an interest in the condition. The recommendations are included in an audit of diabetes care for England and Wales...

Rural GPs demand more GMS funding.(general practitioners)(general medical services)(Brief article)
September 29, 2006... Rural services must receive more money from their PCTs particularly for enhanced and out-of-hours services, according to the Institute of Rural Health. A report released to coincide with Rural Health Week this week found that the new GMS...

Cleft lip caused by gene suppression.(underexpression of SUMO1)(Brief article)
September 29, 2006... Cleft lip and palate has been associated with underexpression of a gene called SUMO1, according to US scientists. The gene could be the link between previously discovered 'clefting' genes, highlighting the regulatory pathway that could be key...

GPC urges boycott of unfunded appraisals.(general practitioners committee)(Brief article)
September 29, 2006... GPs in areas where primary care organisations (PCOs) are refusing to fund appraisals should not take part, according to the GPC. Negotiators' exasperation followed DoH advice to PCOs that appraisals should be paid for. The GPC named...

Government makes guidance available on fire regulations.(Brief article)
September 29, 2006... Government guidance to help GP practices comply with fire regulations starting from 1 October will be available when the law changes. The Department for Communities and Local Government (DCLG) delayed the regulations' introduction for...

Flu jabs delayed until December.(spotlight on health)
September 29, 2006... Practices may have to wait until December for flu vaccine deliveries, which will put patients at risk, the GPC has warned. Meanwhile, the GPC is working with the DoH on a plan to move vaccines from areas that have more than is needed to...

Researchers suggest GPs lose PBC powers.(general practitioners)(practice-based commissioning)(Creating NHS Local: a new relationship between PCTs and local government)
September 29, 2006... Commissioning powers for local health services should be ent-rusted to local councils, according to a report from the University of Birmingham's Health Services Management Centre. The report, 'Creating NHS Local: a new relationship...

Probe after exit of four MDU directors.(Medical Defence Union)(Brief article)
September 29, 2006... The Financial Services Authority will look into an allegation of financial irregularity at the MDU following the resignation of four independent directors. But MDU chief executive Dr Michael Saunders has denied reports that they resigned...

GPs to charge dentists.(general practitioners)(Brief article)
September 29, 2006... Talks are under way between the BMA, British Dental Association and General Dental Council about how GPs will provide information that dentists need to register patients. The intention is that GPs will be able to charge for this, but it...

Racing escape.(the lighter side of general practitioners )(Brief article)
September 29, 2006... South London GP Dr Peter O'Donnell joined staff from Sutton and Merton PCT to win an NHS sailing regatta on the Solent in Hampshire. They faced competition from 16 other yachts, crewed by staff of various acute hospital and PCTs. Dr...

Row over 'tariff' for primary care.(Payment by Results-style tariff)
September 29, 2006... GPs and district nurses are set for a row over whether a Payment by Results-style tariff should be introduced to primary care in 2008. GPs oppose the DoH plan because it would close the loophole that allows practices to make savings of up...

Screening smokers for COPD needs resources.(chronic obstructive pulmonary disease)
September 29, 2006... GP respiratory specialists have called for a boost to primary care resources and changes to the quality framework to back smoking cessation efforts in patients with COPD. The call follows UK research that showed there may be four people...

Dentists earn pounds 5,000 a year more than GPs.(general practitioners)(Brief article)
September 29, 2006... Dentists who own their own practices earned an average of pounds 105,000 in 2004/5. But more than half that income comes from private work. Pay has actually decreased by about 3 per cent as dentists have moved to new contracts. ...

Behind the headlines: Can emergency pill stem abortion?
September 29, 2006... Although use of emergency contraception has risen, there has also been a rise in abortion rates. Jo Carlowe investigates. What is the story? The 'morning-after pill' has always been a popular topic for newspapers, so the latest claim...

Quality points lower in poorer areas.(focus on health)
September 29, 2006... Low quality scores in deprived areas are likely to exacerbate health inequalities in the UK, writes Nick Bostock. Quality framework data from England and Wales show that practices in deprived areas are likely to score fewer GMS quality...

Letter: Calls & Emails - Consultation length was not debated by grass-roots GPs.
September 29, 2006... Dear Editor I was disappointed by the comments of Dr Krishna Korlipara, a GMC member, who appears to believe that the updated GMC guidance, 'Good Medical Practice' will necessitate a lengthening of GP consultations from 10 minutes to 15...

Letter: GP's restaurant was well worth long drive.
September 29, 2006... Dear Editor We are writing to say how much we enjoyed the meal that Dr Chris Duckham prepared for us at his Restaurant Cote du Nord, a couple of weeks ago. My wife and I do not profess to be food buffs, but we recognise and enjoy...

Letter: DVT was indicator of cancer in my patient.
September 29, 2006... Dear Editor I was reading the article on DVT and cancer (GP, 15 September) and, interestingly, this year, I had a fit 62-year-old with little medical history, who is a keen walker and traveller. His wife alerted me to the possibility...

Letter: Does GP/actor have too many balls in the air?
September 29, 2006... Dear Editor If showing your genitalia to a group of your 70- or 80-year-old patients, as Dr Tim Kimber apparently proposes to do in his production of The Full Monty, is arty then I think I'd prefer to be crafty and stay at home (GP, 8...

Opinion: It's a matter of life and death.(a general practitioner speaks of his profession)(Personal account)
September 29, 2006... Someone had told me Jimmy had died, and I had known him many years ago, so, when I saw his widow I went over to pay my respects. I was embarrassed that I had somehow missed the wake (attendance at wakes is de rigueur in Ireland), so I...

Opinion: Not the Indian summer I expected.(a general practitioner's recounts his unforgettable trip to India)(Personal account)(Brief article)
September 29, 2006... Some research is so complicated that I struggle to find its real significance, but the best lessons are simply learned. Our summer trip to Ladakh in India followed an unusual pattern - lightning strike hits camp, camp washed away, group...

Opinion: Editorial - Don't ask the DoH where the NHS is going.(department of health)(national health service)(Editorial)
September 29, 2006... At last the cat is out of the bag. Health secretary Patricia Hewitt revealed last week what many GPs have suspected all along. The 15 per cent lid on private involvement in the NHS is to be officially scrapped. So there is no longer an...

Ensuring revalidation is right.(analysis of tests to assess knowledge of general practitioners)
September 29, 2006... I have no problem with the principle of revalidation: it is patently obvious that the nation needs to ensure its doctors are competent. But can revalidation be carried out accurately? It's not as simple as you might think. For example, I...

Clinical: Journals Watch - Green tea, needles and prescribing.(briefs)
September 29, 2006... No time to read the journals? Let Dr Suzanne Hunter guide you through the latest findings. GREEN TEA IS GOOD FOR YOU JAMA 2006; 296: 1,255-65 Green tea is a tea where the leaves are steamed or baked immediately on plucking,...

Clinical: Strange pain and tingling in lower legs.
September 29, 2006... CASE STUDY Four criteria permit the diagnosis of restless leg syndrome, writes Dr Julian Spinks. Margaret had first noticed strange sensations in her legs at night when she was in her early twenties, but these did not happen very...

Clinical: Managing hypertension after the latest GP guidelines.(general practitioner)
September 29, 2006... VIEWPOINT Keeping the patient in mind is a key factor in hypertension care, writes Dr Brian Crichton. An estimated 40 per cent of adults in England and Wales have high BP and thus the management of this potent cardiovascular risk...

Clinical: The Good Old Days.(Plastic bronchitis)(Excerpt)
September 29, 2006... Plastic bronchitis Plastic bronchitis is a rare variant of bronchitis, being quite distinct from the catarrhal form of the disease. It is not the spreading of croupous inflammation from the larynx into the bronchi, but a distinct...

Clinical: At a glance - Nut allergy.(Disease/Disorder overview)(Brief article)
September 29, 2006... Epidemiology and pathophysiology - Peanut allergy is one of the commonest food allergies. - Incidence and prevalence is increasing rapidly; it is not known why. - Typically begins in early childhood. - Type I IgE-mediated...

Clinical: Sites on the subject of sleep apnoea.(Scottish Intercollegiate Guidelines Network )
September 29, 2006... Websites relating to this week's Clinical Review selected by Dr Keith Barnard. GOOD GUIDANCE I'm a big fan of the Scottish Intercollegiate Guidelines Network (SIGN) guidelines, especially the quick reference guides. This one on...

Clinical: The pros and cons of herbalism.(herbal medicine)
September 29, 2006... COMPLEMENTARY MEDICINE In the latest of our series, Professor Edzard Ernst investigates herbal medicine. Herbalism can be defined as the medicinal use of preparations that contain only plant material as active ingredients. ...

Clinical: Success curing common ear conditions.(Micromedics EarPopper )
September 29, 2006... EQUIPMENT REVIEW The Micromedics EarPopper is a cost-effective device, says Dr Peter Ilves. The cost of excess use of antibiotics, secondary care referral and surgery throughout the world, in cash and human terms, is significant for...

Clinical: Obstructive sleep apnoea.(Disease/Disorder overview)
September 29, 2006... By Dr Michael Polkey, consultant physician in sleep medicine, the Hospital of St John and St Elizabeth and the Sleep and Ventilation service, the Royal Brompton Hospital, London. 1. EPIDEMIOLOGY AND AETIOLOGY Obstructive sleep apnoea...

Registrar: Professional development - Become an expert in sexual health.
September 29, 2006... Registrars can take a range of diplomas including the DRCOG. The MRCGP is not the only qualification available for GP registrars. If you crave professional development, there are many diplomas which you can take. The Diploma...

Registrar: MRCGP Exam Update - Management of angina.(Member of the Royal College of General Practitioners)
September 29, 2006... Current situation - Angina is a very common problem. In the UK more than two million people are affected by the condition. - Thirty per cent of patients with recent-onset angina will suffer a major cardiac event such as death, MI or...

Registrar: Pictorial case study.(hand foot and mouth disease care and treatment)(Disease/Disorder overview)(Brief article)
September 29, 2006... The case A six-year-old boy attended the surgery with his mother who had just noticed the appearance of a few spots on his hands in the past 24 hours. His mother thought that he had been slightly unwell and he had a reduced...

Registrar: Revision and regulation.(childhood immunization of pneumococcal vaccine)(Brief article)
September 29, 2006... EDUCATIONAL TOOL KIT Childhood immunisation The pneumococcal vaccine was added to the childhood immunisation schedule on 4 September. The vaccine will be offered to each child beginning his or her routine programme of...

Registrar: How to ... look after yourself.(Brief article)
September 29, 2006... - Prioritise tasks The changes that you will encounter during your registrar year can be daunting. Your consultation time is cut from 20 to 10 minutes. You need to prepare for the summative assessment and the MRCGP exam. If you do not...

Registrar: Save pounds 119.
September 29, 2006... Buy your exclusive GP registrar 'starter kit' at the fantastic price of just pounds 383.20 including VAT. The multi-pocket doctor's bag contains a Keele pocket diagnostic set, Omron sphyg, Littmann Classic stethoscope and Dialight pen torch....

Medeconomics: Finance - How to ... screen and treat the obese.
September 29, 2006... Avoid thinking of obese patients as time-consumers who need to make big changes, says Jennifer Taylor. Points for screening obese individuals are likely to be added to the quality framework in future, according to National Obesity Forum...

MedEconomics: The best mortgage and pension for you.
September 29, 2006... MORTGAGES I am told that many people find themselves unable to pay off an interest-only mortgage at the end of its term. As a new GP and first-time buyer, I do not have any investments. Would it be best to get a capital repayment...

MedEconomics: Where no mobile has gone before.(02 Airwave service is a useful tool during emergencies)
September 29, 2006... In a rural area with no mobile signal, one GP is using a new service to stay in touch, writes Lucie Benson. Dr Jim Finlayson is a single-handed GP in the village of Southend, close to the Mull of Kintyre, Scotland. He looks after 500...

MedEconomics: Look at what our PBC consortium is offering.(practice-based commissioning)(CueDoc PBC Limited's unique service)
September 29, 2006... YOUR PRACTICE 2010 Our Cumbrian commissioning group has the support of GPs and ambitious plans, writes Dr Peter Weaving. North Cumbria's Lake District is truly beautiful - unlike our health economy. When I go for a morning jog I...

GP Life: Honda tackles green issue.(Honda Australia Proprietary Ltd.)
September 29, 2006... Honda is on a mission. It reckons that many British drivers do not know what a hybrid car is, let alone understand any financial or environmental benefits they might offer. It hopes the new Civic Hybrid will enlighten the masses. It is...

GP offer: medical dramas on DVD.(General Practitioners)(Brief article)
September 29, 2006... No, don't do it that way, try intubating first... If you have been missing the drama of Chicago's County General ER, you will be pleased to know that the complete seventh season of the award-winning medical series is now available on...

GP Life: Win a complete hi-fi system.
September 29, 2006... One GP reader will take away the Arcam Solo plus an iPod, worth pounds 1,500. Audiophile quality hi-fi in one sleek, easy-to-use system? That'll be the Arcam Solo. Inside the clean, contemporary lines of the Arcam Solo, there beats...

GP Life: How an acidic wine became a rich port.(Brief article)
September 29, 2006... As the nights start drawing in, we begin to think about some of those more wintry delights. One of the most traditional is port. Port as we know it was a British invention. Portuguese wines have been drunk in Britain from as early as the...

GP Life: Tasting time.(General Practitioners)(Product/service evaluation)
September 29, 2006... Elegusto ports The Infantado LBV 1998, (pounds 14.95) This port is full of the rich, concentrated fruit that this traditional style would lead you to expect. Rich and peppery on the nose, with great intensity and length on the...

GP Life: My perfect short break ... a luxury hotel in Mallorca.(Gran Hotel Son Julia)(Personal account)(Travel narrative)
September 29, 2006... I've tried weekends in Europe's capital cities - Paris, Prague and the like. I've signed up for a shopping trip to London with a West End show and visit to museums and art galleries. And I've enjoyed them, but with all that rushing about,...

GP Life: Exclusive mortgage rates for GP readers.
September 29, 2006... GP is linking up with Savills Private Finance (SPF), one of the UK's leading independent mortgage brokers, to offer readers access to exclusive mortgage deals. This is the latest in a series of partnerships that GP has launched with...

Plain tales from the surgery.(general practitioners)
September 29, 2006... CASE OF PEN AND INK Some weeks ago, I did an out-of-hours shift. A father brought along his five-year-old daughter who had been unwell for a few days and now had a rash. She seemed fairly well but did have an odd purpuric rash over...

Independent Nurse: Payment by results community tariff will be in place by 2008.(payment by results)(Brief article)
September 29, 2006... A payment by results (PBR) tariff for community and primary care is expected to be in place by 2008. Lynn Young, primary care adviser to the RCN, confirmed that work had started on the tariff, although admittedly in an 'embryonic' form....

Independent Nurse: DoH looking for pathfinder social enterprises.(Department of Health)(Brief article)
September 29, 2006... The DoH's social enterprise unit is looking for 10 to 15 'pathfinder' social enterprise schemes in the NHS to fund and evaluate. Sue White, head of the new social enterprise unit, told a QNI conference in London that they were about to...

Independent Nurse: Nurses encouraged to freelance.(Brief article)
September 29, 2006... School nurses should work as independent consultants and sell their services back to schools and youth groups, according to one of England's deputy chief nursing officers (CNO). Kate Billingham, deputy CNO in charge of primary care and...

Independent Nurse: Bursts of intense exercise 'beneficial'.(Brief article)
September 29, 2006... Short bursts of very intense exercise can produce the same physical results as traditional endurance training, according to researchers in Canada. They recruited 16 university-aged students who performed six training sessions over two...

Independent Nurse: New risk assessment model proposed.(Brief article)
September 29, 2006... UK researchers appear to have found a more feasible cardiovascular risk assessment tool for primary care clinicians than the Framingham model. They recruited 3,582 women aged between 60 to 79 years who were free of CHD at entry into the...

Independent Nurse: Parkinson's Disease.(questionnaire for parkinson's disease)(Brief article)
September 29, 2006... A new questionnaire has been published to make it easier for non-motor symptoms such as sleep problems, depression, fatigue, blurred vision and sweating to be picked up and treated in Parkinson's disease sufferers. It follows a survey that...