GP articles from September 2010

GP archives from September 2010

Behind the Headlines: Can young adults take an Alzheimer's test?
September 24, 2010... Young adults could be screened for risk of Alzheimer's disease many years before onset of symptoms, according to media reports. Researchers in the US found sites of beta-amyloid plaque formation in the brains of people with Alzheimer's...

Traffic light label plan for driving safety.
September 24, 2010... All medicines should be given a 'traffic light' warning to show whether they are safe to take before driving, a government report has recommended. The Department of Transport report by lawyer Sir Peter North said such information should be...

Opinion: Let us live according to the Art.(Viewpoint essay)
September 24, 2010... The Ryanair attendant, desperation in his eyes, was trying to flog me a scratch card, while the gaudy blue and yellow paint was offending my sensibilities and making me nauseous. Ryanair takes this miracle and turns it to dross; this miracle...

Opinion: GPs to save Middle-earth, again.
September 24, 2010... Another White Paper popped through the Hobbit's letter box and he was not pleased. The last one had designated Hobbits as major characters and he had ended up in Mordor trying to hurl someone's ring off a cliff and save Middle-earth. He had...

Clinical: Journals Watch - Epidurals and childhood cancers.(Report)
September 24, 2010... Too busy to read all the latest journals? Let Dr Gwen Lewis bring you up to date with the research. Epidurals may help prevent prolapse BJOG 2010; doi 10.1111/ji1471-0528.2010.02704.x I regularly see patients with symptoms of prolapse....

Clinical: The Basics - Managing eczema.(Report)
September 24, 2010... Patient education plays an important role in the management of eczema, explains Dr Nigel Stollery. Atopic eczema is a common inflammatory skin condition that can develop at any age. The majority of cases (approximately 70 per cent) first...

Clinical: Meningococcal disease prevention.(Report)
September 24, 2010... For travellers, appropriate vaccination is the mainstay of control. Neisseria meningitidis is the leading cause of bacterial meningitis worldwide. In developed countries, most cases are caused by endemic disease, although there are...

Clinical Solutions: Stye.
September 24, 2010... THE CASE A middle-aged woman presents with a localised, painful eyelid swelling A small pus-filled spot is visible on the eyelid margin. What are styes? A stye is an abscess of the eyelid, usually caused by a staphylococcal infection....

Clinical: Streptococcal infections.
September 24, 2010... Impetigo Impetigo is a bacterial infection of the skin caused by Streptococcus pyogenes or Staphylococcus aureus. It is frequently seen in school children. This child developed weeping sores and crusting around his mouth. A swab was taken and...

Clinical: Diagnosing venous thromboembolism.(Report)
September 24, 2010... One of the most challenging aspects is knowing which patients to investigate, explains Dr Kerstin Hogg. Recent advances in research and technology have transformed the way DVT and pulmonary embolism (PE) are diagnosed. Despite more...

Clinical: Degenerative spine disease.(Report)
September 24, 2010... Contributed by Dr Keyoumars Ashkan, consultant neurosurgeon and senior lecturer, King's College Hospital, south-east London. Section 1: Epidemiology and aetiology Degenerative spine disease (DSD) is a general term which includes...

Clinical: Generic substitution.(Clinical report)
September 24, 2010... The Dilemma: A disgruntled patient comes to see you unhappy that he has been changed, without discussion, from a branded drug to a generic equivalent. He shows you a newspaper article about how GPs are prescribing 'cheap' drugs and expresses...

Education: Gaining CPD credits.(Continuing Professional Development)
September 24, 2010... To ease into revalidation, keep a log of all learning events and their impact on practice, advises Dr Rodger Charlton. The introduction of revalidation confirms that attaining a medical degree or royal college membership is not an end point....

Education: Pictorial case study.(seborrheic keratosis)(Case study)
September 24, 2010... The case During a routine appointment, this 74-year-old man mentioned that one of his warts had started bleeding. He had attended the surgery three years before and the GP had diagnosed seborrhoeic keratoses as the cause of his multiple...

Education: A registrar survival guide ... follow up and safety netting.
September 24, 2010... A crucial component of the Calgary-Cambridge model for consultations comes right at the end of the consultation: safety netting and follow up. Once the history has been taken, examination performed and an explanation provided, it is vital...

MedEconomics: Guide to good medical records.
September 24, 2010... Dr Tony Grewal provides advice on how to ensure you include all the essential data about the patient. Medical record-keeping has come a long way since the 1960s when we needed merely to write the date we saw the patient, the diagnosis made...

MedEconomics: Ask the experts - Income tax, theft and premises.
September 24, 2010... Q: INCOME TAX What impact does the new tax regime for high earners have on my finances and what can I do about it? From 6 April 2010, people with an annual income exceeding pounds 150,000 will have to pay a top rate of 50 per cent income...

MedEconomics: Get smart about surgery cover.
September 24, 2010... Jason Brown explains 'cheap' is not always 'best', so it pays to compare insurance policies carefully. In the ever-growing digital universe, price remains the key search differentiator in people's buying behaviour, and price comparison...

MedEconomics: Medico-legal - Being under the GMC's scrutiny.
September 24, 2010... Dr Stephanie Bown and Sarah Whitehouse explain help is at hand if your fitness to practise is probed. Facing a GMC investigation can be very daunting and we have all seen the mileage the press can get out of 'doctors under fire'. The...

MedEconomics: In a nutshell ... disability discrimination.
September 24, 2010... Practices need to know the law and avoid discriminating against disabled staff, says Martin Edwards. Discriminating against a disabled employee is prohibited by the Disability Discrimination Act 1995. Employers that discriminate could find...

MedEconomics: Dispensing Implications of the White Paper
September 24, 2010... Dr Jeremy Phipps ponders the reforms and whether the sun is rising or setting on dispensing practices. Following the release of the White Paper Liberating the NHS, we now know some of the intentions of the coalition government. Of...

Commissioning: GP consortia - Taking over staff from PCTs.(PTC Technology)
September 24, 2010... The TUPE regulations apply to transfers of PCT employees to the new consortia. Commissioning is to shift to GP consortia, as the White Paper proposals stand. However, very few GPs have hands-on experience of commissioning and additional...

Commissioning: Can you carry on as normal?
September 24, 2010... Dr David Jenner suggests simple steps GPs can take now to be ready for consortia and commissioning. Since the publication of the White Paper in July and its four underpinning consultation documents, GP has given a lot of coverage to how the...

Plain Tales from the Surgery.
September 24, 2010... - Infidelity benefits I have been seeing a woman who has a frozen shoulder for many months and she has been signed off work. At a recent consultation she told me her boss had suggested she tried getting income support or infidelity benefit....

Practice staff pay on the rise despite falling income of GPs.
September 24, 2010... Practice managers' pay increased by 2.3 per cent in 2010. Practice managers' pay has continued to rise despite falling GP profits, a survey has shown. A survey of 1,100 practice managers found their average income rose 2.3 per cent to...

Test may detect diabetes in pregnancy.
September 24, 2010... A large waistline and high triglyceride levels in pregnant women could be used to screen for gestational diabetes, research suggests. Researchers from Quebec, Canada, found women with the hypertriglyceridemic-waist phenotype were more likely...

PCTs consulting GPs on key decisions.
September 24, 2010... Areas with poor PBC struggle to involve GPs in management decisions. PCTs are starting to involve GPs in commissioning decisions as they prepare to hand over the reins in 2013, LMC leaders say. But they warned that the level of...

MDU warns over missed cancer.
September 24, 2010... GPs should remain vigilant for signs and symptoms of malignancy to avoid legal complications, the Medical Defence Union (MDU) has warned. A quarter of all settled medical claims over the past five years related to delay or failure to diagnose...

Seasonal flu jab cuts first MI risk by a fifth, study shows.
September 24, 2010... Protective benefit greater for earlier vaccinations. Seasonal flu vaccination can cut the risk of MI by a fifth, UK research suggests. Patients given the seasonal flu jab were 19 per cent less likely to suffer a first MI than those...

Paracetamol 'not linked' to asthma.
September 24, 2010... Paracetamol use does not increase the risk of children developing asthma, research has shown. Evidence has suggested paracetamol exposure in early life could cause asthma, eczema and allergic rhinitis in some children. To examine this...

Research Brief: Self-management in heart failure.
September 24, 2010... Self-management counselling for patients with heart failure does not improve outcomes, a US study suggests. Researchers found that counselling and heart-failure education did not cut rates of death or hospital admissions among 902 patients with...

Research Brief: Game on to speed up decisions.
September 24, 2010... Fast-paced video games are good for you, research suggests Scientists assessed two groups of young adults to see if playing video games could affect decision-making. They found those who played action games were then able to make 25 per cent...

Pertussis jab use may need to widen.
September 24, 2010... Whooping cough jabs may need to be given to adolescents and adults to boost falling immunity, and to pregnant women to protect unborn children, HPA research suggests. Dr Helen Campbell, based at the HPA's Centre for Infections, said there...

Family flu jabs could cut child hospital admission rates.
September 24, 2010... Vaccinating family members is likely to be the best way of preventing young children from being admitted to hospital with flu, a leading GP researcher has argued. Dr Douglas Fleming, director of the RCGP research and surveillance centre,...

Campaigns must boost jab uptake.(Brief article)
September 24, 2010... National education programmes are required to ensure misperceptions about vaccination do not undermine public health, a UK study suggests. Dr Elizabeth Dubois from Imperial College London and colleagues examined the success of the DoH's 2002...

GMC says poor doctors may slip through revalidation net.
September 24, 2010... GMC admits process will not be perfect initially. Revalidation may not filter out all poor performance at first, the GMC has admitted. GMC chief executive Niall Dickson said revalidation would evolve, but at first 'will not be perfect'. At...

Smoking ban cuts asthma attacks.
September 24, 2010... The Scottish smoking ban reduced child asthma attacks by a fifth within three years, research shows. Hospital admissions for childhood asthma fell 18.2 per cent following the ban, which came into force in March 2006. Researchers studied...

GPC leaders demand control of maternity services.
September 24, 2010... White Paper plans for national commissioning board to run maternity services leave GPs concerned. The GPC will oppose White Paper plans for maternity services to be run by the NHS Commissioning Board, and will call for GP consortia to control...

Aspirin use cuts bowel cancer risk.
September 24, 2010... Regular aspirin can help prevent bowel cancer, even at a low dose, research suggests. Aspirin has a protective effect that is apparent after just one year and is effective in the general population, researchers from Western General Hospital,...

How big should GP consortia be?
September 24, 2010... The DoH does not want to prescribe consortia size, but GP organisations have clear opinions. Susie Sell reports. Speculation about the size of GP consortia has been rife since the White Paper Liberating the NHS confirmed DoH plans to hand...

GPs embrace YouTube to boost patient engagement.
September 24, 2010... Quick online videos offer patients information. A trailblazing GP practice in Middlesex is using YouTube to boost communication with patients and potentially cut costs. The Hillview Surgery has scrapped its website in favour of a free NHS...

Side-effect risks of using inhalers.
September 24, 2010... Psychological and behavioural side-effects associated with inhaled and intranasal corticosteroid use have been highlighted by the MHRA. In its latest Drug Safety Update, the agency highlights a review of data on inhaled and intranasal...

Blood test offers early pre-eclampsia warning.
September 24, 2010... Condition emerges late in pregnancy but key group of metabolites can identify risk in early stages. A blood test could identify pregnant women at risk of pre-eclampsia, a study suggests. A team led by Professor Louise Kenny from University...

A round-up of the best from GP's website this week.
September 24, 2010... Online-only - Mary Selby blog What does the GP columnist think about the news that she will need only one multi-source feedback each five years instead of two? 'This is Great News as it means she only has to behave properly for, say, a year...

Opinion: Ballot Box.
September 24, 2010... 62% of GPs think GPs should not run the 111 service replacing NHS Direct Source: Healthcare Republic -------------------- Did you find this article useful? Why not subscribe to the magazine? Please call 08451 55 73 55 for more...

Opinion: Your Say Online.(Brief article)
September 24, 2010... Consortia regulations could stifle GP innovation - Precisely, this is why practice-based commissioning consortia could not work. National Programme for IT to be axed - This is without doubt an expensive mistake and false economy...

Editorial: GPs are setting a good example on staff pay.(Editorial)
September 24, 2010... Last week official NHS data showed that average GP income had fallen for the third consecutive year. It is news that will come as little surprise to those of you running practices at a time when the rosy glow has long since dimmed on the new...

Opinion: Consortia must not inherit PCT debts.
September 24, 2010... I am convinced that the White Paper represents a golden opportunity for clinicians to run the NHS both efficiently, and for the good of the patients. But what about existing financial deficits? Setting up and running the consortia will be...

QOF pay skewed by Darzi centres.
September 24, 2010... Practices lose thousands as expanding lists expose loophole in prevalence formula. The establishment of Darzi centres undermined the weighting of QOF pay and has left some practices facing losses worth thousands of pounds. Rapidly growing...

GP Enterprise Award winners revealed.
September 24, 2010... The Upton Surgery in Worcestershire has been voted the overall winner of the GP Enterprise Awards 2010. Upton Surgery had won the Practice Team award in the first round of judging, before all readers of GP newspaper were asked to vote for...

GP pay falls for the third year.
September 24, 2010... GP partners' profits have fallen for a third year running as expenses and staff salaries continue to soar. The average UK GP partner earned pounds 105,300 before tax in 2008/9, a fall of around 0.7 per cent on the previous year. Although...

Exclusive - GPs face chaos as NICE's role shifts - TA to help GPs commission.
September 24, 2010... GPC warning over impact of GP drug funding decisions and end of boundaries. Plans to transfer drug funding decisions to GPs and scale back NICE's role could widen postcode prescribing and cause huge problems for some practices, GPs have...

DoH portfolio of best practice to help GPs commission.
September 24, 2010... The DoH is developing a portfolio of best practice for GP commissioners and will investigate areas where practice-based commissioning (PBC) has failed, GP can reveal. Senior civil servants are understood to have told GP leaders that only 20...

Exclusive - Swine flu warning to be given for seasonal jab.
September 24, 2010... GPs must warn patients that swine flu has been included in this year's seasonal jab, advises GMC. GPs should alert patients who refused last year's swine flu vaccine that it is included in this year's seasonal flu jab, the GMC has advised. ...

Patients want non-GPs to be able to lead consortia.
September 24, 2010... GP consortia should have a proportion of lay leaders and a statutory duty to involve patients in their decisions, patient groups have said. Delegates at a conference run by National Voices, a coalition of health and social care charities,...

Call for QOF to boost focus on children.
September 24, 2010... GPs reject 'kneejerk' plan to overhaul QOF and set up GP practices in schools. The QOF should be updated to include indicators for the health and welfare of young people, a review of children's services recommends. The review, led by...

Consortia's child protection role.
September 24, 2010... GP consortia could take on a statutory duty to safeguard children and young people once PCTs are abolished. In a consultation document on the future of children and young people's services, the DoH called this an 'important new role' for...

BMA Will Work with DoH on White Paper Review
September 24, 2010... Commissioning GPC review of BMA consultation response results in plans for 'constructive engagement'. The BMA is to adopt a policy of 'constructive engagement' in its response to the White Paper consultation, GP leaders say. On Thursday,...

GP Diary.
September 24, 2010... RED-FACED MINISTER Health minister Anne Milton was bemoaning the use of political jargon this week, while responding to a journalist's question. 'Where did you read the word 'engagement'?' she huffed, 'I hate the word engagement.' The...

Patient outcome measures 'unreliable' to assess quality.
September 24, 2010... First PROMs show huge variation in patients' views. Patients' reports of treatment effectiveness have shown huge variation in the first official UK assessment of this form of data. The government is planning to use patient-reported outcome...

HMRC nets pounds 9 million from tax amnesty for doctors.
September 24, 2010... Her Majesty's Revenue and Customs (HMRC) netted pounds 9 million from this year's 'tax amnesty' where medical professionals were encouraged to declare unpaid tax. More than 28,000 medical professionals received warning letters from HMRC, and...

New variety of painkiller found.
September 24, 2010... Compounds that target receptors in the peripheral nervous system but not those in the brain, could lead to the development of new painkillers, research suggests. Current molecules that target the endocannabinoid system produce pain relief in...

Opinion: Some traditions are worth keeping.
September 17, 2010... Call me a cynical old goat, but to me 'traditional' is just another word for outmoded, narrow-minded, tacky, obsolete and kitsch. 'Traditional' music usually means some old guy moaning gibberish in a corner surrounded by bewildered tourists,...

Opinion: As in metaphor, so in life.(life of general practitioners)(Viewpoint essay)
September 17, 2010... It's important to recognise a metaphor, particularly when you're in a hire car on the side of a mountain and the road runs out. 'I thought,' says my husband in the cheerful fashion of one who hopes that smiling in the face of disaster might...

Clinical: Journals Watch - Breast cancer and smoking.
September 17, 2010... Too busy to catch up on all the journals? Let Dr Alison Glenesk update you on the latest research. Childbirth after breast cancer treatment Br J Surg 2010; 97 (8): 1,253-59 Advising patients about pregnancy risk after breast cancer...

Clinical: Case study - A schoolgirl with muscle weakness.
September 17, 2010... A detailed history will often provide a likely diagnosis, writes Dr Simon Gowda. As a medical student, I remember hearing a lecture from a venerable professor, who said that 80-90 per cent of the time diagnosis can be deduced from the history...

Clinical: NICE guidelines - Constipation in children.(National Institute for Health and Clinical Excellence)(Disease/Disorder overview)
September 17, 2010... Recent NICE guidance will assist in assessing and managing constipation, explains Dr Zoe Rawlinson. In May 2010, NICE published guidelines on managing idiopathic childhood constipation in primary and secondary care. Constipation is defined...

Clinical: Management of depression.
September 17, 2010... Explore patients' beliefs about antidepressants and dispel myths. By 2020, depression will be second only to cardiovascular diseases as the world's most common disabling disease. Prevalence may be as high as 30 per cent in older people and 20...

Clinical: The basics - Gonorrhoea.(Disease/Disorder overview)
September 17, 2010... This common STI is becoming harder to treat as antibiotic resistance grows. Gonorrhoea is the second most common bacterial STI in the UK. The main risk groups include men who have sex with men (MSM), who account for 30 per cent of diagnoses...

Clinical: Red flag symptoms - Nipple discharge.(Disease/Disorder overview)
September 17, 2010... Dr Mehul Mathukia highlights reasons for concern with this presentation. - Bloody discharge - Unilateral discharge - Spontaneous discharge - Hard, irregular palpable mass - Age > 40 - Male Nipple discharge is a common...

Clinical Review: Glomerulonephritis.
September 17, 2010... Contributed by Dr Noshaba Khiljee, specialist registrar, and Dr Simon Steddon, consultant nephrologist, department of nephrology & transplantation, Guy's & St Thomas' NHS Foundation Trust, south London. Section 1: Epidemiology and...

GMC to limit fitness to practise hearings.
September 17, 2010... Higher proportion of performance concerns could be dealt with outside formal hearing process. The GMC is to reform its fitness to practise procedures in a bid to cut the number of doctors who end up in hearings. GMC chief executive Niall...

GP DIARY.
September 17, 2010... BLANK CANVAS Your diarist attended a recent workshop where GPs were encouraged to discuss the White Paper, in order to feed back ideas to health secretary Andrew Lansley, who we are told is in 'genuine listening mode'. As always there were...

DoH stockpile to guarantee essential medicine supply.
September 17, 2010... Buffer stock plan could tackle weaknesses in supply chain identified during swine flu pandemic. Emergency stocks of more than 450 essential medicines are being set up under a pounds 260 million deal to prevent supply short-ages hitting the...

NICE backing for diabetes drug.
September 17, 2010... NICE has approved the GLP-1 analogue liraglutide for some type-2 diabetes patients. In draft guidelines, liraglutide 1.2mg daily has been recommended in combination with metformin or a sulphonylurea. Its use is limited to patients...

Freezing is best option for warts.
September 17, 2010... Common warts are best removed using cryotherapy, a study has shown. Dutch researchers found cryotherapy using liquid nitrogen was a more effective treatment for warts than salicylic acid, or using a 'wait-and-see' approach. Researchers...

Cilostazol may cut repeat stroke rate.
September 17, 2010... Cardiology Japanese researchers compare antiplatelet agents in non-inferiority study. Using cilostazol rather than aspirin to prevent repeat stroke is associated with fewer bleeding events and may be more effective, a study has found. ...

Research Brief: Physical tasks linked to longevity.(Brief article)
September 17, 2010... People who are better at simple physical tasks are likely to live longer, research suggests. A UK study found that measures of physical capability, such as standing balance ability, grip strength and walking speed, can predict mortality in...

Research Brief: The value of money.(Survey)(Brief article)
September 17, 2010... Money buys happiness, but only up to pounds 50,000 a year, a study claims. Researchers from Princeton University in the US studied 1,000 people's responses to a well-being survey, and compared these with earnings Emotional well-being rose...

DoH must not underestimate costs of running consortia.
September 17, 2010... King's Fund commissioning conference Consortia management costs lower than US l Lessons from PBC. GP consortia could be forced to operate with management budgets 10 times smaller than similar organisations overseas, the King's Fund chief...

GP consortia are urged to learn the lessons of PBC.
September 17, 2010... GP consortia must learn from the failures of practice-based commissioning (PBC) by forming quickly while the profession remains enthusiastic, according to a senior GP. Speaking at the King's Fund event on commissioning last week, Dr Shane...

Prostate screening backed for high-risk men.
September 17, 2010... Screening Study shows PSA tests work better on patients with genetic mutation linked to higher prostate risk. Regular PSA screening in men whose genes put them at a higher risk of prostate cancer may lead to earlier diagnosis, research...

Administration dominates young doctors' working life.
September 17, 2010... Junior doctors spend more time on administrative tasks than in formal training, a BMA report has concluded. The BMA's cohort study traced the career progression of 430 medical graduates who qualified in 2006. Researchers asked junior...

Warning over collection of practices' clinical waste.
September 17, 2010... Crackdown by environment watchdog leaves practices with just weeks to provide data on waste. Clinical waste may be left to fester at GP practices from next month unless they provide detailed information about what they are throwing away. ...