Doctor articles from February 2004

Doctor archives from February 2004

Act to avoid claims for constructive dismissal.
February 5, 2004... Continuing our series, KATHIE APPLEBEE BRINGS SOLUTIONS TO GPs' ORGANISATIONAL HEADACHES Employment law is primarily aimed at protecting employees from unscrupulous employers. However, if certain standards are maintained, it can also...

Speed reading for busy people.
February 5, 2004... Want to read a book in an hour or two and know it well enough for a viva? Dr Richard Westcott shows you how You may not be able read a whole book in an hour or two, but it is perfectly possible to tear the guts out of even the most weighty...

Ys and wherefores.
February 5, 2004... Y is a curious and challenging letter when you think about it. Symmetrical and apparently simple, but it ends in mystery, asking itself a question. Y? Why indeed? As we near the end of the alphabet, you might be wanting to ask a few questions....

Defence experts in; lay judges warning.
February 5, 2004... MEDICO-LEGAL experts are worried new complaints procedures will mean GPs are judged by panels with no clinicians. The Department of Health has published draft proposals for consultation on changing procedures. The plans include replacing...

Tips on improving patient compliance with statins.
February 5, 2004... Dr Mark Dancy discusses why more focus is needed on improving statin compliance and how to go about it Statins have been one of the big success stories of the last ten years, yet their potential to delay or prevent coronary artery disease...

Quick wins for the Q&O.
February 5, 2004... Dr Anthony Lamb gives time-saving tips on implementing the quality and outcomes framework There are a number of pitfalls to avoid and loopholes that can be exploited in the clinical domain of the new contract. The following areas are...

Drug firm's promotion ; 'misled' GPs.
February 5, 2004... A GP has won a complaint against Leo Pharma, after accusing it of misleading doctors by making a promotional mailing appear to be a medical journal. The GP complained to the Prescription Medicines Code of Practice Authority after receiving...

Contract 'penalises' small lists.
February 5, 2004... Cathy Comerford GPs in small practices fear they will be penalised under the new GMS contract's quality framework because they will struggle to reach targets. The Small Practices Association says single-handers and GPs in two-doctor practices...

Practices paid extra to improve access.
February 5, 2004... GPs in the area of England that has the worst access record are being paid extra to join advanced access schemes. Yorkshire Wolds and Coast PCT has tripled the number of practices on its Primary Care Collaborative scheme after being given the...

If we don't help ourselves, nobody will.
February 5, 2004... Does the new contract really advance the interests of GPs? The Government sold us the new contract on the basis that it would make our lives easier. This is the same government that told us there were weapons of mass destruction in Iraq, so...

Call to end NI boycott.
February 5, 2004... NORTHERN IRELAND's GPs are being urged to drop their boycott of the region's new health groups. GPC (NI) chairman Dr Brian Dunn said GPs had to start engaging with local health and social care groups (LHSCGs) as the new contract was...

Ten tips to improve; communication.
February 5, 2004... The new contract will soon encourage and reward GPs for doing patient surveys, and the results will form part of a doctor's evidence for revalidation and appraisal. So it's time to focus on improving your communication skills. Dr David...

Invest in your staff now.
February 5, 2004... GPs' staff are a tremendous resource and, with the right encouragement, they can contribute even more to help make the new contract a greater success. Dr Andrew Spooner explains It's only right that doctors' staff should have decent...

College chief wants contract to reward consulting skills.
February 5, 2004... Some Doctor readers recently described the RCGP as a waste of time. Here, its president hits back, saying the 'slightly fluffy' side of general practice needs protecting under the new contract. Rachel Solotti reports RCGP president Dr...

GMC looks at training option ; to cut conduct; case hearings.
February 5, 2004... Cathy Comerford GPs COULD avoid facing the GMC about their conduct under plans to allow them to do pre-emptive training. The council is considering introducing 'consensual disposal', or the opportunity to voluntarily undergo remedial...

GPs attack 'biased' seniority scheme.
February 5, 2004... Christina Golding Overseas-trained GPs are accusing the Government of discrimination over their seniority pay under the new GMS contract. GPs who qualified outside the EU will lose money because of the new rules and this will also affect their...

Follow-up frequency in BP 'not as important' as previously thought.
February 5, 2004... Frequency of GP follow-up is not as important in blood pressure control as previously thought, say Canadian researchers. A study looked at hypertension in 609 patients, aged 30-74, from 50 practices. Participants were followed up every three...

Communication with mentally ill patients improved by check-list.
February 5, 2004... Doctors can improve communication with mentally ill patients via a simple check-list filled in before a consultation, research shows. A European team randomly allocated 134 schizophrenia patients to either standard care or a simple screening...

Health care workers show higher H.pylori infection risk.
February 5, 2004... Health care workers are more likely to be infected with Helicobacter pylori than members of the public, although it is not clear why, say Israeli researchers. Study authors tested and surveyed 191 staff from gastrointestinal units, 98 from...

UK-trained candidates fare better in GP training selection process.
February 5, 2004... Candidates are most likely to be accepted for GP training if medically trained in the UK, according to an audit. Researchers from Birming- ham University assessed the regional GP trainee selection process in the West Midlands. They followed...

Most DNAs are due to patients forgetting their appointments.
February 5, 2004... The majority of missed appointments are due to patient forgetfulness, a survey of primary care staff suggests. Researchers used questionnaires and focus groups to assess attitudes to missed appointments in general practices across Yorkshire....

Women are twice as likely; as men to have an inadequate sigmoidoscopy examination.
February 5, 2004... Inadequate sigmoidoscopy examinations occur more frequently among older patients and women than other patient groups, a US study reveals. Adequate depth for sigmoidoscopy is considered to be 50cm to 60cm. Researchers assessed colonoscopy...

GPs register; stroke the; easy way.
February 5, 2004... Steve Ford GP RESEARCHERS have come up with an economic way to compile stroke registers for the new contract. To earn four points under the quality and outcomes framework, GPs will need to have in place a register of all patients with a history...

GP exodus from PCOs; as contract work bites.
February 5, 2004... Simon Meek GPs are set to abandon their roles in PCOs in droves, potentially leaving the profession with little representation as the new contract is bedded down. English LMCs are predicting an exodus of GPs from PCTs' professional...

Co-ops urged to use non-GP employees.
February 5, 2004... GP co-operatives should draw on other clinicians and the public to boost their membership once doctors quit their 24-hour responsibility later this year, says a think-tank. A paper by Mutuo, released last week, said GPs were expected to 'be at...

HRT trial halted over breast cancer; recurrence.
February 5, 2004... ANOTHER HRT trial has been stopped early after finding unacceptably high risks of breast cancer recurrence. The Swedish HABITS study, involving 345 women with a history of breast cancer, was stopped in December after two rather than five years...

SSRIs 'safe for under-18s'.
February 5, 2004... Michelle Roberts Contrary to UK advice, SSRIs are safe to use in young people with depression, according to a US task force. In a preliminary report, the American College of Neuropsychopharmacology concludes there is only weak evidence to...

Trust condemned for ban on dissenting doctors.
February 5, 2004... A PCO which banned two GPs for disagreeing with its plans has been told that local practices have no confidence in it. Sunderland's practice managers have told the city's PCT that they have no confidence in its management, and the regional GPC...

Time for the; 'fluffy' things; in medicine.
February 5, 2004... THE NEW contract should reward GPs for consulting skills, and videotaped consultations could be the way to do it, says the RCGP's new president Dr Roger Neighbour, who began his three-year term in November, has joined the criticism of the new...

GP death prompts two investigations.
February 5, 2004... Two separate investigations are to be held over the actions of a PCO following the apparent suicide of a GP in Leicestershire. Leicestershire, Northamptonshire and Rutland Health Authority is to review the case of Dr Stephen Farley, who was...

NI reaches deal on access.
February 5, 2004... Northern Ireland's GPs will earn [pounds sterling]5,000 on average in the first year of the new contract for guaranteeing patients access to a primary care professional within 48 hours. The GPC (NI) and Department of Health, Social Services...

Between a Nobel; Prize and the ; wooden spoonists.
February 5, 2004... Until quite recently, our practice rarely used locums. However, times change. Nowadays, it is not always possible for the regular doctors to cover the workload, nor is it easy to recruit long-term assistants. As a result, I am coming into...

Conflict over clause 473 rages.
February 5, 2004... GPs ARE receiving conflicting advice on whether to sign the new GMS contract, as the profession's leaders try to get a controversial clause scrapped. GP negotiators are trying to drop or change clause 473, which makes GPs liable for PCOs' costs...

Contract countdown.
February 5, 2004... Each week, we ask GPs how they are preparing for the new contract. This week, we talk to Dr Mayur Lakhani, the RCGP's director of quality and a partner practising with two salaried GPs in a semi-rural PMS surgery near Loughborough What...

Democracy; needs GPs; to take part.
February 5, 2004... Awhile back, England's North-east was pushing to get its own regional assembly. Well, if the shenanigans going on in Sunderland are anything to go by, it's a good thing this never happened. Maybe it is only that city's PCT, but there are...

Exclusions must be the exception.
February 5, 2004... Too much exception reporting and you risk PCO scrutiny Why should an exceptional practice be investigated by its PCO? The answer is when it exception-reports all its patients. One of the main strengths of the new GMS contract's quality and...

Hutton orders; PCOs to pay up.
February 5, 2004... Minister promises more enhanced services cash Christina Golding EXCLUSIVE HEALTH MINISTER John Hutton has waded into the enhanced services row, warning PCOs against taking advantage of GPs, and announcing more money. Mr Hutton this...

PMS exodus predicted if PCOs try to drive cut-rate deals for services.
February 5, 2004... Christina Golding PMS GPs could flood back to GMS because PCOs will try to force them into bargain-rate deals for services, say GP leaders. As negotiations for enhanced services get under way, GP leaders say it is becoming clear that...

Pointing the way on quality street.
February 5, 2004... I am getting into this 'Points Make Prizes' thing by treating it as one of those tasks that the DoH sets GPs to test our ingenuity, like the [pounds sterling]45 night visit fee. The 1990s night visit scam that ran my Golf GTi relied on the fact...

The 10 heart failure; commandments.
February 5, 2004... By Prof Martin R. Cowie, Professor of Cardiology at the National Heart and Lung Institute, Imperial College, and Honorary Consultant Cardiologist at the Royal Brompton Hospital, London 1 Consider a provisional diagnosis of heart...

The wheezy infant.
February 5, 2004... Doctor's regular guide to the presentations and pathologies commonly seen in general practicE - written this week by Dr julian spinks, a GPin strood What do you do? Jamie, a six-month-old boy, is brought in to see his GP...

Switch on to E-records.
February 12, 2004... continuing our series, kathie applebee brings tried and tested solutions to GPs' common organisational headaches The new GMS contract is finally signalling an end to the use of paper medical records in general practice. Now the steady...

Sarcoidosis.
February 12, 2004... Well-written, user-friendly FACTsheets for patients have always been hard to come by. But now Doctor has come to the rescue with its series of leaflets for you to cut out and copy. The fact sheets have been compiled by london GP Dr...

Obesity raises chances of aggressive cancer in men.
February 12, 2004... Obese men are more likely to get aggressive forms of prostate cancer and suffer relapses after surgery than other men, according to two US studies. Researchers suggest that, while further studies are needed, obese men may reduce their risk of...

Take a deep breath and go for peak cash flow.
February 12, 2004... Dr Hilary Pinnock looks at how you can maximise your income by hitting the top rung in the management of COPD The new contract offers 45 points for the quality indicator targets linked to chronic obstructive pulmonary disease, (COPD) out of...

Understanding chronic pain and knowing when to refer.
February 12, 2004... Dr Joan Hester offers advice on referring patients who are suffering from chronic pain Chronic pain affects between seven and 50 per cent of the population - its prevalence increasing with age. The most common cause is arthritis and the...

Training has minimal impact on; GPs' adoption of guidelines.
February 12, 2004... Training sessions to promote guidelines fail to radically alter how GPs manage patients, according to a study. Researchers tested whether an outreach education strategy affected the implementation of RCGP guidelines for acute low-back pain. The...

The power of delayed scrips.
February 12, 2004... This series condenses must-read research for everyday practice and the MRCGP. Dr Rodger Charlton examines the evidence for issuing prescriptions, but encouraging patients to only collect medication if their condition deteriorates It is...

Investing in your practice now will pay dividends later.
February 12, 2004... Gps need to think harder about investing money in their practices under the new contract. Dr andrew Spooner looks at the issues to consider GP practices and partnerships usually see themselves as businesses whose goal it is to maximise...

23 payments for GP practices under some key areas of the new contract.
February 12, 2004... a guide to what GPs can expect to earn in key areas of the new contract 1 Global sum Swallows up 27 current payments. Said to reflect patient need, contractor costs, and worth an average of [pounds sterling]50 per registered patient. Will...

GPs in limbo over premises.
February 12, 2004... GPs TRYING to develop their premises are in limbo because the Government has frozen funding until the new GMS contract is implemented. Practices had to halt development after the Department of Health set a retrospective cut-off date of 30...

Strike love off your list.
February 12, 2004... How many valentines are you expecting in the post this Saturday? And what should you do if you are the subject of amorous advances from a patient? Cathy Comerford finds out Lord Byron said there was 'nothing wrong in a connubial kiss' -...

Primary care trusts must realise.
February 12, 2004... PCOs must lose their bureaucracy and start pooling resources if they are to succeed As 1 April rapidly approaches, practices are becoming increasingly aware of their PCTs' ability to deliver the goods required for the new GMS contract....

Primary care diabetes services preferred by most.
February 12, 2004... GPs and patients both value clinics that provide secondary care diabetes services in a specialist primary care setting, say researchers. A team looked at 19 new clinics run by specialist GPs in Bradford. Researchers questioned clinic staff,...

'We want to do all we can to help primary care and GPs'.
February 12, 2004... With the clock ticking on the new contract, relations between GPs and PCOs are becoming increasingly sour. Last week, Christina Golding quizzed Health Minister John Hutton on IT funding, PCO deficits and GPs feeling torn between getting paid...

Call for Government; to act on public health.
February 12, 2004... ROYAL COLLEGES and the BMA are urging the Govern-ment to act on the public health time-bomb. Last week, Health Secretary John Reid announced a national consultation on tackling obesity, smoking and sexually transmitted infections, which will...

GPs prefer to see scans before deciding osteoporosis treatment.
February 12, 2004... GPs want scan results before prescribing osteoporosis prophylactics, even though guidelines recommend who to treat on clinical grounds, research in the UK suggests. By examining ten surgeries, the authors found GPs were three times more likely...

Reid to seek GPs' input on key health issues.
February 12, 2004... DOCTORS ARE being asked how to tackle key public health matters, such as obesity, smoking and sexually transmitted diseases. Health Secretary John Reid is to hold a public consultation over the next few months on improving the nation's health,...

Diabetes alert over second generation antipsychotics.
February 12, 2004... Check for signs of diabetes in patients taking second- generation antipsychotics, advise US experts. The British National Formu- lary already notes weight gain and hyperglycaemia as potential side-effects. But a review by the American Diabetes...

Screening: 'more harm than good'.
February 12, 2004... Some forms of cancer screening are scientifically unproven and do more harm than good, claims a leading preventive medicine expert. Prof Malcolm Law, of the Wolfson Institute of Preventive Medicine and 'polypill' fame, argues that there is no...

GP leaders warn against doing services for free.
February 12, 2004... Simon Meek and Christina Golding GPC negotiators have warned practices against being 'blackmailed' into doing enhanced services for free. The advice follows revelations in Doctor that many PCOs have done nothing on negotiating enhanced...

GPs with closed lists face ban on services contracts.
February 12, 2004... Christina Golding GPs ARE being told to find ways around closed list rules to avoid PCO bans on giving them enhanced services work. Several PCOs may impose blanket bans on any practice with a closed list, refusing to consider them for...

Pharmacists give ill-informed advice.
February 12, 2004... Steve Ford A survey has underlined GP concerns that pharmacists are not ready to take on extra prescribing roles. Undercover investigators from Which? magazine judged the advice given to them to be unsatisfactory in 35 out of 84 pharmacy...

It's time to fire; the first shots in the PR war.
February 12, 2004... When she finally stopped laughing, Dr Anne Godridge admitted this week to being flattered. The Castleford GP embodies the person British people most trust: a brunette, brown-eyed, bespectacled female GP with a Yorkshire accent. The finding, in...

Taking the call.
February 12, 2004... Follow-up telephone calls may increase compliance with drugs prescribed by a GP, but only in female patients, research findings suggest. Swedish investigators found a phone call one week after a drug was prescribed increased the likelihood a...

GPs call for opiates law; clarification.
February 12, 2004... Steve Ford GPs say that, in the wake of Shipman, regulations on the use of opiate analgesics in general practice must be clarified. Statutory rules on managing controlled drugs (see box) are decades old and the systems for maintaining them...

Scotland's GPs fight on for retainers.
February 12, 2004... Simon Ebbett Scotland's GPs are still fighting for a retainer scheme, more than a year after putting the idea to politicians. The SGPC put a proposal to the Scottish Executive for a programme similar to England's so it could try to plug...

NHS must admit racism - and act.
February 12, 2004... Institutional racism is in the NHS, and we must fight it A report this week slams the NHS for being 'riddled with institutional racism'. The report, stemming from an inquiry into the death of a black patient at a mental health facility,...

Doh denies gloating claim.
February 12, 2004... Simon Meek THE GOVERNMENT has rejected allegations that its negotiating team engineered the new GMS contract to 'bring GPs to heel'. Health Minister John Hutton is writing to all GPs this week to say reports of contract negotiators gloating...

Victory for GPs as 'unfair' clause 473 is scrapped.
February 12, 2004... GPs HAVE won the battle to get a controversial clause in the new contract scrapped. GPC negotiators responded to worries highlighted in Doctor over the last two weeks about clause 473 of the new contract, which made GPs liable for costs...

GPs ready to hand over out-of-hours.
February 12, 2004... GPs IN Somerset and Cumbria will be among the first to give up out-of-hours on 1 April. Three Cumbria PCTs and four Somerset PCTs are developing out-of-hours services that will allow GPs to opt out of out-of-hours eight months before the...

GPs to get global sums this week.
February 12, 2004... Practices have a fortnight to agree their share of [pounds sterling]4.26bn global sum and MPIG funding Christina Golding GPs SHOULD receive their global sum and MPIG estimates by the end of this week and must agree them with PCOs...

You think your deal has delays...
February 12, 2004... EVER SINCE talk arose of a new GP contract, the process has been hit by a series of delays. And now it seems this tardiness bug has spread to secondary care. The BMA reports that every single NHS hospital trust in England has missed the...

. . . as confusion reigns over funding.
February 12, 2004... A LACK of clarity in the contract over funding for enhanced services could leave GPs out of pocket. Doubt over who pays for set-up and treatment costs for some enhanced services is leaving the contract open to interpretation, where PCOs will...

Men don't have the balls for screening.
February 12, 2004... 'Start screening for prostate or testicular cancer, and imagine the tidal waves of castration anxiety' This morning I was consulted by a young man of 40. You might question whether a man of 40 is truly young - I know I did, until I turned...

Tired all the time? Try all these tests.
February 12, 2004... Between you and me, I am completely shagged. Thank God for London's Evening Standard. The occasional copy gets left behind in the waiting room by my commuting patients and today's included the definitive guide to TATT-ness. According to their...

Dissenting doctors; banned by trust had 'absolute right' to ; speak out, says GPCcolleenshannonuk@yahoo.co.uk.
February 19, 2004... Simon Meek A BRANCH of the GPC has joined in the row over Sunderland Teaching PCT, accusing it of 'grossly overreacting' in barring two GPs from its executive committee. Northumberland and Tyne & Wear GPC has written to the chairman of the...

Uncertainty; on pensions; blocks cash; for services.
February 19, 2004... Christina Golding Uncertainty over superannuation payments is having a knock-on effect in delaying enhanced services agreements. GPs may find that 14 per cent of their enhanced services payments will be deducted as an automatic...

OTC not the best option for statins.
February 19, 2004... Steve Ford There are better ways to improve access to statins than those being considered, researchers suggest. There is still debate over the most cost-effective way of using statins for preventing heart disease. The Government is...

GPs brand move; to cut scrip errors; as 'target-mania'.
February 19, 2004... Simon Meek GPs HAVE slammed Government moves to improve prescribing safety, saying they are based on 'target-mania' rather than patient protection. Doctors' leaders say a recent directive to cut medication errors in general practice by 40...

GPs fear heavy impact of EU regulations on scales.
February 19, 2004... Christina Golding NEW EU regulations mean practices could face huge bills to replace supposedly inaccurate weighing equipment. GPs fear the new rules could cost them thousands of pounds if they are forced to replace their current...

GPs fear enhanced services price war.
February 19, 2004... Simon Meek GPs could find themselves in bidding wars for services contracts if PCOs take Government advice and repackage national enhanced services as cheaper local deals. LMCs across the country are battling to keep the price of national...

GPs aim high as most aspire to over 900 points.
February 19, 2004... Doctor reporters GPs ARE cashing in on the quality and outcomes framework, with practices aspiring to more than 900 points on average. A snapshot survey of 40 English PCTs showed that the average practice is aspiring to 924 points for...

Fiscal future is about to get clearer.
February 19, 2004... Christina Golding GPs should be hearing from PCOs in England this week with a complete breakdown of their budgets for the year. Last week, the Department of Health issued a total allocation of [pounds sterling]4.26bn for primary care...