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Asthma alert: be proactive over occupational causes

With the flu season now upon us GPs are faced with conflicting guidance over vaccination of asthma patients. The new GMS contract insists everyone with asthma should get the vaccine, but updated Government advice is to

vaccinate only those with 'moderate to severe' disease. GPs face a stark choice between chasing contract points or adhering to Government-defined best practice. With the contract reaching its six-month point this week and no review planned until 2006, such conflicts look likely to become an unfortunate feature of GPs' lives.

LMCs, however, have suggested a third way, arguing GPs could exception report themselves around areas of conflict. Sadly, the GPC is having none of it, insisting a contradiction in guidance is no grounds to trigger the exception reporting system. So inflexibility on the part of the contract ­ and a complete lack of guidance over when it is appropriate to exception report ­ is leaving GPs in an impossible position once again.

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