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New contract 'is distracting GPs from gastroenterology'

The British Society of Gastroenterology annual meeting heard gastroenterology markers were notably absent from the new GP contract ­ Rob Finch reports

The new GMS contract fails to address the entire specialty of GP gastroenterology and risks 'distracting' GPs from this important area of care, according to the president of the Primary Care Gastroenterology Society.

Professor Roger Jones said that gastroenterology markers were notably absent from the contract. 'It's full of other targets,' he said.

Speaking at the British Society of Gastroenterology annual meeting in Glasgow last week, Professor Jones was presenting results from a survey of 1,790 GPs' implementation of key gastroenterology guidelines (see right).

The researchers had a response rate of 24 per cent to their questionnaire-based survey ­ 'spectacularly low compared with other GP surveys', according to Professor Jones.

'Perhaps GPs perceive gastrointestinal problems as easy to deal with ­ or is it that the demands of the new contact targets have distracted GPs from gastroenterology?' he asked.

But Professor Jones stress-ed that while gastroenterology made up around 10 per cent of GPs' workload, there was a further 90 per cent of work that may have more life-threatening implications.

'Clinical priorities do come into it and I wouldn't be surprised if people are more clued up on the guidelines for heart disease for instance.'

Professor Jones, professor of primary care at Guy's, King's and St Thomas's Medical School, said the survey showed there was a reasonable awareness of gastrointestinal guidelines among GPs.

About three-quarters of GPs used guidelines and peer-reviewed articles for information on practice, while a third said they took advice from pharmaceutical representativ-es, the survey showed.

How good is GPs' gastroenterology care?

 · Approximately 85 per cent of GPs used 'test and treat' or empirical proton pump inhibitor treatment in dyspepsia as recommended by NICE

 · Approximately 80 per cent of GPs used appropriate regimes for H. pylori eradication

 · 88 per cent of GPs recognised the difference between 'step-up' and 'step-down' therapy in gastro-oesophageal reflux disease, with 66 per cent using 'step-up'

 · 82 per cent of GPs are not familiar with the Rome criteria or the Manning

criteria for diagnosing irritable bowel syndrome

 · 88 per cent of GPs recognised a psychological element to IBS

 · 26 per cent of practices had guidelines on rectal bleeding

 · Approximately 90 per cent of GPs would do abdominal and rectal examinations of patients with rectal bleeding under 50 years of age without alarm symptoms and around 50 per cent would do blood tests

 · 92 per cent of GPs would refer a patient with rectal bleeding over 50 years old with alarm symptoms

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