PulseToday - news and resources for GPs

Probe into possible link between swine flu vaccine and narcolepsy

Thu, 02 Sep 2010 08:15:00 GMT

The European Medicines Agency (EMEA) is investigating a possible link between the swine flu vaccine Pandemrix and cases of narcolepsy.

High heart rate a cardiovascular risk factor in heart failure patients

Thu, 02 Sep 2010 08:00:00 GMT

Researchers have shown for the first time that heart failure patients with a high resting heart rate are at higher risk of admission to hospital and death from cardiovascular causes.

GPs may have to inherit some PCT debts, Buckman warns

Wed, 01 Sep 2010 08:45:00 GMT

Exclusive: GP consortia may have to accept taking on some PCT debts when they assume full commissioning power, but they should not be forced to prop up expensive Darzi centre and PFI contracts, GPC chair Dr Laurence Buckman said this week.

Burnham launches bid to block GP commissioning plans

Wed, 01 Sep 2010 08:30:00 GMT

Shadow health secretary Andy Burnham today launched what he has billed as the ‘mother of all battles’ to stop the NHS reforms outlined in the coalition Government's health white paper, claiming they will fatally 'compromise' the role of GPs.

Practice size 'makes no difference' to QOF achievement

Wed, 01 Sep 2010 08:15:00 GMT

The quality of care provided in small and single-handed practices is comparable to that provided by larger practices, an analysis by primary care researchers has shown.

Telemonitoring improves outcomes in heart failure patients

Wed, 01 Sep 2010 08:00:00 GMT

Access to care via telephone or digital, wireless or Bluetooth telemonitoring technology reduces mortality and hospitalisation rates for patients with chronic heart failure, according to a gold-standard systematic review by Australian researchers.

111 number to replace NHS Direct

Tue, 31 Aug 2010 09:39:00 GMT

The Government has said it will close down the controversial NHS Direct telephone service in England, replacing it with a new 111 number to be rolled out across the country.

GP referrals on the rise again, DH figures show

Tue, 31 Aug 2010 08:50:00 GMT

GP referrals to secondary care appear to be accelerating again, with the latest figures from the Department of Health showing a 6% year-on-year rise in the first quarter of 2010/11.

Migraine 'increases risk of mortality'

Tue, 31 Aug 2010 08:40:00 GMT

Migraines with auras increase overall as well as cardiovascular mortality rates, according to Icelandic researchers.

GP vacancies up as locums report 'unprecedented demand'

Tue, 31 Aug 2010 08:30:00 GMT

Practices are finding it increasingly hard to fill GP vacancies, according to new figures from the NHS Information Centre, in the latest sign of recovery for the GP jobs market.

NHS managers to go head-to-head with private sector to provide GP commissioning support

Fri, 27 Aug 2010 09:00:00 GMT

NHS bosses are preparing to pitch themselves into competition with the private sector to offer support to GP commissioning consortia by re-inventing themselves as social enterprises, in moves backed by GP leaders.

Inquiry calls for new measures to deter GPs from prescribing drugs for minor illnesses

Fri, 27 Aug 2010 08:50:00 GMT

GPs should be measured on their ability to prescribe ‘alternatives’ to antibiotics and painkillers when managing acute illnesses in primary care, according to a report commissioned by the King’s Fund.

BNP test required for suspected heart failure diagnosis

Fri, 27 Aug 2010 08:40:00 GMT

NICE has toughened up its guidance on the diagnosis of heart failure, requiring GPs to carry out a B-type natriuretic peptide test in patients with suspected heart failure.

RCGP move to temporary premises

Fri, 27 Aug 2010 08:30:00 GMT

The RCGP has temporarily relocated to new London headquarters whilst awaiting a permanent move to a brand new state-of-the-art facility.

QOF experts advise some thresholds 'should be raised to 100%'

Thu, 26 Aug 2010 09:44:00 GMT

The QOF has had a measurable impact on mortality, but it should be revamped to more effectively incentivise GPs to improve the nation's health, argue an influential group of primary care researchers.

Decisions on end-of-life care 'heavily influenced by GPs' religious beliefs'

Thu, 26 Aug 2010 08:59:00 GMT

GPs who are ‘very or extremely non-religious’ are more likely to take ethically controversial decisions when providing end-of-life care for patients, according to a study by UK researchers.

Aspirin advised for pregnant women at risk of pre-eclampsia

Thu, 26 Aug 2010 07:40:00 GMT

GPs should advise pregnant women at risk of developing high blood pressure to take a daily dose of aspirin, says new NICE guidance.

Record rise in NHS complaints

Wed, 25 Aug 2010 16:06:00 GMT

The rise in patient complaints last year is the highest in 12 years, official figures confirm, but the increase in those complaining about GPs has slowed.

Official figures show rapid rise in STI infections

Wed, 25 Aug 2010 15:30:00 GMT

New Government figures released today show a continued rise in sexually transmitted infections in the UK, particularly amongst young females.

GPC to push for optional commissioning DES to avoid GP contract rewrite

Wed, 25 Aug 2010 08:41:00 GMT

Exclusive: GP negotiators will resist the Government's attempts to make commissioning responsibility part of the core GP contract, and will instead push for it to be offered as an optional enhanced service, Pulse has learned.

GPs face fight for control of new 111 service

Thu, 02 Sep 2010 17:00:00 GMT

GP commissioning groups are set to be plunged into battle with ambulance trusts and a skeleton NHS Direct service for control of the new 111 urgent care number.

GPs left facing funding shortfall as extra investment in enhanced services fails to materialise

Thu, 02 Sep 2010 08:45:00 GMT

Exclusive: Fewer than half of PCTs have increased their investment in enhanced services this year, despite repeated Government assurances that GPs would be able to offset successive pay freezes with extra investment.

GP researchers draw up cancer 'red flags' hit-list

Thu, 02 Sep 2010 08:30:00 GMT

UK primary care researchers have identified a hit-list of signs and symptoms indicative of at least a one in twenty chance of cancer which they say should be built into practice software systems.

The tax implications of taking on private work

Wed, 25 Aug 2010 12:36:00 GMT

Business advisors Gill Salmons and Mark Collins consider some of the pitfalls for GPs who take on private or locum work

Go big or start small?

Wed, 25 Aug 2010 12:29:00 GMT

Two GPs who run successful private services alongside their NHS work describe their very different approaches to starting up.

The first steps in developing a private medical service

Wed, 25 Aug 2010 12:27:00 GMT

Dr Paul Charlson, a GP in East Yorkshire, on how taking on private work could be an ideal way to bolster failing practice income.

QOF coding tips: psychosis and depression

Mon, 23 Aug 2010 16:56:00 GMT

Dr Simon Clay continues his series of articles on QOF coding by looking at why some patients are still required to have a mental health review long after they have recovered.

Google map of commissioning talks

Sun, 22 Aug 2010 23:54:00 GMT

Is your area leading edge or Luddite? Find out how meetings on GPs taking on commissioning are progressing across the country.

Practice dilemma: Police drugs enquiry

Fri, 20 Aug 2010 08:54:00 GMT

Your patient has been arrested by police but claims the drugs in her possession were prescribed by a GP in your practice. They call for confirmation of this. What should you do? Our legal expert advises.

In the eye of the storm

Mon, 16 Aug 2010 15:51:00 GMT

GP Dr John Howarth describes how he faced the unthinkable – coordinating the response after a compete wipeout of health services in his area.

Google map of the cost of practice-based commissioning

Wed, 11 Aug 2010 01:00:00 GMT

Find out the cost and the money saved in your area by practice-based commissioning schemes.

Getting the best out of your practice manager

Tue, 10 Aug 2010 08:46:00 GMT

Practice managers can help practices thrive and expand if they are given enough freedom, says Dr David Clarke

Giving your practice an access overhaul

Mon, 09 Aug 2010 08:09:00 GMT

Balancing the capacity of your practice with patients’ demands need not be a Monty Python sketch, says Dr Greg Simons

QOF coding tips: smoking status

Wed, 04 Aug 2010 09:28:00 GMT

Dr Simon Clay continues his series of articles on navigating the absurdities of QOF coding with advice on how to record smoking status and when it is best not to ask.

Picture quiz - contact dermatitis

Mon, 23 Aug 2010 15:27:00 GMT

Look at these six cases of contact dermatitis, read the short case histories and guess the allergen.

Picture quiz - purpura

Fri, 20 Aug 2010 14:23:00 GMT

Purpural rashes involve a wide differential diagnosis. Make a diagnosis from each photograph and case history.

Fever and neck pain in a university student

Thu, 19 Aug 2010 09:00:00 GMT

The third in our new series which takes you through a detailed case history, describing the key principles of care before offering a take home message.

A 68-year-old woman with severe myalgia

Wed, 18 Aug 2010 09:36:00 GMT

Our new series takes you through presentation, examination, investigation, diagnosis and treatment of a patient- describing the key principles of care before offering a take home message.

Picture quiz - yellow skin lesions

Tue, 17 Aug 2010 15:36:00 GMT

What’s causing the yellowish hue in the skin in each of these patients?

Picture quiz - acute referrals to ophthalmology

Tue, 17 Aug 2010 14:13:00 GMT

Ophthalmologists Dr Hannah Timlin and Dr Abha Gupta present three common conditions referred by GPs to the emergency eye clinic. Study the case histories and the pictures and answer the questions.

Clinical quiz - haematology

Tue, 17 Aug 2010 14:00:00 GMT

Are these statements on four haematological conditions true or false?

Top tips on managing lower urinary tract symptoms (LUTS) in men

Fri, 13 Aug 2010 10:54:00 GMT

In May this year NICE published new guidance on LUTS. Urology GPSI Dr Jonathan Rees was on the guideline development group and offers a guide to the changes

Clinical curios: Juvenile spring eruption

Fri, 13 Aug 2010 10:34:00 GMT

Dr Keith Hopcroft continues our series of fascinating but often unrecognised conditions

Clinical curios: Chondrodermatitis nodularis

Fri, 13 Aug 2010 10:29:00 GMT

Dr Keith Hopcroft continues our series of fascinating but often unrecognised conditions

Ten tips on managing chronic headache

Fri, 13 Aug 2010 10:07:00 GMT

Headache specialist Dr Andy Dowson provides hints on managing headache and identifying which patients to refer.

What are the sore, red lesions on this woman's legs?

Fri, 13 Aug 2010 09:45:00 GMT

This woman thought her lsions were insect bites. Dr Keith Hopcroft describes how a seemingly unrelated symptom led him to the right diagnosis

Halitosis

Thu, 12 Aug 2010 23:00:00 GMT

Oral and maxillofacial surgeon Mr Gary Cousin helps GPs get to the bottom of this symptom

What's causing the swelling on this woman's neck?

Tue, 10 Aug 2010 23:00:00 GMT

This 64 year old woman mentioned her neck as the second thing she was worried about. Dr Keith Hopcroft describes how he found out it should really have been the first.

What’s the take home? A 32-year-old woman with ocular symptoms

Thu, 05 Aug 2010 16:32:00 GMT

Our new series takes you through presentation, examination, investigation, diagnosis and treatment of a patient- describing the key principles of care before offering a take home message.

Pseudo-arguments, strawmen and smoke-screens

Thu, 02 Sep 2010 14:33:00 GMT

Professor Edzard Ernst challenges his critics to show him the evidence

A new QOF indicator, you say? How about this...

Wed, 01 Sep 2010 17:23:00 GMT

Copperfield offers NICE his brainwave for a new QOF indicator: 'Retrospective analysis of medication compliance in newly dead patients'

The BMA is walking a tightrope over GP commissioning plans

Wed, 01 Sep 2010 09:02:00 GMT

Critics of health secretary Andrew Lansley’s plans are gaining in strength, but doctors’ leaders are only beginning to decide which way to jump, says Pulse editor Richard Hoey

Now and at the hour of our death

Tue, 31 Aug 2010 13:17:00 GMT

A dying patient in a nursing home receives a visit from two very different GPs, in the latest 'Through the K hole'

A plethora of partialists

Tue, 31 Aug 2010 09:37:00 GMT

Jobbing Doctor mourns the demise of the General Physician

The fortune teller

Fri, 27 Aug 2010 09:23:00 GMT

Incense, Romanian rhythms and a powerful crystal ball in the latest 'Through the K hole'

Advice to die for

Thu, 26 Aug 2010 12:40:00 GMT

How much harm is caused by incompetent advice in complementary and alternative medicine, asks Professor Edzard Ernst

NHS Direct and the great macramé doily initative

Wed, 25 Aug 2010 10:47:00 GMT

Wii Fit, Jeremy Kyle and making macramé doilies to sell on eBay: the distractions for a home-working nurse adviser will be many, warns Copperfield

The biggest challenge in the white paper

Tue, 24 Aug 2010 15:55:00 GMT

In his latest note from the dark side, Dr Paul Zollinger-Read explores the minefield of GP relationships with local authorities – can these ever be navigated safely?

I don't give a damn what NICE say

Mon, 23 Aug 2010 16:01:00 GMT

Jobbing Doctor looks at good reasons for referring onto specialist care, and when you needn't.

Why 'whole person' medicine is best

Mon, 23 Aug 2010 09:14:00 GMT

The term 'integrative medicine' may elicit sceptical reactions from some, but it is something that many GPs are already practising, says Dr Karine Nohr.

Don't panic! It's the Hitchhiker's Guide to GP commissioning

Fri, 20 Aug 2010 08:16:00 GMT

A management allowance of £9 a patient? It could be the answer, says Pulse editor Richard Hoey… but what exactly is the question?

The best-laid plans of mice and men

Wed, 18 Aug 2010 16:50:00 GMT

Strip-lighting illuminates an anonymous laboratory, in the latest 'Through the K hole'

Traditional herbalism: no good evidence that it works

Wed, 18 Aug 2010 14:50:00 GMT

The evidence for treating patients with an individualised mixture of several plant extracts is patchy at best, says Professor Edzard Ernst

Hold the schadenfreude - the first Darzi centre closure could be bad news for ordinary GPs

Wed, 18 Aug 2010 08:00:00 GMT

If the first closure of a Darzi centre goes ahead, many GPs will celebrate, writes PulseToday editor Steve Nowottny. But there may be a catch…

Pain, but no gain?

Tue, 17 Aug 2010 08:37:00 GMT

In another note from the dark side, Dr Paul Zollinger-Read looks at PCT methods to reduce GP referrals.

Why I am still on-call

Mon, 16 Aug 2010 07:30:00 GMT

Most GPs were relieved to get rid of the responsibility for 24-hour care, but there are still some patients who need the Jobbing Doctor's mobile number

Make-your-mind-up time on GP commissioning

Fri, 13 Aug 2010 10:29:00 GMT

Wrangling among GP groups reflects the wider uncertainty in the profession. But it is the GPC’s response which will be critical, writes PulseToday editor Steve Nowottny

Garlic: a success story in herbal medicine

Thu, 12 Aug 2010 12:43:00 GMT

Professor Edzard Ernst looks at the history and research surrounding garlic's medicinal benefits

Good riddance to revalidation

Thu, 12 Aug 2010 08:41:00 GMT

Pulling the funding for the appraisal toolkit will mean a lot of cutting and pasting for GPs, says Copperfield. But while we're talking about cutting...

A 74 year old man with acute onset visual symptoms

Thu, 02 Sep 2010 10:48:00 GMT

The fourth in our new series- taking you through a detailed case history and describing the key principles of care before offering a take home message.

What is the lump on this young girl's neck?

Thu, 02 Sep 2010 10:39:00 GMT

This swelling had been present for months but had grown after a recent URTI. Dr Keith Hopcroft describes how he came to the right diagnosis.

Picture quiz - acute referrals to ophthalmology

Mon, 16 Aug 2010 16:12:00 GMT

Ophthalmologists Dr Hannah Timlin and Dr Abha Gupta present three common conditions referred by GPs to the emergency eye clinic. Study the case histories and the pictures and answer the questions.

What's new in women's health (1.5 CPD hours)

Sun, 15 Aug 2010 23:00:00 GMT

GP and women’s health researcher Dr Sally Hope rounds up recent developments in our monthly CPD series

Key learning points - ophthalmology

Thu, 12 Aug 2010 10:44:00 GMT

Click...

Ophthalmology referral dilemmas

Thu, 12 Aug 2010 09:10:00 GMT

Consultant ophthalmologist Mr Hunter Maclean describes nine presentations and how best to refer them

Ten top tips on managing red eye

Thu, 12 Aug 2010 09:03:00 GMT

Ophthalmology GPSI Dr Anup Shah on identifying the serious causes

Lesions of the eyelid

Thu, 12 Aug 2010 08:55:00 GMT

Dr Abha Gupta gives an update on diagnosing and treating the most common lid lesions presenting in primary care

Rational management of opticians' letters

Thu, 12 Aug 2010 08:33:00 GMT

Consultant ophthalmologist Dr Nick Jacobs explains how to translate an optician’s recommendation for assessment into an effective referral

Key questions on ocular disorders (1.5 CPD hours)

Thu, 12 Aug 2010 08:19:00 GMT

Consultants at Moorfields Eye Hospital in London answer GP Dr Liz Bowen’s questions on cataracts, ocular antibiotics and laser treatments

The BMA's 'historic mistake' on the White Paper

Mon, 09 Aug 2010 13:55:00 GMT

Read an open letter from the anti-privatisation campaign group London Health Emergency to BMA chair Dr Hamish Meldrum

The health White Paper: FAQs

Wed, 04 Aug 2010 13:59:00 GMT

Pulse news editor Ian Quinn provides a bluffer's guide to the health White Paper and the future of GP commissioning

NHS offering 'golden goodbyes', a beer glass that can prevent a hangover and why smiling babies may not be happy babies

Wed, 01 Sep 2010 23:00:00 GMT

Our roundup of the health news headlines on Thursday 2 September.

Osteopathy techniques: Thoracic spine

Wed, 01 Sep 2010 23:00:00 GMT

In the second video in our series on osteopathy techniques, Dr David Soodeen demonstrates some basic techniques for patients with problems with their thoracic vertebrae.

Dr Laurence Buckman: 'The policy will not get off the ground if debts are not sorted out'

Tue, 31 Aug 2010 23:00:00 GMT

Watch GPC chair Dr Laurence Buckman explain why GPs may have to inherit some PCT debts, but should not be forced to prop up expensive Darzi centre and PFI contracts.

The end of NHS Direct, walking to prevent cancer and can the iPhone replace the stethoscope?

Tue, 31 Aug 2010 09:31:00 GMT

Our roundup of the health news headlines on Tuesday 31 August.

Richard Hoey - Editor, Pulse

Fri, 27 Aug 2010 15:06:00 GMT

Richard Hoey is the editor of Pulse, and oversees content both in the magazine and on the website.

Adam Legge - Deputy Editor

Fri, 27 Aug 2010 15:05:00 GMT

Adam Legge is deputy editor of Pulse.

Ian Quinn - News Editor

Fri, 27 Aug 2010 15:04:00 GMT

Ian Quinn is news editor at Pulse, joining in April 2007.

Steve Nowottny – Editor, PulseToday

Fri, 27 Aug 2010 15:03:00 GMT

Steve Nowottny is editor of PulseToday, leads the online team and oversees the day-to-day operation of the website.

Nigel Praities - Deputy Editor, PulseToday

Fri, 27 Aug 2010 15:02:00 GMT

Nigel Praities is deputy editor of PulseToday, helping to oversee the day-to-day operation of the website, and edits the In Practice section.

Lilian Anekwe - Senior reporter

Fri, 27 Aug 2010 15:01:00 GMT

Lilian Anekwe is a senior reporter at Pulse.

Gareth Iacobucci - Reporter

Fri, 27 Aug 2010 15:00:00 GMT

Gareth Iacobucci is a reporter at Pulse.

Black rice bran, bariatric surgery and the baby 'cuddled back to life'

Fri, 27 Aug 2010 09:41:00 GMT

Our roundup of health news headlines on Friday 27 August.

The plight of the uninsured

Thu, 26 Aug 2010 10:15:00 GMT

Despite political progress on healthcare reform, business is booming at clinics catering to America's uninsured, writes Dr Patrick Neustatter, a former UK GP now working in Fredericksburg, Virginia

Grow your own liver; Pill slows skin cancer and why Florence Cameron is one of the first in an impending ‘baby boom’

Thu, 26 Aug 2010 08:57:00 GMT

Our roundup of health news headlines on Thursday 26 August

Swedes pile on the pounds, exercise 'conquers hunger' and why Mars bars are getting (slightly) better for you

Wed, 25 Aug 2010 09:35:00 GMT

Our roundup of health news headlines on Wednesday 25 August.

Interactive timeline: 100 days that rocked the NHS

Wed, 25 Aug 2010 07:02:00 GMT

View our interactive timeline charting the key changes to health policy in the first hundred days of the new coalition Government.

Cancer concerns, junkie jargon and why greedy friends and a glass of water aids dieting

Tue, 24 Aug 2010 09:24:00 GMT

Our roundup of health news headlines on Tuesday 24 August.

Osteopathy techniques: Lumbar spine

Mon, 23 Aug 2010 07:04:00 GMT

Dr David Soodeen, a GP in Bristol and a qualified osteopath, demonstrates some basic techniques for patients with lower back pain.

Osteopathy techniques: An introduction

Sun, 22 Aug 2010 23:09:00 GMT

GP osteopath Dr David Soodeen introduces our new series of clinical skills videos looking at how to treat patients with various musculoskeletal conditions.

Boil them, mash them, stick them in a stew - potatoes the new superfood?

Sun, 22 Aug 2010 23:00:00 GMT

Our roundup of health news headlines on Monday 23 August.

New to commissioning? Read our quick guide

Tue, 31 Aug 2010 14:10:00 GMT

Read our quick guide to get up to speed on how commissioning works

How our gynae service connects with Asian women

Sun, 22 Aug 2010 16:03:00 GMT

Dr Uma Marthi explains how an all-female staffed primary care gynaecology service is attracting many Asian patients and deflecting hundreds of others from hospital referral

Texting teens to improve sexual health

Sun, 22 Aug 2010 15:04:00 GMT

Dr Marcus Bicknell explains how a mobile phone texting service is allowing teenagers to overcome their embarrassment and seek help for sexual health problems

GP commissioning for hard-to-reach groups

Sun, 22 Aug 2010 14:34:00 GMT

Alisdair Stirling asked our panel of GP commissioning experts what GP-led commissioning is doing for hard-to-reach groups and what impact the new coalition Government’s plans will have

Engaging with hard-to-reach groups

Sun, 22 Aug 2010 13:27:00 GMT

Commissioning consultant Scott McKenzie gives an overview of how GP commissioning is set to enhance engagement with hard-to-reach groups

Five big questions about the white paper

Sun, 22 Aug 2010 12:33:00 GMT

Alisdair Stirling looks at key outstanding questions posed by the landmark white paper on the future of the NHS

Consortium view: Dr Robert White

Sun, 22 Aug 2010 12:26:00 GMT

Dr Robert White, reducing admissions lead with Carrick Commissioning Consortium in Cornwall, on the overlap between the clinical and the manageriakl, apathy in primary care and cutting through layers of red tape.

Five minute interview: Professor Sir Mike Richards

Sun, 22 Aug 2010 12:15:00 GMT

In the second of our new series asking the health service ‘tsars’ for their thoughts on GP commissioning, we speak to Professor Sir Mike Richards, national clinical director for cancer

Over 40% of GPs ready now to take on budgets

Sun, 22 Aug 2010 12:04:00 GMT

Some 44% of GPs say they are ready to play a role in managing a commissioning budget, according to a recent survey of some 325 GPs.

White paper highlights the pioneers and the passive

Sun, 22 Aug 2010 11:59:00 GMT

The white paper has engaged the attention of GPs who have chosen until now to ignore commissioning – while pioneers wonder how they will effectively work with such passive practices

GP leaders warn against pressure to merge

Sun, 22 Aug 2010 11:56:00 GMT

Commissioning leaders have warned GP consortiums to resist pressure from PCTs to hurry into mergers with other commissioning groups.

Commissioning development director added to NAPC conference line-up

Sun, 22 Aug 2010 11:38:00 GMT

Dame Barbara Hakin is the latest speaker to be added to the programme for this year’s NAPC conference.

What do you think of the white paper reforms?

Thu, 19 Aug 2010 08:31:00 GMT

Practical Commissioning is conducting a short survey on how the white paper has impacted so far.

GPs to sit on local authorities as councils take on key commmissioning role

Tue, 10 Aug 2010 23:00:00 GMT

GPs will be forced to work closely alongside local authorities when the new era of GP-led commissioning begins to take place, the Government has revealed.