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Psychotropic medication ... arrangements for monitoring put in place Continue blood monitoring for antipsychotics but consider increasing the interval of testing This information is sourced�from the�RCGP: The RCGP Guidance on workload prioritisation during COVID-19 recommends: Continue blood monitoring for lower risk medications and conditions such as antipsychotics if time/ resources allow This is regardless of the prevalence of ... Date: 19-04-2020 Categories:
Covid vaccine resources for patients A list of resources including where to find providers of private covid tests and how the check vaccination status This information is sourced from PHE, RCOG, British Fertility Society and ARCS. Se ... Date: 02-07-2021 Categories:
GPs missing uptake targets as first phase of swine flu vaccination draws to a close ... iss out on the Department of Health's offer to grant a 10 per cent drop in the upper and 20 per cent drop in the lower thresholds of PE7 and PE8 in the Ipsos MORI survey. With GPs having faced a huge workload to try to hit the target - many reporting a major impact on routine work - it seems likely the vaccination campaign will dent still further practice income based on the Government's access drive, whi ... Date: 05-01-2010 Categories: • Infectious diseases, immunology and allergy
It's a new year - but Pulse is 50 years' old ... hat they were agitating to speed up that process by quitting the NHS altogether.Some of the preoccupations back then were rather familiar. Fiendishly complicated contractual negotiations over pay and workload, and a raging argument over whether general practice should become a fully salaried profession, both featured on the pages of Pulse back then.Others though were rather different. I won't spoil the su ... Date: 08-01-2010 Categories:
MPs back minimum pricing of alcohol ... prices based on the percentage of alcohol in drinks and restrictions on the advertising of alcohol as ways of making the public drink less.The report also says alcohol misuse had a �big effect' on GP workload and called for the detection and provision of brief interventions on alcohol misuse to be included in QOF and a 'stepped programme of care' for those with alcohol addiction problems.Calls from the BM ... Date: 08-01-2010 Categories: • Mental health, pain and addiction
SHAs stamp on swine flu vaccination deals ... ual arrangements with GPs on vaccination or find alternative providers, following the following the collapse of national talks with the GPC.But trusts who have attempted to take into account the huge workload involved by offering concessions on access have been overruled by SHAs, which have in many cases enforced regional deals uncannily similar to the one the GPC rejected.The GPC claims SHA managers, egg ... Date: 11-01-2010 Categories: • Infectious diseases, immunology and allergy
Patient survey deals GPs double pay blow ... lose about �46m in total from the patient survey in 2010, compared with �35m last year.Dr Sarah Wright, a GP in Birmingham, one of the UK's biggest swine flu hotspots last summer, said the increased workload had almost certainly hit access to her practice. �It was inevitable it would have some impact. It is unfair to be financially penalised when we've been trying our best to accommodate the increased wo ... Date: 12-01-2010 Categories: • Infectious diseases, immunology and allergy • Practice and personal finance
Vascular risk assessments costing up to �700 a patient ... ,000 screens have been performed in a year in practices under a LES, said: �Overall it's good preventive medicine. But it is quite work-intensive and some practices are struggling to keep up with the workload.'Google map of vascular screening in your areaVascular screening is costing about twice as much as expected Costs per screen HIGHEST TRUSTS1. NHS Hampshire � �7202. NHS Richmond � �6473. NHS Peterbor ... Date: 13-01-2010 Categories: • Diabetes and endocrinology
Pulse magazine - 13 November 1965 The 'moment of truth' arrives for GPs, as the profession decides whether to back the Red Book deal.GPs were in open rebellion. Many threatened to quit the NHS altogether as rising workload and a failure to hold pay in line with other top professions left GPs disenchanted with the still relatively new health service. But November 1965 was a turning point, as the profession voted by a st ... Date: 13-01-2010 Categories:
Lord Darzi seeks deal closures as hospitals and appointment times face the axe By Ian QuinnIn the week NHS managers credited Lord Darzi as the inspiration behind cutbacks which will see hospital closures, the dumping of a huge extra workload on GPs and appointment times set to be slashed by a third, where was the man himself?Probably just as well, judging by the strength of opposition expressed by GPs to the plans by NHS London, Lord Dar ... Date: 25-01-2010 Categories:
GPs prepare legal challenges over PMS contract reviews ... e completed reviews with another 13 embarking on them.Three trusts, NHS Wakefield, NHS Knowsley and NHS Lewisham, have acted on DH advice to offer new PMS contracts to GMS practices, but with tougher workload targets.Laurence Slavin, an accountant at Ramsay Brown and Partners, said: �The contracts practices are being asked to sign are heavily biased in favour of the PCT.'But Dr Tony Bentley, a GMS GP in L ... Date: 26-01-2010 Categories: • Contract • Politics • Practice and personal finance
Will paediatric GPSIs fragment the care of families? ... n's centres and networks of polyclinics are implemented.The GP, together with the health visitor, has been the mainstay of care for families for decades. Children make up a significant part of the GP workload, with around a quarter of all under-18s attending their GP each year. But under the Heathcare for London proposals, the care of young people will be carried out by a new breed of community paediatric ... Date: 27-01-2010 Categories:
All hospital patients to be assessed for VTE prophylaxis ... heir GP should be notified.A spokesperson for NICE said: 'It is certainly true to expect that GPs will receive more information on the prophylaxis that their patients would be discharged with but the workload increase is really at the hospital side.'The spokesperson dispelled GPs' fears that they would have to assess patients' VTE risk prior to a scheduled hospital visit, saying: 'The hospital staff shoul ... Date: 28-01-2010 Categories:
GP funding now less than before nGMS ... lse investigation, as part of Dr Sam Everington's guest editor issue, showing hospitals were draining money from the primary care budget at the same time as shifting an increasing proportion of their workload onto GPs.Dr Chaand Nagpaul, GPC negotiator and a GP in Stanmore, said: �This reinforces the lamentable reality being felt by GPs on the ground and runs wholly contrary to the Government's stated aim ... Date: 02-02-2010 Categories: • Contract • Practice and personal finance
Open �110bn NHS budget to public scrutiny ... which party wins.Taxpayers have no say in how the hundreds of billions of pounds of NHS budget is spent. Most GPs have already had 10% drops in income in recent years, at the same time as increasing workload, while our political masters are driven only by spin and soundbites. GPs will be squeezed hard on budgets and discredited through the introduction of fundholding by another new name. If only very exp ... Date: 03-02-2010 Categories: • Politics • Practice and personal finance • Regulation
Appointment time cuts are madness General practice is the mainstay of the NHS � and is already working beyond capacity, having taken on a huge workload from secondary care. Chronic kidney disease alone has probably increased my daily workload by 30 minutes. I consistently run 30-60 minutes late because of the incredibly complex problems I am present ... Date: 03-02-2010 Categories: • Practice and personal finance
Enhancing COPD care with a sponsored nurse ... ers are more effective and having fewer side-effects such as sore throats. GPs have valued having a skilled nurse practitioner to work with, and their support has also helped to reduce the practices' workloads.The increased expenditure on medication almost exactly matched the secondary care savings. If the respiratory nurse specialist's salary had not been externally sponsored, the enhanced care would hav ... Date: 07-02-2010 Categories: • NHS structures
Payment by Results (PbR) ... rs relied on block contracts for commissioning purposes. But this produced a perverse system where the more work a hospital had to do the more money it received so there was little incentive to bring workload, particularly waiting lists, down. Under the new PbR system, hospitals are reimbursed for the activity they carry out using a tariff of fixed prices that reflect national average costs. Trusts are pa ... Date: 08-02-2010 Categories: • NHS structures
How a pharma company pump primed our psoriasis redesign ... urse would have a conversation with the GP. The patient would be referred back to their GP if necessary for onward referral to secondary care.There were initial concerns about a potential increase in workload, so we set up a system where one GP in each practice would deal with any patients who needed more attention. In fact, there were only one or two patients per GP in this category. The project ran for ... Date: 09-02-2010 Categories: • Uncategorised
Swine flu delays 'tragic', MPs told ... it is available, people don't want it. That's a tragic situation.'Dr Dean Marshall, a GPC negotiator on swine flu, said the Government wasted six weeks by failing to reach agreement with the GPs on �workload implications'.Pulse revealed at the start of January that GPs face losses of thousands of pounds by not hitting the target of vaccinating 50.7% of clinically at-risk patients aged 5-65. Swine flu vac ... Date: 09-02-2010 Categories: • Infectious diseases, immunology and allergy • Politics • Power 50
Should GPs commission out-of-hours services? ... esponsibility to PCTs to manage this aspect of patients care. There certainly seemed at the time to be minimal financial disadvantage to practices in doing so, as well as major reductions in risk and workload. But it is now becoming clearer that primary care is much better placed to a more distant PCT to commission and manage these services. The role of PCTs needs to evolve into one where they need to en ... Date: 10-02-2010 Categories: • Debate • Urgent care
In full: Buckman's out-of-hours letter ... al, and GPC in particular, are to blame. Others have also tried to set the record straight, but for completeness I should add my contribution.The new GMS contract was born out of necessity because of workload, recruitment and retention issues. There was universal agreement that something had to be done and the government wanted to break the GP monopoly anyway so it suited them. They also were convinced th ... Date: 11-02-2010 Categories: • Politics • Power 50 • Regulation
Should pharmacists be allowed to switch GP scripts to generics? ... titute might be appropriate, mark a prescription to opt out and record their reasons it will add significantly to administration time. Pressure from PCTs for 28-day prescribing already adds vastly to workload for reception staff, doctors, and dispensers, to say nothing of the inconvenience and time wasting for patients. Pressures by Government for excessive generic prescribing are damaging our pharmaceuti ... Date: 17-02-2010 Categories:
Government scraps swine flu vaccination campaign for under fives ... just 17% of children in England having had the vaccine according to the latest uptake figures.GP leaders blamed protracted negotiations with the Government, which refused to provide concessions on GP workload via a national deal, for the lack of uptake in a campaign which ended up being launched as a hugely patchwork and bitter set of local arrangements between PCTs and GPs.The move to scrap child vaccina ... Date: 22-02-2010 Categories: • Infectious diseases, immunology and allergy
Diabetes work to soar under HbA1c switch ... year, a leading GP diabetes expert told Pulse. But new UK research suggests the switch, under which diabetes would be diagnosed in patients with an HbA1c of 6.5% or higher, could greatly increase GP workload.A study to be presented at the Diabetes UK conference in Liverpool next month compared prevalence of type 2 diabetes as diagnosed by either glucose tolerance testing or HbA1c in 9,500 patients from 2 ... Date: 24-02-2010 Categories: • Diabetes and endocrinology
Pulse magazine - 30 May 1970 Does 32 consultations and eight home visits a day sound fun? This was the typical workload in 1970, which unsurprisingly made general practice unattractive to young doctors.May 1970 was momentous for the profession, as a BMA report called for a 'specialty of primary medicine' to reshape th ... Date: 24-02-2010 Categories:
BMA polysystems rally signals start of protests against 'biggest NHS cutbacks in 20 years' By Ian QuinnGP leaders joined nearly 200 key NHS workers at BMA headquarters last night to rally against a massive shift of hospital workload to primary care polysystems, in a move which could herald large-scale public protests against NHS cuts.Dr Laurence Buckman, GPC chair, took to the stage alongside leading hospital consultants and Kee ... Date: 26-02-2010 Categories: • Practice and personal finance • Premises
GP alarm as NHS managers push for paediatric centres in polyclinics ... ave been developed without consulting local practices.NHS North Central London Strategic Health Authority aims to co-locate children's centres in polyclinics as part of plans to move a huge volume of workload out of hospitals. The authority, including Barnet, Enfield, Haringey, Camden and Islington, has set out plans to �shift of up to 40% of outpatient work to the community settings' and for �consolidat ... Date: 08-03-2010 Categories: • Paediatrics
Shift of work to GPs 'to last a decade' ... ces were taken into GP settings in the coming years, which he said would come to be defined as �the decade of primary care'. It follows controversy over plans to implement a massive shift of hospital workload to primary care polysystems, which prompted GP leaders to join nearly 200 health service workers at BMA headquarters last week to rally against NHS cuts. But Mr Burnham insisted:�There is far more th ... Date: 09-03-2010 Categories: • Politics • Practice and personal finance • Regulation
Trusts break the bank for polysystems managers ... each on managers to advise on their controversial rollout of polysystems, Pulse has learnt.The post of polysystems manager has become one of the most in demand roles in health, with the move to shift workload from hospitals to primary care, with NHS trusts in London spearheading the programme and trusts elsewhere considering similar major shifts in care.Trusts in the capital have been advertising for staf ... Date: 10-03-2010 Categories: • Politics • Practice and personal finance • Premises
BMA demands suspension of Summary Care Record rollout By Ian QuinnThe BMA has called on the Government to halt the controversial Summary Care Record programme, as outrage over the rollout's acceleration and a huge workload for practices spills over into open rebellion.In a strongly-worded letter to health minister Mike O'Brien, BMA chair Dr Hamish Meldrum and GPC chair Dr Laurence Buckman demand that the rollout be imm ... Date: 10-03-2010 Categories: • Politics • Practice and personal finance
Never glad confident morning again ... .'What can I tell the students, doc?' he asks. He can no longer say that pharmacy is a great profession where you can offer a good service to the public and make a respectable living. He looks at his workload and recognises that more and more is around income generation, and persuading people to purchase medicines that are ineffective placebos.I sympathise with him. Things aren't what they used to be, and ... Date: 14-03-2010 Categories:
GP care home support 'cuts deaths and workload' ... fell by 16%, from �2,529 to �2,119.Dr Richard Wong, a consultant geriatrician at the Leicester general hospital who worked on the study, said: �One of the GPs was thinking about moving on because the workload generated by requests for reactive care was becoming insurmountable. But after identifying patients in need of care planning their workload was reduced.'�Practice-based commissioning is a way of peop ... Date: 15-03-2010 Categories: • Elderly care
Government halts fast track Summary Care Record rollout ... rong to speed up the rollout BMA turns on records November 2009�There are still concerns among some GPs about patients having the right information to opt out. There are those who are concerned about workload and about confidentiality but they are not really up to date with the current thinking within the BMA.'Dr Phil Koczan, Clinical Lead for the London Programme for IT, tells Pulse of plans to accelerat ... Date: 15-03-2010 Categories: • Politics • Practice and personal finance • Regulation
1100: Dealing with addiction ... day morning. All of the patients, so far, are chronic cases, and three of the six I have seen so far are drug addicts that are having supervised prescriptions from me.This is a significant part of my workload, and although we have a really good service for drug dependent people, it still spills out into my daily work.Establishing them on a regular prescription and supporting people with addiction problems ... Date: 15-03-2010 Categories:
1740: Managing the care home burden ... e care.In addition to running our own practice, we also look after several local nursing homes. This nursing home PMS Practice began in 2003 as a PCT-led practice and was set up to deal with the huge workload generated by a large nursing home in one of our local villages. Although this PCT-led practice worked well and won several awards, it was not cost-effective and was unable to live within the PMS budg ... Date: 15-03-2010 Categories:
Fifth of appointments wasted on 'worried well', leading GPs warn ... costing the NHS �2 billion annually. The letter declares: 'We are now in a society in which the common disturbances to normal good health, such as coughs and colds, account for nearly one fifth of GP workload.' As many as a fifth of GP consultations are taken up by the 'worried well', senior GPs have warned The letter in full Sir, We are now a society in which the common disturbances to normal good health ... Date: 16-03-2010 Categories: • Politics • Practice and personal finance • Regulation
8 - Dr Ian Bogle ... services by GP fundholders from the providers of NHS trusts. He used his speech at his final LMC conference to launch a vitriolic parting shot at politicians for failing to acknowledge �the very high workload and impossibility of giving patients the sort of care we think they should have'.Dr Ian Bogle Top 50 most influential GPs To view the full list of Pulse's top 50 most influential GPs, put together by ... Date: 16-03-2010 Categories:
2 - Sir Denis Pereira-Gray ... specialised in the core topics that have come to define general practice � continuity of care, generalism and the doctor-patient relationship. He was also a visionary for seeing the current shift in workload from hospitals to the community.What he said �More lives will be saved in future in general practice than in hospitals as the power of family doctors to intervene on behalf of patients increases.'Sir ... Date: 16-03-2010 Categories:
Workforce wimps swamping GPs, schoolchildren facing bleep tests and women 'better at booking GP appointments' ... name but a few, has already whipped up a storm of controversy.�We are now in a society in which common disturbances to normal good health, such as coughs and colds, account for nearly one fifth of GP workload,' says the letter, which the Times claims has the backing of current GPC chair Dr Laurence Buckman, as well as a Who's Who of leading academics.There is something of the boot camp about this and toda ... Date: 16-03-2010 Categories:
The values that have lasted 50 years ... of the NHS, and strong advocates such as the legendary Dr Julian Tudor Hart were critical in maintaining support. The 1980s saw controls over GP prescribing tighten, and the 1990s brought spiralling workload as GPs were landed with a contract rigid in its requirements of them. The controversial 2004 contract, negotiated by Dr John Chisolm, brought tick-box medicine as never before, but allowed GPs to reg ... Date: 17-03-2010 Categories:
Swine flu threat to children 'not taken seriously' ... tead of cash-strapped trusts being left to negotiate with practices over vaccine delivery.This led to many SHAs, including London, clamping down hard on any plans to provide extra flexibility over GP workload to enable better take-up.Pulse revealed how NHS London stamped on agreements with PCTs in Richmond, Kingston and Croydon, which Sussex and Surrey LMCs claimed had agreed to concessions over extended ... Date: 17-03-2010 Categories: • Infectious diseases, immunology and allergy
Download Pulse - 17 March 2010 Read Pulse online as it appeared in the print magazine. In this week's issue: Tories to 'rip up' plans to shift workload to GPs; GP partners set for 5% pay cut; Occasional high BP a risk for strokePlease see below for instructions on downloading a PDF of this week's Pulse magazine. Please note you may need Adobe Reader ... Date: 17-03-2010 Categories:
Tories will �rip up� plans to shift workload to GPs By Ian QuinnExclusive: The Conservatives have told Pulse they would �rip up' plans by PCTs to shift huge volumes of outpatient and A&E care to GPs, claiming primary care is not equipped to cope.The party has ... Date: 17-03-2010 Categories: • Politics
How our third-sector provider goes that extra mile ... from GPs about whether CICSS would work. But since they have seen the benefits, many clinicians have given us great feedback and believe it helps patients. GPs also say the service has reduced their workload because CICSS staff not only visit patients, but also refer when necessary to other agencies.Added valueOne of the key successes of this scheme is flexibility, which goes back to the values of the Br ... Date: 22-03-2010 Categories: • Uncategorised
An elephant in the room ... ributed equitably on a needs basis. The elephant in the room is the link between practice income, services provided and expenses. If I don't replace a practice nurse and community staff pick up the workload, my personal income will go up. Conversely, if my community services budget is reduced because I have a high GMS/PMS share and I have to provide more nursing services, my income will fall. Now, how ... Date: 22-03-2010 Categories: • NHS structures
Minister defends closed doors talks on polysystems By Ian QuinnHealth minister Mike O'Brien has defended the decision to hold the talks on shifting hospital workload to GP polysystems in secret.He told MPs it was necessary not to reveal details of discussions to prevent the clinicians involved from withdrawing from the process.Mr O'Brien, speaking a week after sh ... Date: 23-03-2010 Categories: • Practice and personal finance
GPs could be legally liable for errors in care record ... s � due to be finished by April 2011 � will begin.The GPC has passed a motion �deploring' the way the rollout has been handled. GP leaders have complained that:� practices are reporting a big rise in workload to deal with worried patients, despite assurances it would be �minimal'� guidance on the quality of data expected from GPs is still to be published� ministers have failed to respond to a BMA submissi ... Date: 24-03-2010 Categories: • Power 50
Tories pledge to ramp up private companies' role in NHS ... ver the restructuring of primary care.The declarations mark the latest clear dividing line between the parties on primary care policy, following Conservative pledges to rip up plans to shift hospital workload en masse into GP polysystems and hand GPs commissioning responsibility for out-of-hours care.Last month health secretary Andy Burnham delivered guidance to help NHS managers deliver on his pledge tha ... Date: 06-04-2010 Categories: • Contract • Politics • Practice and personal finance
GPs told to review patients on high-dose simvastatin ... avastatin may be chosen.Dr Alan Begg, a GP in Montrose, Scotland and a member of the SIGN guideline steering group on coronary heart disease, said going back through patients records �would be a huge workload.'�Simvastatin 40mg is the standard that is used across the UK today. Prescribing advisors have gone out of their way to encourage GPs to do that, whereas perhaps a more evidence based approach would ... Date: 13-04-2010 Categories: • Long-term conditions and prescribing

Psychotropic medication ... arrangements for monitoring put in place Continue blood monitoring for antipsychotics but consider increasing the interval of testing This information is sourced�from the�RCGP: The RCGP Guidance on workload prioritisation during COVID-19 recommends: Continue blood monitoring for lower risk medications and conditions such as antipsychotics if time/ resources allow This is regardless of the prevalence of ... Date: 19-04-2020 Categories:

Covid vaccine resources for patients A list of resources including where to find providers of private covid tests and how the check vaccination status This information is sourced from PHE, RCOG, British Fertility Society and ARCS. Se ... Date: 02-07-2021 Categories:

GPs missing uptake targets as first phase of swine flu vaccination draws to a close ... iss out on the Department of Health's offer to grant a 10 per cent drop in the upper and 20 per cent drop in the lower thresholds of PE7 and PE8 in the Ipsos MORI survey. With GPs having faced a huge workload to try to hit the target - many reporting a major impact on routine work - it seems likely the vaccination campaign will dent still further practice income based on the Government's access drive, whi ... Date: 05-01-2010 Categories: • Infectious diseases, immunology and allergy

It's a new year - but Pulse is 50 years' old ... hat they were agitating to speed up that process by quitting the NHS altogether.Some of the preoccupations back then were rather familiar. Fiendishly complicated contractual negotiations over pay and workload, and a raging argument over whether general practice should become a fully salaried profession, both featured on the pages of Pulse back then.Others though were rather different. I won't spoil the su ... Date: 08-01-2010 Categories:

MPs back minimum pricing of alcohol ... prices based on the percentage of alcohol in drinks and restrictions on the advertising of alcohol as ways of making the public drink less.The report also says alcohol misuse had a �big effect' on GP workload and called for the detection and provision of brief interventions on alcohol misuse to be included in QOF and a 'stepped programme of care' for those with alcohol addiction problems.Calls from the BM ... Date: 08-01-2010 Categories: • Mental health, pain and addiction

SHAs stamp on swine flu vaccination deals ... ual arrangements with GPs on vaccination or find alternative providers, following the following the collapse of national talks with the GPC.But trusts who have attempted to take into account the huge workload involved by offering concessions on access have been overruled by SHAs, which have in many cases enforced regional deals uncannily similar to the one the GPC rejected.The GPC claims SHA managers, egg ... Date: 11-01-2010 Categories: • Infectious diseases, immunology and allergy

Patient survey deals GPs double pay blow ... lose about �46m in total from the patient survey in 2010, compared with �35m last year.Dr Sarah Wright, a GP in Birmingham, one of the UK's biggest swine flu hotspots last summer, said the increased workload had almost certainly hit access to her practice. �It was inevitable it would have some impact. It is unfair to be financially penalised when we've been trying our best to accommodate the increased wo ... Date: 12-01-2010 Categories: • Infectious diseases, immunology and allergy • Practice and personal finance

Vascular risk assessments costing up to �700 a patient ... ,000 screens have been performed in a year in practices under a LES, said: �Overall it's good preventive medicine. But it is quite work-intensive and some practices are struggling to keep up with the workload.'Google map of vascular screening in your areaVascular screening is costing about twice as much as expected Costs per screen HIGHEST TRUSTS1. NHS Hampshire � �7202. NHS Richmond � �6473. NHS Peterbor ... Date: 13-01-2010 Categories: • Diabetes and endocrinology

Pulse magazine - 13 November 1965 The 'moment of truth' arrives for GPs, as the profession decides whether to back the Red Book deal.GPs were in open rebellion. Many threatened to quit the NHS altogether as rising workload and a failure to hold pay in line with other top professions left GPs disenchanted with the still relatively new health service. But November 1965 was a turning point, as the profession voted by a st ... Date: 13-01-2010 Categories:

Lord Darzi seeks deal closures as hospitals and appointment times face the axe By Ian QuinnIn the week NHS managers credited Lord Darzi as the inspiration behind cutbacks which will see hospital closures, the dumping of a huge extra workload on GPs and appointment times set to be slashed by a third, where was the man himself?Probably just as well, judging by the strength of opposition expressed by GPs to the plans by NHS London, Lord Dar ... Date: 25-01-2010 Categories:

GPs prepare legal challenges over PMS contract reviews ... e completed reviews with another 13 embarking on them.Three trusts, NHS Wakefield, NHS Knowsley and NHS Lewisham, have acted on DH advice to offer new PMS contracts to GMS practices, but with tougher workload targets.Laurence Slavin, an accountant at Ramsay Brown and Partners, said: �The contracts practices are being asked to sign are heavily biased in favour of the PCT.'But Dr Tony Bentley, a GMS GP in L ... Date: 26-01-2010 Categories: • Contract • Politics • Practice and personal finance

Will paediatric GPSIs fragment the care of families? ... n's centres and networks of polyclinics are implemented.The GP, together with the health visitor, has been the mainstay of care for families for decades. Children make up a significant part of the GP workload, with around a quarter of all under-18s attending their GP each year. But under the Heathcare for London proposals, the care of young people will be carried out by a new breed of community paediatric ... Date: 27-01-2010 Categories:

All hospital patients to be assessed for VTE prophylaxis ... heir GP should be notified.A spokesperson for NICE said: 'It is certainly true to expect that GPs will receive more information on the prophylaxis that their patients would be discharged with but the workload increase is really at the hospital side.'The spokesperson dispelled GPs' fears that they would have to assess patients' VTE risk prior to a scheduled hospital visit, saying: 'The hospital staff shoul ... Date: 28-01-2010 Categories:

GP funding now less than before nGMS ... lse investigation, as part of Dr Sam Everington's guest editor issue, showing hospitals were draining money from the primary care budget at the same time as shifting an increasing proportion of their workload onto GPs.Dr Chaand Nagpaul, GPC negotiator and a GP in Stanmore, said: �This reinforces the lamentable reality being felt by GPs on the ground and runs wholly contrary to the Government's stated aim ... Date: 02-02-2010 Categories: • Contract • Practice and personal finance

Open �110bn NHS budget to public scrutiny ... which party wins.Taxpayers have no say in how the hundreds of billions of pounds of NHS budget is spent. Most GPs have already had 10% drops in income in recent years, at the same time as increasing workload, while our political masters are driven only by spin and soundbites. GPs will be squeezed hard on budgets and discredited through the introduction of fundholding by another new name. If only very exp ... Date: 03-02-2010 Categories: • Politics • Practice and personal finance • Regulation

Appointment time cuts are madness General practice is the mainstay of the NHS � and is already working beyond capacity, having taken on a huge workload from secondary care. Chronic kidney disease alone has probably increased my daily workload by 30 minutes. I consistently run 30-60 minutes late because of the incredibly complex problems I am present ... Date: 03-02-2010 Categories: • Practice and personal finance

Enhancing COPD care with a sponsored nurse ... ers are more effective and having fewer side-effects such as sore throats. GPs have valued having a skilled nurse practitioner to work with, and their support has also helped to reduce the practices' workloads.The increased expenditure on medication almost exactly matched the secondary care savings. If the respiratory nurse specialist's salary had not been externally sponsored, the enhanced care would hav ... Date: 07-02-2010 Categories: • NHS structures

Payment by Results (PbR) ... rs relied on block contracts for commissioning purposes. But this produced a perverse system where the more work a hospital had to do the more money it received so there was little incentive to bring workload, particularly waiting lists, down. Under the new PbR system, hospitals are reimbursed for the activity they carry out using a tariff of fixed prices that reflect national average costs. Trusts are pa ... Date: 08-02-2010 Categories: • NHS structures

How a pharma company pump primed our psoriasis redesign ... urse would have a conversation with the GP. The patient would be referred back to their GP if necessary for onward referral to secondary care.There were initial concerns about a potential increase in workload, so we set up a system where one GP in each practice would deal with any patients who needed more attention. In fact, there were only one or two patients per GP in this category. The project ran for ... Date: 09-02-2010 Categories: • Uncategorised

Swine flu delays 'tragic', MPs told ... it is available, people don't want it. That's a tragic situation.'Dr Dean Marshall, a GPC negotiator on swine flu, said the Government wasted six weeks by failing to reach agreement with the GPs on �workload implications'.Pulse revealed at the start of January that GPs face losses of thousands of pounds by not hitting the target of vaccinating 50.7% of clinically at-risk patients aged 5-65. Swine flu vac ... Date: 09-02-2010 Categories: • Infectious diseases, immunology and allergy • Politics • Power 50

Should GPs commission out-of-hours services? ... esponsibility to PCTs to manage this aspect of patients care. There certainly seemed at the time to be minimal financial disadvantage to practices in doing so, as well as major reductions in risk and workload. But it is now becoming clearer that primary care is much better placed to a more distant PCT to commission and manage these services. The role of PCTs needs to evolve into one where they need to en ... Date: 10-02-2010 Categories: • Debate • Urgent care

In full: Buckman's out-of-hours letter ... al, and GPC in particular, are to blame. Others have also tried to set the record straight, but for completeness I should add my contribution.The new GMS contract was born out of necessity because of workload, recruitment and retention issues. There was universal agreement that something had to be done and the government wanted to break the GP monopoly anyway so it suited them. They also were convinced th ... Date: 11-02-2010 Categories: • Politics • Power 50 • Regulation

Should pharmacists be allowed to switch GP scripts to generics? ... titute might be appropriate, mark a prescription to opt out and record their reasons it will add significantly to administration time. Pressure from PCTs for 28-day prescribing already adds vastly to workload for reception staff, doctors, and dispensers, to say nothing of the inconvenience and time wasting for patients. Pressures by Government for excessive generic prescribing are damaging our pharmaceuti ... Date: 17-02-2010 Categories:

Government scraps swine flu vaccination campaign for under fives ... just 17% of children in England having had the vaccine according to the latest uptake figures.GP leaders blamed protracted negotiations with the Government, which refused to provide concessions on GP workload via a national deal, for the lack of uptake in a campaign which ended up being launched as a hugely patchwork and bitter set of local arrangements between PCTs and GPs.The move to scrap child vaccina ... Date: 22-02-2010 Categories: • Infectious diseases, immunology and allergy

Diabetes work to soar under HbA1c switch ... year, a leading GP diabetes expert told Pulse. But new UK research suggests the switch, under which diabetes would be diagnosed in patients with an HbA1c of 6.5% or higher, could greatly increase GP workload.A study to be presented at the Diabetes UK conference in Liverpool next month compared prevalence of type 2 diabetes as diagnosed by either glucose tolerance testing or HbA1c in 9,500 patients from 2 ... Date: 24-02-2010 Categories: • Diabetes and endocrinology

Pulse magazine - 30 May 1970 Does 32 consultations and eight home visits a day sound fun? This was the typical workload in 1970, which unsurprisingly made general practice unattractive to young doctors.May 1970 was momentous for the profession, as a BMA report called for a 'specialty of primary medicine' to reshape th ... Date: 24-02-2010 Categories:

BMA polysystems rally signals start of protests against 'biggest NHS cutbacks in 20 years' By Ian QuinnGP leaders joined nearly 200 key NHS workers at BMA headquarters last night to rally against a massive shift of hospital workload to primary care polysystems, in a move which could herald large-scale public protests against NHS cuts.Dr Laurence Buckman, GPC chair, took to the stage alongside leading hospital consultants and Kee ... Date: 26-02-2010 Categories: • Practice and personal finance • Premises

GP alarm as NHS managers push for paediatric centres in polyclinics ... ave been developed without consulting local practices.NHS North Central London Strategic Health Authority aims to co-locate children's centres in polyclinics as part of plans to move a huge volume of workload out of hospitals. The authority, including Barnet, Enfield, Haringey, Camden and Islington, has set out plans to �shift of up to 40% of outpatient work to the community settings' and for �consolidat ... Date: 08-03-2010 Categories: • Paediatrics

Shift of work to GPs 'to last a decade' ... ces were taken into GP settings in the coming years, which he said would come to be defined as �the decade of primary care'. It follows controversy over plans to implement a massive shift of hospital workload to primary care polysystems, which prompted GP leaders to join nearly 200 health service workers at BMA headquarters last week to rally against NHS cuts. But Mr Burnham insisted:�There is far more th ... Date: 09-03-2010 Categories: • Politics • Practice and personal finance • Regulation

Trusts break the bank for polysystems managers ... each on managers to advise on their controversial rollout of polysystems, Pulse has learnt.The post of polysystems manager has become one of the most in demand roles in health, with the move to shift workload from hospitals to primary care, with NHS trusts in London spearheading the programme and trusts elsewhere considering similar major shifts in care.Trusts in the capital have been advertising for staf ... Date: 10-03-2010 Categories: • Politics • Practice and personal finance • Premises

BMA demands suspension of Summary Care Record rollout By Ian QuinnThe BMA has called on the Government to halt the controversial Summary Care Record programme, as outrage over the rollout's acceleration and a huge workload for practices spills over into open rebellion.In a strongly-worded letter to health minister Mike O'Brien, BMA chair Dr Hamish Meldrum and GPC chair Dr Laurence Buckman demand that the rollout be imm ... Date: 10-03-2010 Categories: • Politics • Practice and personal finance

Never glad confident morning again ... .'What can I tell the students, doc?' he asks. He can no longer say that pharmacy is a great profession where you can offer a good service to the public and make a respectable living. He looks at his workload and recognises that more and more is around income generation, and persuading people to purchase medicines that are ineffective placebos.I sympathise with him. Things aren't what they used to be, and ... Date: 14-03-2010 Categories:

GP care home support 'cuts deaths and workload' ... fell by 16%, from �2,529 to �2,119.Dr Richard Wong, a consultant geriatrician at the Leicester general hospital who worked on the study, said: �One of the GPs was thinking about moving on because the workload generated by requests for reactive care was becoming insurmountable. But after identifying patients in need of care planning their workload was reduced.'�Practice-based commissioning is a way of peop ... Date: 15-03-2010 Categories: • Elderly care

Government halts fast track Summary Care Record rollout ... rong to speed up the rollout BMA turns on records November 2009�There are still concerns among some GPs about patients having the right information to opt out. There are those who are concerned about workload and about confidentiality but they are not really up to date with the current thinking within the BMA.'Dr Phil Koczan, Clinical Lead for the London Programme for IT, tells Pulse of plans to accelerat ... Date: 15-03-2010 Categories: • Politics • Practice and personal finance • Regulation

1100: Dealing with addiction ... day morning. All of the patients, so far, are chronic cases, and three of the six I have seen so far are drug addicts that are having supervised prescriptions from me.This is a significant part of my workload, and although we have a really good service for drug dependent people, it still spills out into my daily work.Establishing them on a regular prescription and supporting people with addiction problems ... Date: 15-03-2010 Categories:

1740: Managing the care home burden ... e care.In addition to running our own practice, we also look after several local nursing homes. This nursing home PMS Practice began in 2003 as a PCT-led practice and was set up to deal with the huge workload generated by a large nursing home in one of our local villages. Although this PCT-led practice worked well and won several awards, it was not cost-effective and was unable to live within the PMS budg ... Date: 15-03-2010 Categories:

Fifth of appointments wasted on 'worried well', leading GPs warn ... costing the NHS �2 billion annually. The letter declares: 'We are now in a society in which the common disturbances to normal good health, such as coughs and colds, account for nearly one fifth of GP workload.' As many as a fifth of GP consultations are taken up by the 'worried well', senior GPs have warned The letter in full Sir, We are now a society in which the common disturbances to normal good health ... Date: 16-03-2010 Categories: • Politics • Practice and personal finance • Regulation

8 - Dr Ian Bogle ... services by GP fundholders from the providers of NHS trusts. He used his speech at his final LMC conference to launch a vitriolic parting shot at politicians for failing to acknowledge �the very high workload and impossibility of giving patients the sort of care we think they should have'.Dr Ian Bogle Top 50 most influential GPs To view the full list of Pulse's top 50 most influential GPs, put together by ... Date: 16-03-2010 Categories:

2 - Sir Denis Pereira-Gray ... specialised in the core topics that have come to define general practice � continuity of care, generalism and the doctor-patient relationship. He was also a visionary for seeing the current shift in workload from hospitals to the community.What he said �More lives will be saved in future in general practice than in hospitals as the power of family doctors to intervene on behalf of patients increases.'Sir ... Date: 16-03-2010 Categories:

Workforce wimps swamping GPs, schoolchildren facing bleep tests and women 'better at booking GP appointments' ... name but a few, has already whipped up a storm of controversy.�We are now in a society in which common disturbances to normal good health, such as coughs and colds, account for nearly one fifth of GP workload,' says the letter, which the Times claims has the backing of current GPC chair Dr Laurence Buckman, as well as a Who's Who of leading academics.There is something of the boot camp about this and toda ... Date: 16-03-2010 Categories:

The values that have lasted 50 years ... of the NHS, and strong advocates such as the legendary Dr Julian Tudor Hart were critical in maintaining support. The 1980s saw controls over GP prescribing tighten, and the 1990s brought spiralling workload as GPs were landed with a contract rigid in its requirements of them. The controversial 2004 contract, negotiated by Dr John Chisolm, brought tick-box medicine as never before, but allowed GPs to reg ... Date: 17-03-2010 Categories:

Swine flu threat to children 'not taken seriously' ... tead of cash-strapped trusts being left to negotiate with practices over vaccine delivery.This led to many SHAs, including London, clamping down hard on any plans to provide extra flexibility over GP workload to enable better take-up.Pulse revealed how NHS London stamped on agreements with PCTs in Richmond, Kingston and Croydon, which Sussex and Surrey LMCs claimed had agreed to concessions over extended ... Date: 17-03-2010 Categories: • Infectious diseases, immunology and allergy

Download Pulse - 17 March 2010 Read Pulse online as it appeared in the print magazine. In this week's issue: Tories to 'rip up' plans to shift workload to GPs; GP partners set for 5% pay cut; Occasional high BP a risk for strokePlease see below for instructions on downloading a PDF of this week's Pulse magazine. Please note you may need Adobe Reader ... Date: 17-03-2010 Categories:

Tories will �rip up� plans to shift workload to GPs By Ian QuinnExclusive: The Conservatives have told Pulse they would �rip up' plans by PCTs to shift huge volumes of outpatient and A&E care to GPs, claiming primary care is not equipped to cope.The party has ... Date: 17-03-2010 Categories: • Politics

How our third-sector provider goes that extra mile ... from GPs about whether CICSS would work. But since they have seen the benefits, many clinicians have given us great feedback and believe it helps patients. GPs also say the service has reduced their workload because CICSS staff not only visit patients, but also refer when necessary to other agencies.Added valueOne of the key successes of this scheme is flexibility, which goes back to the values of the Br ... Date: 22-03-2010 Categories: • Uncategorised

An elephant in the room ... ributed equitably on a needs basis. The elephant in the room is the link between practice income, services provided and expenses. If I don't replace a practice nurse and community staff pick up the workload, my personal income will go up. Conversely, if my community services budget is reduced because I have a high GMS/PMS share and I have to provide more nursing services, my income will fall. Now, how ... Date: 22-03-2010 Categories: • NHS structures

Minister defends closed doors talks on polysystems By Ian QuinnHealth minister Mike O'Brien has defended the decision to hold the talks on shifting hospital workload to GP polysystems in secret.He told MPs it was necessary not to reveal details of discussions to prevent the clinicians involved from withdrawing from the process.Mr O'Brien, speaking a week after sh ... Date: 23-03-2010 Categories: • Practice and personal finance

GPs could be legally liable for errors in care record ... s � due to be finished by April 2011 � will begin.The GPC has passed a motion �deploring' the way the rollout has been handled. GP leaders have complained that:� practices are reporting a big rise in workload to deal with worried patients, despite assurances it would be �minimal'� guidance on the quality of data expected from GPs is still to be published� ministers have failed to respond to a BMA submissi ... Date: 24-03-2010 Categories: • Power 50

Tories pledge to ramp up private companies' role in NHS ... ver the restructuring of primary care.The declarations mark the latest clear dividing line between the parties on primary care policy, following Conservative pledges to rip up plans to shift hospital workload en masse into GP polysystems and hand GPs commissioning responsibility for out-of-hours care.Last month health secretary Andy Burnham delivered guidance to help NHS managers deliver on his pledge tha ... Date: 06-04-2010 Categories: • Contract • Politics • Practice and personal finance

GPs told to review patients on high-dose simvastatin ... avastatin may be chosen.Dr Alan Begg, a GP in Montrose, Scotland and a member of the SIGN guideline steering group on coronary heart disease, said going back through patients records �would be a huge workload.'�Simvastatin 40mg is the standard that is used across the UK today. Prescribing advisors have gone out of their way to encourage GPs to do that, whereas perhaps a more evidence based approach would ... Date: 13-04-2010 Categories: • Long-term conditions and prescribing

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