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  1. GP deal gives "breathing space"

    GPs have gained "breathing space" from changes to next year's contract, it was claimed yesterday.

    The news came amid controversy about Conservative promises to extend GP opening hours.

    GP leaders said they had gained promises of reductions in bureaucracy - together with a deal to ensure practices are reimbursed when locums are brought in during maternity or paternity leave.

    And they have reached an agreement on assigning a named GP to every patient.

    The negotiators said the deal would give GPs more time to manage the care of vulnerable patients and cut unnecessary admissions to hospital.

    British Medical Association GP committee chair Dr Chaand Nagpaul said: "Now that we have agreed a contract for next year, we need to work together to focus on solutions for both the short and longer-term to ensure that general practice can deliver on the ever increasing demand and provide the care which patients deserve.

    “We welcome, in particular, those changes aimed at freeing up GPs’ time and improving patients’ experience of general practice. Measures to reduce bureaucracy, provide enhanced care to vulnerable patients and allow family doctors to spend more time with patients are a step in the right direction."

    He added: "We are now at a critical juncture, faced with a shortage of GPs, with surgeries closing and facilities in many practices increasingly inadequate to deliver high-quality care."

    NHS England's national director for commissioning operations Dame Barbara Hakin said: “Our vision is to see general practice play an even stronger role at the heart of local communities, offering more joined up and proactive care for patients. This is vital in addressing the rising demands on NHS services.

    “Today’s contract changes recognise that and most importantly are aimed at improving care for patients.”

    * According to one report today the deal will require practices to publish the average earnings of partners by April 2016.

  2. Row over GP hours plan

    Extended GP opening hours could be a misuse of NHS cash in some area - where other measures could be taken to improve services, according to a senior doctor.

    Prime Minister David Cameron set out his plan to introduce seven-day opening by 2020 yesterday.

    But the Royal College of GPs said practices should be allowed to tailor opening hours to the news of local people.

    Chair Dr Maureen Baker said: “Newspaper headlines implying that all patients will be able to walk into their local surgery in the evenings or at weekends merely raise expectations that general practice cannot live up to with the resources we are currently being given.

    “Investing in longer opening hours may not be the best route to improving care for patients in every area, and today’s announcement does not tackle the challenges of caring for an ageing population increasingly living with multiple long term conditions."

    She added: "To meet this new aspiration practices will need to collaborate in federations. Whilst we feel this allows greater flexibility of workforce and premises, it will mean that patients cannot expect access to their own practice or their own GP for these extended hours."

    Mr Cameron said there were 5,000 more GPs "in the pipeline".

    But the college said a total of 8,000 was needed by 2020 simply to manage existing services.

    The chair of the British Medical Association's GP committee, Dr Chaand Nagpaul, said the proposals did not deal with the "current reality" that GPs and their patients face.

    He said: "We need immediate solutions to the extreme pressures that GP practices are facing, with inadequate numbers of GPs and practice staff to manage increasing volume of patients, who are already having to wait too long for care."

    * Meanwhile GPs in Manchester said their extended opening hours scheme - one of the national pilot schemes - had helped relieve pressure on local hospital emergency departments.

    In five months, about 600 people used the service rather than going to hospital, according to an evaluation.

    In total more than 3,000 people used the service at The Range Medical Centre, Whalley Range, the Manchester Evening News reported.

    The practice opens for three hours on Saturdays and Sundays and evening surgeries between 6pm and 8pm. It says that surgeries are staffed by doctors from around the area as well as its own GPs.

    Practice director Colin Tate said: “To date, feedback has been very positive - especially from those patients where having an out-of-hours appointment has allowed them to continue with work, family and other commitments.”

  3. Cancer gene screening plan

    Young patients with bowel cancer should be screened for a genetic condition that might be responsible for their disease, researchers said yesterday.

    The genetic disease, Lynch Syndrome, is thought to be responsible for two thirds of cases of bowel cancer in people under the age of 50 - but is often not identified.

    The researchers at Exeter University Medical School say screening would help identify families carrying the Lynch Syndrome gene. Close relatives of affected people have a 50% chance of having the gene.

    This would allow relatives to be tested and other cases of cancer prevented.

    Some 1,700 people are year are diagnosed with bowel cancer and 550 die from the disease.

    According to the research, published in Health Technology Assessment, this would prevent 40 cases of cancer a year, including 28 cancer-related deaths.

    Researchers analysed some 42 studies of Lynch Syndrome and bowel cancer and then created a computer model to calculate the impact of screening.

    Researcher Dr Tristan Snowsill, said: "This is the first evidence that systematic testing for Lynch syndrome could be cost-effective in the NHS."

    Dr Ian Frayling, of the Cardiff University Institute of Medical Genetics - who advised on the research - said: "This is a very significant piece of work which is much to be welcomed. It justifies the National Health Services in the UK implementing such testing, which is already carried out in other European countries.

    "Those with Lynch Syndrome will now be found and given the care that they warrant, saving time, lives, money and resources."

    Health Technology Assessment September 2014

  4. Alcohol price policy wrong - researchers

    Banning supermarkets from selling alcohol below cost will have a fraction of the impact of the abandoned proposal of minimum pricing, researchers claimed today.

    Under new laws, supermarkets will be banned from offering cut-price deals.

    But the latest analysis says this will increase the price of fewer than 1% of alcohol sales.

    The Sheffield University researchers say that a minimum price of 45p a unit would increase the price of more than 23% of sales.

    Their findings were published in the The BMJ.

    The findings were welcomed by senior physician Sir Ian Gilmore, chair of the Alcohol Health Alliance.

    He said: "It is really powerful to see the science securely behind the impact of a minimum unit price - confirming that it is a targeted measure that has its impact on the most harmful drinkers.

    "It is also excellent to have confirmed what we have been telling the Westminster Government, namely that a ban on below cost selling has no worthwhile impact."

    Researcher Professor Alan Brennan, a health economist, said banning sales below cost would prevent 14 deaths and 500 hospital admissions a year.

    A 45p minimum unit price would prevent 624 deaths and 23,700 hospital admission in the UK.

    The BMJ 1 October 2014 [abstract]


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