Kings Medical Practice News www.kingmedicalpractice.co.uk

Controversy about the risks and benefits of breast screening has been on the news in the last couple of days. The debate is about whether screening does more harm than good. An independent review published in the Lancet - click here for the summary , has concluded that for every life saved from breast screening, three women had treatment for cancer that would never have been fatal. Currently women aged 47 to 70 are invited every three years to have a mammogram that helps to detect early breast cancer in the hope that early treatment is more successful. And indeed it is because women who have a screen detected breast cancer are almost always cured. That is the really good news. But on the other hand if a women goes for screening they have a 1% risk of being over diagnosed and there is debate as to whether the number of women who are treated unnecessarily for every life saved is higher than three. Some critics have said that it might be as high as ten. To read more about this click

On Wednesday the practice was closed all afternoon for a training session. The training session was about 'Preventing Falls in Older People'. We had a multidisciplinary session with staff from the practice (doctors, nurses and our admin staff), district nurses, Wakefield Council, Wakefield District Housing, Carelink, Mid Yorks Community Therapy Services and Wakefield Carers Council. The number of older people in Normanton is increasing and the number of older people who fall and sustain a fracture is increasing as well. The workshop discussed ways in which we can identify people who are at risk of falling and then address some of these risk factors. The way that we are trying to screen people who are at risk of falling is through a Falls Risk Assessment Tool. The four questions we ask as part of this screening process are: 1 Have you had any falls in the last 12 months - yes or no 2 Do you take 4 or more medications - yes or no 3 Have you had a stroke or do you suffer for

We have recently received updated advice from the Medical Health Regulatory Authority about the increased risk of myopathy associated with other medication being taken at the same time. Muscle aches with simvastatin are a fairly common side effect but myopathy is more serious when muscles become inflamed and then weak. The full advice can be read here on the MHRA website . The commonest drug that will be affected is amlodipine. Amlodipine is a drug that we commonly use to treat patients with raised blood pressure and the new advice says that the maximum dose of simvastatin that should be used is 20mg. We have decided that the easiest way to manage this situation is actually to swap patients to a different statin that does not have an interaction with amlodipine. Our thinking is that if patients are taking simvastatin in a dose of 40mg cutting the dose down to 20mg will have an adverse effect on their cholesterol control. Advice from Wakefield PCT Medicines Management departments is

If you had your hospital appointment at Pinderfields or Pontefract changed last year then you were not alone! Figures from Mid Yorks Hospital Trust, the Trust that runs Pinderfields and Pontefract, show that last year nearly 30% of appointments were either cancelled or reschedule. Not being able to book a Choose and Book appointment at Pinderfields or Pontefract is the commonest complaint to our local Patient Advice and Liaison Service. But now that GPs are in charge of commissioning we have a plan! The Trust has acknowledged that this is unacceptable and has introduced the Out-Patients Improvement Programme. This programme aims to deliver seamless Out-Patient and Choose and Book booking programmes so that when you ring to make an appointment you can and it is not cancelled. The programme will be actively managed through Contract meetings between NHS Wakefield Clinical Commissioning Group and Mid Yorks. The pathway to success plans that by the end of March 2013 only 9% of appointment