The number of deaths involving Clostridium difficile in England and Wales rose by 28 per cent between 2006 and 2007, according to the Office for National Statistics.

The Scottish Labour party has called on a leading Conservative to go to Glasgow and apologise after he suggested health funding should be cut there.

The BMA is appealing to the High Court to stop GPs over the age of 65 being charged to remain on the GMC's register.

All anti-psychotic drugs can increase the risk of stroke, with dementia sufferers at double the risk, UK researchers have warned.

The Dispensing Doctors' Association (DDA) is urging the government to make no change to pharmacy regulations.

NICE has published guidance on the appropriate prescribing of antibiotics for respiratory tract infections (RTIs) in primary care.

Vacancy rates for GPs, practice nurses and practice staff in England and Wales have shrunk for the third year in a row, according to figures published by the NHS Information centre today.

The government has published its next consultation on the Pharmacy White Paper.

Objectives To investigate the association between use of typical and atypical antipsychotic drugs and incidence of stroke in patients with and without dementia.

Design Self controlled case series.

Setting UK based electronic primary care records in the general practice research database (GPRD).

Participants All patients registered in the database with a recorded incident stroke and at least one prescription for any antipsychotic drug before the end of 2002: 6790 eligible participants were identified and included in the final analysis.

Main outcome measures Rate ratio for stroke in periods of time exposed to antipsychotics compared with unexposed periods.

Results Use of any antipsychotic drug was associated with a rate ratio for stroke of 1.73 (95% confidence interval 1.60 to 1.87): 1.69 (1.55 to 1.84) for typical antipsychotics and 2.32 (1.73 to 3.10) for atypical antipsychotics. In patients receiving any antipsychotic drug, the rate ratios were 3.50 (2.97 to 4.12) for those with dementia and 1.41 (1.29 to 1.55) for those without dementia.

Conclusions All antipsychotics are associated with an increased risk of stroke, and the risk might be higher in patients receiving atypical antipsychotics than those receiving typical antipsychotics. People with dementia seem to be at a higher risk of an associated stroke than people without dementia and use of antipsychotics should, when possible, be avoided in these patients.

Objective To determine if a complex nursing and midwifery intervention in hospital labour assessment units would increase the likelihood of spontaneous vaginal birth and improve other maternal and neonatal outcomes.

Design Multicentre, randomised controlled trial with prognostic stratification by hospital.

Setting 20 North American and UK hospitals.

Participants 5002 nulliparous women experiencing contractions but not in active labour; 2501 were allocated to structured care and 2501 to usual care.

Interventions Usual nursing or midwifery care or a minimum of one hour of care by a nurse or midwife trained in structured care, consisting of a formalised approach to assessment of and interventions for maternal emotional state, pain, and fetal position.

Main outcome measures Primary outcome was spontaneous vaginal birth. Other outcomes included intrapartum interventions, women’s views of their care, and indicators of maternal and fetal health during hospital stay and 6-8 weeks after discharge.

Results Outcome data were obtained for 4996 women. The rate of spontaneous vaginal birth was 64.0% (n=1597) in the structured care group and 61.3% (n=1533) in the usual care group (odds ratio 1.12, 95% confidence interval 0.96 to 1.27). Fewer women allocated to structured care (n=403, 19.5%) rated staff helpfulness as less than very helpful than those allocated to usual care (n=544, 26.4%); odds ratio 0.67, 98.75% confidence interval 0.50 to 0.85. Fewer women allocated to structured care (n=233, 11.3%) were disappointed with the amount of attention received from staff than those allocated to usual care (n=407, 19.7%); odds ratio 0.51, 98.75% confidence interval 0.32 to 0.70. None of the other results met prespecified levels of statistical significance.

Conclusion A structured approach to care in hospital labour assessment units increased satisfaction with care and was suggestive of a modest increase in the likelihood of spontaneous vaginal birth. Further study to strengthen the intervention is warranted.

Trial registration Current Controlled Trials ISRCTN16315180.

Practice-based commissioning groups could be buying the wrong services, because nearly a sixth of clinical procedures are wrongly recorded by hospitals.