The National Health Service (NHS) Health Check Programme aims to identify and manage patients in England aged 40-74 years with a 10-year cardiovascular disease (CVD) risk score over 20%. In an article published in the European Journal of Cardiovascular Prevention & Rehabilitation. Andrew Dalton and colleagues from the Department of Primary Care & Public Health at Imperial College London assessed the prevalence of high CVD risk in the English population, using the two CVD risk scores and the 20% cut off mandated in national policy, and the prevalence of risk factors within this population. They found that of those eligible for an NHS Health Check, 10.5% (2,012,000) had a risk score greater than 20% using the QRISK2 risk score; 22.0% (4,267,000) using Joint British Societies' (JBS2) score. To reduce risk in those at high CVD risk, we estimate the total costs of the Programme to be £176 million using QRISK2 or £378 million using JBS2. They concluded that a large number of high-risk patients will be identified by the NHS Health Check programme. The NHS must consider whether extra costs for the programme if JBS2 is used are justified.
Dear Dr, I am writing to refer a 28-year-old male patient of mine, Mr [Patient's Name], for assessment for the diagnosis and treatment of Attention Deficit Hyperactivity Disorder (ADHD). After a thorough clinical assessment, I believe that Mr. [Patient's Name] meets the criteria for adult ADHD as outlined in NHS guidance for primary care teams in SE London. Mr [Patient's Name] has been under my care for XX years and, during this time, he reports several symptoms (greater than five symptoms in total) consistent with ADHD in adults that have been present for more than six months. These symptoms include difficulties in focusing, following through on tasks, hyperactivity, forgetfulness, impulsiveness, restlessness, and irritability. Mr [Patient's Name] also reports being easily distracted, struggling with time management, organisation, and completing tasks efficiently. Many of Mr [Patient's Name]'s symptoms have been present since he was under 12 years old; and have
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