As I was returning home via my local tube station, I was handed a flyer for a newly established private general practice. I live in a relatively affluent part of London so there may well be demand for private primary care services, particularly as many local NHS general practices are under considerable workload and funding pressures, and are struggling to meet demand. The new private general practice offers individual insurance plans that start ‘from’ £35 per month (£420 per year). For patients without insurance, a one-off 20 minute consultation is £110 and an ECG is £95. A private prescription (excluding cost of medication) is £15. I compared this to my own practice where the entire sum we receive annually for each patient on our list is about £120 (this includes the annual capitation fee plus various other payments such as reimbursement of costs of premises). The average payment per patient to general practices in England is around £136 annually. It made me realise what good value for money our existing NHS services are. Jeremy Hunt may criticise doctors but the bottom line is that we are already providing cost-effective care. There is always more we can do to improve the quality and efficiency of the health services we provide but this requires a collaborative approach between the government and doctors, rather than the very adversarial approach we have seen from the government in recent years.
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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