The Secretary of State for Health and Social Care, Steve Barclay, has confirmed the UK government is considering plans to allow patients in England to bypass their GP and directly access some diagnostic tests for suspected cancer. The clinical and cost-effectiveness of these new diagnostic pathways must be compared with alternative solutions such as investing more in core NHS general practice services. My article in the British Medical Journal discusses some of the key issues and challenges in implementing this radical new policy.
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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