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Clinical Update for Primary Care Team 9 March 2023

1. New GP Contract for 2023-24

NHS England has imposed a new contract on general practices for the 2023-24 year following the breakdown of negotiations with the BMA. We will need to look at this in more detail in a future meeting. Some of the changes are in areas such as access to GP services, access to medical records, QOF, additional roles (ARRS) and telephone systems.

 

2. ADHD Update

Following previous discussions, I have prepared a template referral letter for adults with suspected ADHD based on NHS guidance.

See https://medical-centre.blogspot.com/2023/02/example-adhd-referral-letter.html

 

3. Covid-19 vaccination

The Autumn booster vaccination programme has now ended. A Spring booster programme will start soon. This will target adults aged 75 years and over, residents in care homes for older adults, and individuals aged 5 years + who are immunosuppressed. People who are not fully vaccinated will no longer be able to get a first or second dose of Covid-19 vaccine after 30 June 2023.

 

4. Evusheld

Draft guidance from NICE does not recommend Evusheld for preventing Covid-19 in adults who are unlikely to have an adequate immune response from vaccination or who can’t be vaccinated due to a lack of evidence of effectiveness.

See https://www.nice.org.uk/news/article/nice-says-no-evidence-that-covid-19-treatment-evusheld-is-effective-in-protecting-vulnerable-adults-against-current-variants-as-it-announces-new-rapid-update-process-for-covid-19-medicines

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Example ADHD Referral Letter

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