During May 2025 Clinical Knowledge Summaries were published or updated in the following areas.
All of the topics have been reviewed and updated with minor structural and layout changes. The Appendicitis topic has been updated with changes to the basis for recommendations amended in line with current clinical guidelines and expert opinion review articles. The Dupuytren's disease topic has been updated with minor additions and clarifications for the recommendations, to align with current evidence. The Menopause topic has been updated in line with the National Institute for Health and Care Excellence (NICE) clinical guideline. A section detailing the investigation and management of unscheduled bleeding on hormone replacement therapy (HRT) has been added in line with guidance prepared on behalf of the British Menopause Society by stakeholder organisations.
Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.
The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of May 2025. This month there is one guideline and one technology appraisal that impact upon primary care.
The Suspected cancer: recognition and referral guideline has been updated. It covers identifying children, young people and adults with symptoms that could be caused by cancer. The update amended referral criteria for suspected upper gastrointestinal tract cancers.
The Cenobamate for treating focal onset seizures in epilepsy technology appraisal has been updated. Recommendation 1.1 has been updated to allow healthcare professionals with expertise in epilepsy to commence treatment to reduce inequity of access to the treatment. After commencement, treatment can be continued in primary care.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
The Medicines and Healthcare products Regulatory Agency (MHRA) has published a Drug Safety Update for May 2025.
This update warns clinicians of an increased risk of intrahepatic cholestasis of pregnancy (ICP) associated with thiopurines (azathioprine, mercaptopurine and tioguanine). ICP has rarely been reported in association with azathioprine therapy but the risk is believed to apply to other thiopurines. ICP may occur earlier in pregnancy when thiopurines are in use. Stopping or reducing the dose of the thiopurine drug may improve liver function tests but a case-by-case assessment is required to determine the appropriate course of action. Patients should be advised to report symptoms of ICP which include intense itching without a rash, nausea, and loss of appetite.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
During April 2025 Clinical Knowledge Summaries were published or updated in the following areas.
All of the topics have been reviewed and updated with minor structural and layout changes. No major changes have been made to the recommendations made.
Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.
The Department of Health and Social Care has announced that NHS prescription charges will be frozen for the first time in 3 years to help with the cost of living.
Charges for prescriptions will remain at £9.90 for a single charge or £32.05 for a 3-month prescription prepayment certificate (PPCs). 12 month PPCs will remain at £114.50 and can be paid for in instalments, meaning people can get all the medicines they need for just over £2 a week.
The prescription freeze will also apply to NHS wigs and fabric supports. The current exemption categories remain unchanged and the NHS Low Income scheme remains in place.
Action: Clinicians should be aware of the current prescription charge and also the value for money represented by pre-payment certificates.
