Brace position. An envelope arrives from my local surgery in Sussex. So far as I recall, I’m not expecting the results of any tests for exotic conditions. So this must be even more serious; in my experience, the front line of the NHS never writes to you unless it’s about to cost you, either in raised prices or cut services.

Sure enough, the letter comes straight to the point: “We are reviewing how we look after patients … As part of this, we are seeing if we can improve symptom control but also reduce the cost of the drugs used. This is to help the NHS better treat more patients with other conditions.”