Long Term Conditions Annual Health Reviews
We recommend an Annual Review if you have one or more of the Long Term Conditions listed below. Please contact us to book for review in the month of your birthday each year. You may need to see more than one clinician (GP and/or Nurses) however we will combine appointments where we can. We hope this will make it easy for you to remember and to get your health fully reviewed in a timely fashion.
NHS website information is available by clicking on the condition's name in the LTC column. You might also want to look at our Long Term Conditions page (under Your Health in the website footer)
| Dementia||30 minute appointment with your Usual GP who will advise of any further follow-up required for conditions usually covered by Nurse review. Please bring completed Dementia Care Plan to your appointment|
| Learning Disabilities||10 min HCA appointment for blood test then 30 minute GP appointment 1 week later with specialist GP who will advise of any further follow-up required for conditions usually covered by Nurse review. Please bring completed Learning Disabilities Questionnaire (PDF) / Word Action Plan (electronic completion)|
|specific Mental Health conditions:||Schizophrenia, Bipolar Disorder and/or Psychosis - 30 minute appointment with your Usual GP who will advise of any further follow-up required for conditions usually covered by Nurse review. Please bring completed Mental Health Care Plan (PDF) / Word Care Plan (electronic completion)|
| Rheumatoid Arthritis (RA)||Please ensure you discuss your RA care with your GP at a routine appointment at least annually, using your birth month as a prompt - you do not need to book a specific appointment for review |
| Asthma||if currently on medication, i.e. inhaler prescription issued by us in the last 12 months. Please bring your inhalers with you to appointment (or be prepared to demonstrate your inhaler technique via video consultation for telephone reviews). You are recommended to agree an Asthma Action Plan at your review|
|COPD||Please bring your inhalers and completed COPD Assessment Test to review appointment (or be prepared to demonstrate your inhaler technique via video consultation for telephone reviews). You are recommended to agree a COPD Flare Up Action Plan at your review|
|Cardiovascular Disease ||CHD (Coronary Heart Disease), Stroke / TIA ( Transient Ischaemic Attack) and/or Peripheral Arterial Disease (PAD). 10 minute HCA appointment + Nurse review 1-2 weeks later|
|Diabetes||10 minute HCA appointment + Nurse review 1-2 weeks later. COVID-19 arrangements: you will need to attend the practice for a blood test & foot check with the remainder of your review being done with the nurse by telephone/video 1 week later|
High Blood Pressure FAQs 10 minute HCA appointment. Your results will be reviewed by a Pharmacist or Nurse and you will be advised if follow-up appointment necessary.
Home blood pressure monitoring is recommended - guidance available here (1 page pdf). Lifestyle guidance is available on the patient.info website.
An annual review is also advisable for Chronic Kidney Disease (CKD) - as this is often secondary to other long term conditions such as Diabetes this will usually be covered within a Nurse Annual Review. If you only require kidney monitoring you should book an annual Blood Test - the results will be reviewed by the GP to see if any follow-up action is needed.
We no longer advise you to routinely book interim checks, such as mid-year checks of HbA1c for diabetics or mid-year blood pressure checks. You will be advised at your annual review to book additional appointments if your condition needs further management.
Our receptionists will be able to advise you what Long Term Conditions you have been diagnosed with and what appointments you will require. If you are transitioning to this system from a non-birth month recall date, there may be a shorter or longer than usual gap from your last review to your birthday month so you may wish to delay or bring forward your first review accordingly - please contact reception for advice. Alternatively queries can be emailed to email@example.com