Long Term Reviews
If you have a chronic health or long term condition your annual reviews will be scheduled around your birth month (alternatives can be agreed as requested or for patients with a new diagnosis). The practice aims to make this recall system more convenient by reducing multiple appointments, more efficient by using technological advances, and using the most appropriate clinical team to manage your health conditions. Those inidividuals who need support in accessing their reviews will have this provided including teams to manage housebound patients.
Asthma Annual Review
For your asthma annual review you will be sent an asthma control questionnaire by text or email. Please submit your personal best peak flow readings; if you do not have a peak flow meter please request a peak flow meter (we will send a prescription to your nominated pharmacy).
Once we have received your responses and your personal best peak flow readings we will send you your personalised Asthma Action Plan and reauthorise your asthma medication for 12 months.
If your asthma is not well controlled:
You will have a telephone or face-to-face review booked with our Pharmacy or Practice Nursing teams.
NB: Please note if you are experiencing any problems with your asthma control, please contact the practice to arrange a review via eConsult or calling the practice.
COPD (Chronic Obstructive Pulmonary Disease) Annual Review
For your COPD annual review you will be sent a COPD control questionnaire by text or email.
Once we have received your responses we will send you your personalised COPD Action Plan and reauthorise your COPD medication for 12 months.
If your COPD is not well controlled:
You will have a telephone or face-to-face review booked with our Pharmacy or Practice Nursing teams.
If you have a combination of COPD and asthma or asthma-COPD overlap syndrome (ACOS) you will need to complete both asthma and COPD questionnaires.
NB: Please note if you are experiencing any problems with your COPD control, please contact the practice to arrange a review via eConslut or calling the practice.
Cardiovascular Annual Review – Hypertension, Atrial Fibrillation, Coronary Heart Disease (including Heart Attacks/Angina), Strokes/TIAs, Peripheral Vascular Disease and Chronic Kidney Disease (CKD)
When your annual review is due you will be sent a text message or email to arrange an appontment with the HCAs (heathcare assistants) for a blood test and health check. If you have known kidney problems you will need to provide a urine sample.
You may be sent a questionnaire via text or email as part of the review.
If you have been asked to monitor your blood pressure please submit by using our Blood Pressure average calculator or respond to the text/email message sent to you.
If you are experiencing problems or need a medication change then an appointment will be scheduled with an appropriate clinician.
NB: If you have hypertension you need to have a blood pressure check at least every 6 months.
Diabetes Annual Review
When your diabetes annual review is due you will be contacted by phone to arrange an appointment with the HCAs (health care assistant) for a blood and urine test, health check and foot check. You will have a review appointment arranged with the Practice Nursing team about two weeks later to complete your annual review – this can be arranged as a face-to-face or telephone review.
If you have other conditions, for example any of the cardiovascular diseases, all these will be managed at the same as there is an overlap in how these conditions are managed.
NB: To assess your diabetic control you will need to have an interim blood test as a minimum every 6 months – depending on the results you may be contacted on the phone or sent a text mesage.
Prediabetes or At Risk of Diabetes Annual Reviews
You will be sent a reminder every year to arrange a blood test with the HCAs (healthcare assistants) to assess your overall glucose control with an HbA1c blood test. If you have other conditions such as cardiovascular diseases this wil be automatically included in your review.
Rheumatoid Arthritis / Osteoporosis / Heart Failure Annual Reviews
An appointment will be arranged with an appropriate clinician either on the phone or face-to-face.
Serious Mental Illness / Learning Disabilities / Dementia Annual Reviews
When your annual review is due you will be contacted by phone to arrange an appointment with the Pharmacy or Practice Nursing teams as appropriate alongside any other reviews you need. This will be scheduled after any other health reviews to enable focussed reviews. If you need additional health checks or blood tests these will be organised at the time.
Interim Reviews: Asthma, COPD, Hypertension, Heart Failure, Diabetes, CKD
You will get a reminder for interim reviews as some conditions need more frequent reviews especially if you have more severe or poorly controlled health problems.
Hypertension
If you have been asked to monitor your blood pressure please submit by using our Blood Pressure average calculator.