Long Term Condition Reviews

Below are examples of long-term conditions (Follow the links for more information from the NHS on each condition):

Annual reviews are important if you have a long-term condition so that we can make sure your condition is properly managed. Our aim is to help you maintain good control of your condition with regular checks and reduce the risks of you having an exacerbation or an incident where you become acutely unwell because of your condition. For example, if you have asthma, we want to make sure that you are on the inhaler regime that works best for you, to prevent you from having asthma attacks that you may need to go to hospital for. It is important to attend your review even if you think your condition is well controlled already.

There are some conditions that are not classed as long-term conditions but do put you at higher risk of developing one. These include Pre-diabetes and Gestational Diabetes. If you have one of these conditions, you will also be invited for an annual review. This is so that we can monitor your condition and help you manage it to prevent you from developing the LTC. It also means that if you do develop the condition, we can catch it early and implement interventions, so that you have better health outcomes.

If you have a long-term condition which requires a review, you will be invited every year in your birth month. For example, if you were born in April, you will receive an invitation by SMS, email, phone, or letter just before or at the start of April. We use a birth month review system so that it is easier for you to remember when your review is due, and to make the process more streamlined for our staff as well.

If you have consented to receiving SMS or emails from us, then you will be sent a link that you can use to book yourself in for your appointment, without having to call the surgery. We will let you know the type and the length of appointment you need when we send you your invitation.

When using this booking link, it is important that you check which site you are booking, as we have two surgery sites to choose from. When booking your review, you will be able to see appointments up to 6-weeks in advance by changing the date range, so you can choose an appointment time and date that best suits you. If you cannot follow the link for any reason, please contact us as soon as possible and a member of our team will be happy to book your appointment for you.

If it is your birth month and you have not received an invitation, please contact us and we will be happy to arrange your review for you.

Your annual review appointment will depend on which condition(s) you have. Some people will just require 10-minute appointment for a blood test. For example, if you have hypothyroidism we need to check your thyroid levels every year. Your review will just be a blood test and a doctor will check your results. You may only be contacted after this if your blood test needs repeating, or if you need any other intervention (changing medication etc.).

Other patients will require a longer 20- or 30-minute appointment with one of our Health Care Assistants. This may include a blood test, checking your height, weight and blood pressure, and some lifestyle and wellbeing questions. If you have diabetes, we will also complete a diabetic foot check and if you are on certain medications (some antipsychotics), we may need to do an ECG.

If you have a respiratory condition (Asthma or COPD) we will invite you for a review with our respiratory nurse. They will review how you are managing your condition, check your inhaler technique and review your asthma medications. They may also discuss a care plan with you. You will be asked to attend a longer appointment if you have both asthma and COPD so that the nurse has time to review both conditions including how they interact together.

Certain conditions will require a follow-up appointment with a doctor or a nurse. We will arrange this for you after your initial appointment. For example, if you have diabetes, our diabetic nurse will call you once she has reviewed your HbA1c blood test results.

We will do our best to bring you in for as few appointments as possible, at times that suit you. However, please be aware that you may need multiple appointments if you have complex health needs or more than one type of condition. For example, if you have diabetes and asthma you will need an HCA appointment for your blood test and diabetic foot check, an appointment with our respiratory nurse, and a follow-up telephone call with our diabetic nurse.

We may ask you to provide an early morning urine sample for your appointment. If we do, you can pick up a urine sample pot for free from our reception at any time during our opening hours. You can also hand these in at any time after it has been requested. Please note that we cannot accept samples on a Friday afternoon as we cannot store these over the weekend.

If you are invited for an Asthma or COPD review, please bring any inhalers you have with you to your appointment.

If you are expecting to have a blood test, please remember to stay well hydrated before your appointment and have something to eat.

If you have had a blood test, your results will be reviewed by a doctor or the diabetic nurse if you have diabetes. If there are any concerns you will be contacted regarding your results.

We understand that getting to the doctors can be stressful for several reasons, and this can cause your blood pressure (BP) to be higher than expected in your LTC review. If this is the case, we may ask you to come back again another time for a repeat BP check or may ask you to provide some home BP readings.

If you are taking any medication and it is on a repeat prescription you will need an annual medication review. If you have consented to being contacted by SMS or email, we will send you a medication review questionnaire. It is important that you complete this using the link we send you as soon as you can, so that your usual prescription is not affected. If you cannot complete the online questionnaire for any reason, please contact us so that we can arrange for our pharmacy team to complete your review another way. If we do not have consent to send SMS or emails, we will arrange for your medication to be reviewed by our pharmacy team. This may involve a telephone call from a Clinical Pharmacist or a Pharmacy Technician. Please note that this call may come from a withheld number.

If your medication passes the review date without a review being completed, we will not be able to re-authorise your repeat medication.

If no-one has any concerns, then we will not need you to have another review until your next birth month.

If we have changed your medication or your condition is not well controlled, you may be asked to attend more regular reviews, or have repeat blood tests.

Can I discuss my other medical questions or conditions in my review even if it is not a long term condition?

We will do our best to answer any queries you have, any time you contact us. However, we are sorry we cannot discuss other medical conditions in your long-term condition review. Our Health Care assistants will not be able to discuss your joints, aches and pains, rashes etc. in your LTC review if it does not relate to your long-term condition. Our clinicians have a limited time with each patient and if they over-run, it affects multiple other staff and patients.

If you have a new or ongoing problem that you would like to discuss with a clinician, please contact us via SystmConnect on our website home screen or call us to go through the same process with a receptionist. Our Clinicians are reviewing every request on the day, and you will receive a response within the same day.

Call 999 if you have any of the following symptoms:

• Signs of a heart attack: chest pain, pressure, heaviness, tightness or squeezing across the chest
• Signs of a stroke: face dropping on one side, cannot hold both arms up, difficulty speaking
• Sudden confusion (delirium): cannot be sure of own name or age
• Suicide attempt: by taking something or self-harming
• Severe difficulty breathing: not being able to get words out, choking or gasping
• Choking: on liquids or solids right now
• Heavy bleeding: spraying, pouring or enough to make a puddle
• Severe injuries: after a serious accident or assault
• Seizure (fit): shaking or jerking because of a fit, or unconscious (cannot be woken up)
• Sudden, rapid swelling: of the lips, mouth, throat or tongue
• Labour or childbirth: waters breaking, more frequent intense cramps (contractions), baby coming, or just born

British Sign Language (BSL) speakers can make an emergency call using the 999 BSL video call service .

Deaf people can use 18000 to contact 999 using text relay.

If you need an interpreter for your review, please contact our reception team to book your appointment so we can book extra time for you.

Please let our receptionist know when you book your appointment so that we can allow extra time for your appointment.

Please contact us and one of our team will be happy to discuss this with you. Occasionally this may need further investigation so we may need time to look into this and contact you back.

If there is an incorrect diagnosis on your record, we will make sure that your record is up-dated and corrected. If however, we discover that the diagnosis is medically accurate, we cannot remove the diagnosis, even if you do not believe it is correct. We can put a note on your record that you are disputing the diagnosis, but we will not be able to remove it. The same is true for historical conditions. We cannot remove a diagnosis that you had in the past but no longer suffer with as it is accurate medical information.

Please be aware that we have a duty of care to you and will invite you for an annual review every year, even if you are disputing the condition.

Yes. If you only need a blood test for your review you can choose to get your blood test done at the Future Inn walk-in phlebotomy service:

• Future Inn, William Prance Road PL6 5ZD (no appointment required).
• Open Monday-Friday 08:00 to 16:50

If you would like to go to the Future Inn, you will need to let us know before you go so that we can request your blood test on a system that Future Inn can access as well.

If you have been invited for a 20-minute or longer appointment, you will still need to attend the surgery for your review so that we can complete the other areas of your review, in addition to the blood test.

You don’t have to attend if you don’t want to. However, we strongly encourage you to attend your review so that we can help you to manage your condition.

If you are not sure whether you want to attend your review or not, please contact us and one of our team will be happy to discuss this with you.

If you do not want to attend the review because the dates and times available do not work for you, for example if you will be on holiday for your birth month, please contact us and we will do what we can to accommodate you. We can adjust your review date to a later month as a one off.

If you have read and understood all the information above and still do not want to attend your review this year, please contact us to let us know. We will put a note on your record that you are declining your review which will stop you from receiving further invites for this birth month cycle. We have a duty of care to you and do have to offer you a review every year. Please let us know every year if you wish to decline your review. Declining once will not exclude you from invites for future years.

In most cases yearly medicine reviews are a legal requirement for us to be able to continue issuing your repeat prescriptions. Therefore, if you have declined your LTC review but are taking regular medication, you may still require a medication review.

Declining your review will not affect any other care you receive from the surgery.

If you missed your LTC review in your birth month or if you did not respond to your review invitation but have since changed your mind, please contact us and we can arrange for you to have a review. If you have a review outside of your birth month, please make sure you attend your next review in your birth month, even if it is close together.

Occasionally we may ask that you only have the blood test and then have your full review in your next birth month.

Due to safeguarding and safety policies, if you are responsible for a child with a long-term condition and they are not brought to their annual review, we take this very seriously. You will need to let us know why they have not attended and make a plan to bring them in or complete their review in another way. We will make any reasonable adjustments necessary to make this accessible.

If we do not hear from you and the child is not brought for their review, we may have to raise this as a safeguarding issue with social services as you are putting a child in your care at risk.