Long Term Conditions care
We have listened to patient feedback and have changed the way we do annual long term condition (LTC) reviews over the last few months.
As a Practice, we always aim to provide an efficient service for all of our patients and to give the best outcomes and guidance that we can.
Our aim, for patients who have a long term condition(s), is to proactively invite you for an annual review, around your birth month.
Once the review has been completed, where appropriate, medication can then be authorised for up to 12 months if you are suitable for, and have consented to, Electronic repeat dispensing (eRD)
This approach will hopefully make it easier for you to remember when your review is due, ensures that long term condition reviews are spread through the year and positively impact appointment capacity.
What is a Long Term Condition?
A Long Term Condition is defined as a condition that cannot, at present, be cured but can be controlled by medication and therapies.
You may have more than one long term condition; more than one illness or disease occurring in one person at the same time is called ‘comorbidity’ and more than two illnesses or diseases occurring in the same person at the same time is ‘multimorbidity’ means
These conditions include:
- Asthma
- Diabetes
- Chronic obstructive pulmonary disease (COPD)
- Hypertension (High blood pressure)
- Heart Failure
- Atrial Fibrillation
- Chronic kidney disease (CKD)
- Severe mental illness
- Learning Disability
The aim of a routine long term condition annual review is to enable you to take more control of your health, have the confidence to manage your condition(s), identify problems early, reduce the risk of admission to hospital, improve your quality of life and provide health education.
For many, your condition will be well managed, however long term conditions can cause problems that develop slowly over a period of time.
How will you contact me?
We will usually contact you by text message or email
What if I do not have a mobile or email?
Where we do not have either a mobile or email contact, we will contact you by landline telephone or letter.
Please ensure we have the most up to date contact information for you and your contact preference
Who will I see for my annual review?
For some conditions it may be necessary to have more than one appointment; for example, you may need a blood test appointment with a Phlebotomist first to ensure results are available for the annual review
Your review appointment(s) for Diabetes, Asthma and COPD will be with our Practice Nursing team who have knowledge and experience in managing these long term conditions
It may also be necessary to have a follow up appointment with a GP or ANP to review all medications
If you have other long term conditions you will be booked for a review with the most appropriate Clinician once the results of initial tests and questionnaires are available
Some conditions may also require an interim review e.g. at six months, this will be discussed at your annual review if indicated.
Will my review be face to face or telephone?
We offer both face to face and telephone review appointments however, depending on your long term condition, you may need a blood test appointment or a physical examination which will need to be face to face
What information would be helpful for me to provide before my appointment?
To help assess and monitor your health when carrying out an annual review, you may be asked to provide your height, weight, blood pressure (BP) readings, a urine sample and complete (and return) a short questionnaire prior to your review
Many people are more tense than usual in healthcare settings which can raise your blood pressure even if you don’t feel stressed, therefore, we will usually ask you to provide home blood pressure readings.
We would encourage all our patients to buy a Home BP machine to help manage their conditions
Tips for your annual review appointment
We know that managing a long term condition can be difficult for some of our patients.
- Write down any questions that you have in advance of your annual review
- Ensure that you focus on your long term condition in your annual review appointment(s); there is often a lot for the Clinician to cover in this appointment
- Book a separate GP/ANP appointment if you have another health concern that you wish to discuss
- Be honest in your review so Clinicians can develop a management plan in collaboration with you.
These reviews are really important. We strongly encourage all patients with a long term condition to engage in your annual review.
