Long Term Conditions Review

We have introduced a new annual review recall process.  We hope the new process will be more efficient and less time consuming for patients.

We want to give our patients with long-term conditions the best outcomes and guidance that we can.  To do this we need to ensure that we have an organised process for reviewing our patients on at least an annual basis.

This new review process provides a better way of reviewing patients’s needs, especially for patients who may have more than one Long Term Condition.

What is a Long Term Condition?

A long-term condition includes illnesses such as:

  • respiratory disease
  • heart disease
  • stroke
  • diabetes
  • kidney disease
  • high blood pressure
  • rheumatoid arthritis
  • epilepsy
  • mental health problems
  • other long-term health issues that affect the health or lifestyle of a patient 

These conditions require an annual review to ensure that the condition is being managed appropriately (by you the patient and also by us as your healthcare provider), identify any problems or concerns and ensure patients are confident to deal with their condition between reviews and By having these regular checkups we can help you to prevent any problems in the future and hopefully reduce your risk of hospital admissions.

How does the process work?

Patients with long-term conditions will be invited for their annual review within the month of their birthday. Some patients have more than one long-term condition. If this is the case, all relevant conditions will be reviewed within the one annual review process. This ensures that you are only attending the surgery when you need to and that we are not asking you to attend the surgery unnecessarily.

For some conditions, it may be necessary to have more than one appointment for example, a blood test appointment with the health care assistant (to ensure results are available for the review) and then a review with the practice nurse or nurse practitioner. In some case it may also be necessary to have an appointment with the GP, but most reviews will take place with our specialised Nursing team who have knowledge and experience of managing long-term condition patients.

Some conditions may require an interim review e.g. at six months this will be discussed at the annual review where it is felt to be appropriate.

We hope you find this new process straight forward and easy to use. If you have any questions regarding the annual review process, please do not hesitate to contact us. As this is a new process, we would appreciate any feedback on how the system works for you.