Long-term Condition Management

All our patients who suffer from a long-term condition should be contacted and seen by a doctor, practice nurse and/or phlebotomist for regular check-ups.

The practice will send you a letter inviting you to book an annual review with a Health Care Assistant.

If you have Asthma, then you will be sent an Asthma Control Test to complete and return to the practice, this will be sent to you either by letter or text message.

Please contact the Reception Team on 01373 830316 to arrange or re-arrange a long-term condition monitoring appointment if necessary.

Diabetes

Diabetes

Regular diabetic reviews are available at both St Luke's and Fromefield by our Diabetes Nurses, how often you have a review will depend on how well your diabetes is managed but everyone can expect a review at least once a year.

Your review will include a blood test and urine sample which will allow us to monitor your health by looking at your long-term blood glucose control, cholesterol levels, blood pressure and kidney function.

The nurse will want to look at your feet to check for any loss of feeling, ulcers and infections. We will also ensure that you have your eyes checked annually to look for any damage to the blood vessels.

Diabetes can affect people in a variety of ways, some people might have no symptoms at all, while others may have physical and/or emotional symptoms. It is not uncommon for people with a chronic condition like Diabetes to suffer from depression, please use this time to speak to the Nurse about any concerns you may have.

More information for Diabetes on the following links: Patient Info and NHS UK

Asthma

Asthma

Asthma is a common condition that fortunately responds well to proper treatment and most people with the condition should therefore be able to live life without interference from symptoms. The key to this is understanding how to manage the condition and having appropriate treatment, so regular reviews to discuss symptoms and treatment are a very important part of living safely and well with asthma.

Patients with asthma should attend for regular check-ups, at least annually, to monitor treatment. This can be with the practice nurse or the doctor. Two of our nurses have asthma training and are able to assist the doctors in giving specific help and advice. They have a particular role in providing education about asthma to those newly diagnosed with the condition, as well as doing regular reviews.

If you are joining the practice and have asthma we suggest that you make your initial appointment with a GP, who can re-prescribe your regular medication and discuss further follow-up appointments with you.

Immunisations against Influenza (flu) and Pneumonia are important and it is recommended that if you have COPD you should have an annual 'flu' vaccine – please contact the surgery to arrange this. A 'Pneumo' vaccine is available.

 

More information on Asthma is available on the patient.co.uk website, and from asthma.org.uk.

Chronic Heart Disease

Coronary Heart Disease

Coronary Heart Disease (CHD) is caused by narrowing of the arteries around the heart, causing angina or possibly a coronary event in the past.

You should have an annual review. At the review you will be asked about your symptoms and how you get on with the medication. Also lifestyle issues will be discussed including exercise and at the clinic you will have your pulse and blood pressure taken.

The aim is to monitor your condition, highlight any issues you may have and prevent future coronary events.

More information on Coronary Heart disease is available on the British Heart Foundation website.

 

Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a lung condition usually caused by smoking but occasionally by genetic problems or environmental exposure. Although it cannot be cured, good treatment and care can help to prevent infections and acute exacerbations of the condition. The key to slowing the progress of the condition and staying well is to stop smoking. Please ask the GP or nurse if you would like advice or help with this.

Regular reviews are important and we recommend you have one at least once a year, when you can discuss symptoms and how to manage the condition and we can check inhalers are appropriate and being used effectively. We also have access to a Somerset COPD service who provide further assessments and advice as well as rehabilitation classes to give you confidence in keeping active and managing your breathlessness.

COPD reviews can be with any of our GPs or with some of our practice nurses – if you are new to the practice we suggest that you see a GP first.

Immunisations against Influenza (flu) and Pneumonia are important and it is recommended that if you have COPD you should have a an annual ‘flu' vaccine and a Pneumo vaccine – please contact the surgery to arrange this.

More information on Chronic obstructive pulmonary disease is available on the patient.co.uk website.

Hypertension

Hypertension

Patients with hypertension (high blood pressure) will need a blood pressure check twice a year. All Practice Nurses are trained in titrating medication and monitoring blood pressure. We recommend you see the Nurse for your medication review. Please check whether or not you are due a blood test, which should be organized ideally a week before your review.

At the review your blood pressure will be taken and we will enquire whether you are taking your tablets without any problems. If you experience side effects of medication this should be mentioned at the review as we can adjust the medication if necessary. Apart from medication we will also encourage you to lead a healthy lifestyle. More information can be found on the links below.

We do have automated blood pressure machines which can be borrowed from the surgery if the nurse or your doctor asks you to take some readings at home. Please ask at reception for information.

More information on hypertension is available here.

More information on a healthy lifestyle is available here .