Annual reviews of long term conditions

Do you have a long term condition? Do you have annual reviews at the surgery for your condition?

General Practices was instructed to stop all routine annual reviews at the start of the covid 19 pandemic. This was to protect our patients and staff, as per the government guidance on ‘Stay at home, save lives and protect the NHS’.

Our nursing staff had to completely change the way they were working, to meet the care needs of our shielded and most vulnerable patients. Our clinicians opened a Red Site, which is still in operation, to review patients with COVID suspected symptoms, isolating them from other more vulnerable patient groups. 

As the risk level has reduced and our shielded patients are now able to return to our surgeries for care, we are now starting to focus on restarting the routine annual reviews with a reduced capacity. In order to protect our patients from the ongoing risks associated with COVID 19 we will be completing as much of our review as possible using phone calls and other digital solutions. This will reduce the need for patients to attend the surgeries unnecessarily, which is important going forward.


annual review

Due to the new way of working and to the COVID 19 pandemic we are unable to invite all our patients with long term conditions this year. We are focusing on reviewing our most vulnerable patients in the ‘shielding and high risk of COVID’ groups. By focusing on these groups we are able to optimise and better prepare them of the challenges of the winter ahead.


How will I know if I need to attend for a review?

Although we have been unable to continue with our Routine Annual review system, over recent months we have been working on a better system to make your annual reviews easier for both you and our teams. We will be inviting patients by letter for an annual review of all their conditions in the month of their birth, starting with those who at higher risk.

This will mean we can reduce unnecessary appointments and focus on the patients who have more urgent need of our support. For those patients who are managing their condition well with no changes in symptoms or deterioration you may be asked to wait until next year for your review.


How will the recall process for routine reviews work this year?

Routine Long Term Condition Annual reviews are there for many reasons, to check you are doing well with your condition, for health education and monitoring ongoing health care. In these unprecedented times we need our patients to be responsible for their condition and to work with us to achieve the best health outcomes we can for all our patients. 

If you are unwell or symptoms of your condition are worsening you need to contact us where we can take the appropriate action to ensure you are looked after. Due to covid 19 restrictions we will not be able to offer annual reviews to everybody this year. We must concentrate on our shielded and high risk patients first.

Patients will be invited to attend in the month of their birth so starting in September we will begin to send letters to our most vulnerable or shielded patients whose birthday is in September and who have a long term condition they will be invited to make an appointment for their review. Once a patient has received the letter they may call the practice for an appointment. Please do not call the practice if you have not received this letter.


My birthday is in September why have I not had a letter?

Our teams are working hard to invite our most vulnerable and high risk groups of patients in first. Due to the changes in how we work we are not able to offer everyone a Routine Long Term Condition Annual Review. As we move into winter and Flu vaccination season, we ask for your patience and support through this time as our amazing staff continue working extremely hard looking after our patients.

If you are concerned your health is deteriorating or symptoms worsening please do NOT wait for your routine long term condition annual review and call the surgery where we can assess how we can help you.


What do I do if my condition is worsening?

It was never the role of a long term condition review to treat deteriorating conditions, it is even more vital that you contact the practice regarding any deterioration in your condition when it happens. Our Patient Advisors will forward your details to our review nurses who will either contact you to discuss of refer you to our urgent care team who with assist you.


How can you help us help you?

There is certain information that our nurses need to assess a patient’s progress when carrying out a review. Patients would normally be able to have their weight, height and also have their Blood pressure taken in the surgery with current restrictions we would ask our patients try to acquire this information .  Unfortunately we have had to remove all the blood pressure machines from our waiting areas due to the infection risk of COVID 19. We ask our patients, If you are able to buy a Blood pressure monitor, which are reasonably priced, please do so , or borrow one from a family member who owns one if it is safe to do so.

It is as important to monitor blood pressure as it is to monitor weight.

A list of valid blood pressure monitors for use at home can be found by clicking here


What is happening to my Routine Long Term Condition Annual Review?

We are prioritising our vulnerable and shielded patients - the“at risk” , for their Routine Long Term Condition Annual Review first. If your condition is well managed we will not be calling you this year but again please let us know if your condition is deteriorating or symptoms begin to worsen the recall team is here to help those who need it

INDEX - Long Term Conditions