Chronic Disease Management

Long-Term Condition Reviews

If you have a long-term (chronic) health condition, we will invite you for an Annual Review. The goal is to ensure your medication is working correctly and to help you stay as well as possible.

How it works:

The Invitation: We will contact you (usually via text or letter) during your birth month.

Part 1 (The Check-up): You may first see a Healthcare Assistant (HCA) for blood tests, blood pressure checks, or a foot check (for Diabetes).

Part 2 (The Review): Once your results are back, you will have a follow-up with a Nurse or Pharmacist to discuss your results and renew your prescriptions.

Conditions we monitor include:

Asthma & COPD

Diabetes

Heart Disease & High Blood Pressure

Kidney Disease

Mental Health & Dementia

Page last reviewed: 16 April 2026
Page created: 16 April 2026