For a number of chronic diseases, it is important to have regular checks in order to monitor the condition. This monitoring would often involve a combination of physical health checks, blood tests, and in some cases more focussed checks. At Bridge Street our chronic disease monitoring is done by a team approach between the nursing team and doctors, and would usually vary between 6 monthly and yearly checks.
The following table will provide some information on our usual follow up of the more common chronic diseases. It is important that these checks are done, as we will often link our medication reviews to these checks. It will reduce any inconvenience when it comes to ordering your medications if these checks are done on time. We would normally try and remind patients by letter if these reviews are missed.
|Condition||Frequency of follow up||Detail||Flu jab recommended|
|Asthma||Yearly||Review with nursing team or GP. Will require doctor review if symptoms are not controlled||Y|
|Chronic obstructive pulmonary disease (COPD)||Yearly||30 min nurse review including spirometry and then doctor review||Y|
|Hypertension||Annual check and 6 month review||Nurse review including bloods. Review by GP if identified by nursing team||Y|
|Coronary heart disease||Annual review +/- 6 monthly bloods||Nurse review with GP follow if identified by nursing team||Y|
|Diabetes||Yearly + bloods up to 3 monthly||30 min nursing team review including physical checks and bloods followed by GP follow up||Y|
|Mental health||Yearly for those with significant illness||Nurse appointment for physical checks +/- bloods and GP review|