Preparing for your appointment

If you have made an appointment (or if you need to do so) it is often helpful to consider what you need to make it the most effective.  This simple guide suggests things to consider.

Once you have read the following this link takes you to our online appointment booking service

Asthma

If you have a peak flow meter, record your best and worst readings.

Are you getting night time cough, exercise symptoms or symptoms doing everyday things.  If not and you are well then consider completing an online review instead

Who is best to see, Your own GP

Annual Medication Reviews

We try and issue 9 months of most stable medication.  Please tell us if you aren’t needing anything on your list, and if doses need adjusting.  Often we consider blood tests with your review, as detailed for each of the conditions listed.  Specifically we look for values that show your treatment is working and also values that might show the medication is causing side effects, often relating to liver and kidney function.  Ring reception if you know you usually need a blood test with your review.

COPD

You will be called in for an annual review periodically.  We generally like people with COPD to have a supply of antibiotics and steroids as a “rescue pack” so check to see if you have an in-date supply before coming in.

Who is best to see, Lucy, Specialist COPD Nurse, or your own GP

Coughs and colds

We spend a lot of time seeing people with these conditions.  It is often because people are unsure what is concerning.  It is reasonable to say that if you don’t have a temperature, and any phlegm coughed up is white-ish, and you have no underlying illnesses like diabetes etc, then we usually find that antibiotics are of no value.  Even with more symptoms we often try and delay use of antibiotics so you body can learn to fight it off itself and strengthen your own immunity for next time.

Who is best to see, your pharmacist for advice

Diabetes

For your annual review we will contact you and you will have an initial check and blood test followed by a review about 2 weeks later (when a doctor will have checked your results and you will have a chance to discuss your care with the nurse)

If you feel your diabetes is not well controlled then it helps to record a sequence of blood sugar readings through the day (before and after breakfast, before and after lunch, before and after supper, and before bed) and bring that with you.  We will often ask for an HbA1c blood test as well if you haven’t had one in the last 3 months to see how things are changing.  Ring reception to ask for a blood test form if you don’t have one.

Who is best to see, Zoe or Judith Specialist Diabetes Nurses, or your own GP

Heart Disease

For people with stable, well controlled heart disease we recommend seeing the nurse for your annual review.  For this we recommend testing your cholesterol and kidney function but will tell you for your annual review.  Generally once controlled you don’t need you cholesterol tested more than once a year

Who is best to see, Jacqui Specialist Heart Nurse (or Zoe/Judith if you have Diabetes as well) or your GP if you have problems

High Cholesterol without heart disease

If you have high cholesterol and treated with tablets (e.g. statins) we generally test people before and after starting treatment, but we don’t need to regularly check cholesterol levels as we know they always reduce your levels very predictably.  We often show people that once treated the levels come down and stay very static over many years and tests are a waste of time and effort.

If you are well and on no other treatment it is often only necessary to have your blood pressure recorded

Hypertension (Blood Pressure)

For your annual review it is helpful for us to know your home BP readings if you take them.  We like to see about 5-10 readings over a weeks period.  We generally like a kidney function blood test once a year and this is best to be done before the appointment.  If your blood pressure seems well controlled and you are well then consider submitting your readings online instead

Who is best to see, Online, if well controlled, The surgeryPOD by reception if you would just like to record your BP , or your own GP

Hypothyroidism (low thyroid activity)

This condition once treated is often very stable.  Symptoms of concern include weight change, low mood or anxiety, lethargy and tiredness.  If you haven’t had a recent blood test, ask for one before your appointment.  If you feel well and are happy on your treatment tell us so here

Who is best to see, Online if well, or your own GP

Fit Notes (and discussion about returning to work)

If you are going into hospital e.g. for an operation make sure you ask for a fit note to cover your recovery whilst in hospital (they know best how long before you will be able to work).  If you simply need an extension and have recently seen a doctor we can often provide an extension over the phone.  If you are planning to return to work that is great and you DO NOT need a certificate to say so.  If you feel you need to “ease in gently” it often works best to have a chat with your line manager first to make an informal arrangement and if needed we can then give you an advice note to match (although this is often not then needed)

Who is best to see, your usual GP