Services for on-going management of long-term conditions
Diabetic clinic every two weeks, with a GP and nurse specialising in diabetes, and a dietician
Weekly nurse-led Asthma/COPD clinics
Annual mental health reviews and care plans for all patients with a current condition
Annual review for patients with hypertension
Annual medication reviews for all patients on long-term repeat medication
On-going review, monitoring and care plans for patients with heart disease, kidney disease, epilepsy, dementia, hypothyroidism, cancer and history of stroke/TIA.