Chronic Disease Management

Asthma

Asthma is a disease that can vary in severity throughout the year. If you notice a worsening of symptoms, such as a cough, wheeze or tight chestiness please make an appointment for an asthma check as soon as possible so we can ensure you have the correct medication.

Please ensure you are seen annually by the asthma nurse even if you feel well.

The practice aims to review all patients who need regular use of medication or who suffer from severe or troublesome Asthma every year. Patients will be invited for review in or around their birthday month.

Who does this mean?

  • Any patient who has received regular medication for Asthma within the last 12 months
  • Asthmatics who have received care during an emergency admission to hospital
  • Asthmatics who have difficulty in controlling or monitoring their condition.

What are the aims of treating Asthma?

  • If you smoke the aim will be to stop smoking and we will provide you with support to enable you to do this.
  • The aim is that symptoms of Asthma should be reduced or stopped completely to allow you to live a normal active life. This may require the use of inhaled and/or oral therapy on an intermittent or continuous basis.
  • Give sufferers or their carers an understanding of the causes and triggers of Asthma and knowledge of effective preventative measures to reduce these in the future.
  • To teach sufferers or their carers how to recognise and react to changes in symptoms of Asthma and to develop a plan of personal care.
  • To tailor therapy to maximise effectiveness and safety from possible side-effects.

Diabetes

Once a patient has been diagnosed with this condition via a blood test an initial 30 minute appointment with the nurse will take place for general discussion and advice.

We will then see you for an annual review during your birthday month. This will involve a fasting Blood Test, followed a week or so later with an appointment with either the Diabetes nurse alone or nurse and a doctor. You will also be seen 6 monthly for a quick review and update with the nurse. The practice will contact you in advance to remind you to book these appointments. Advice will be given on diet, smoking, exercise and checking of feet. Patients are able to have access to a chiropodist if needed.

You will be invited by Bedford Hospital retinopathy Screening as part of the Diabetic Screening programme.

Management of your condition depends on the severity of your symptoms and presence of complications and other medical conditions.

Coronary Heart Disease

If you have been diagnosed with Heart Disease we will see you for an annual review during your birthday month. This will involve a fasting Blood Test, followed a week or so later with an appointment with your usual GP.

You will also be seen 6 monthly by the specialist Nurse. The practice will contact you in advance to remind you to book these appointments.