Long term conditions

We are improving the way we work with patients with long-term conditions

Patients living with certain long-term conditions will be encouraged to attend a Yearly Health Check. Long-term conditions are those that impact over a long period of time, such as diabetes and heart diseases.

Patients will receive personalised care and support from healthcare professionals from their general practice. This will cover things that patients say matter most to their health and wellbeing, from the best treatment for their condition, to wider things like employment, housing, and mental health.

Our goal is that by planning care together with care, patients will have the confidence to manage their health, reduce their risk of being admitted to hospital, and have a better quality of life.

Who is this for?

Initially, we will cover nine long-term conditions:

– Cardiovascular disease (for example, strokes, health failure, ischaemic heart disease, and peripheral artery disease)
– Diabetes
– Hypertension (High blood pressure)
– Hyperlipidaemia (High cholesterol)
– Non-alcoholic fatty liver disease
– Atrial fibrillation
– Chronic kidney disease
– Asthma
– Chronic obstructive pulmonary disease.

In the future, we will look to expand this to cover more long-term conditions.

How will I be contacted if this is for me?

We will contact you via text, phone call, or letter to organise your appointments. We will contact patients over the year so please do not worry if you do not hear from us right away. If you are concerned or have questions, please contact us.

Watch the short film below to see an example of a patient’s journey through the key stages of the process and help you understand what to expect from your Yearly Health Check.

View the information video on YouTube

Download the annual review leaflet for further information

Date published: 8th May, 2025
Date last updated: 8th May, 2025