Clinics & Services
CHRONIC DISEASE MANAGEMENT
If you have one of the following conditions, we would like to see you on an annual basis to review your condition:
- Asthma / Chronic Obstructive Pulmonary Disease (COPD)
- Coronary Heart Disease, Atrial Fibrillation, Heart Failure and High Blood Pressure (Hypertension)
- Diabetes
- Non Diabetic hyperglycemia
- Dementia
- Learning Disabilities
- Mental Health
- Rheumatoid Arthritis
- Stroke and Transient Ischemic Attacks (TIAs)
An Annual Review may include blood tests and is required for all patients with a chronic disease. The purpose of an annual review is to ensure patients are taking the right medication and receiving the best possible care for their condition(s).
Our aim is to see our patients in the month of their birthday. Our annual review service includes a reminder for our patients when their annual review is due, although we do encourage patients to take an active role in helping to manage their own conditions, so if your birthday has passed and you have not received a letter, please do contact us to book yourself in.
The majority of our annual reviews are carried out by our nursing team. You may need an appointment: with a Healthcare Assistant and one with the Practice Nurse. Contact our reception team on 01803 553558. The reception team will advise accordingly and book your appointment(s) with the most appropriate clinician(s).
Our invite system for annual reviews is based on your month of birth. you will be contacted 2 times each year. If you have not had an annual review since the 1st of April each year, you will receive your first invite within a couple of months of your birth month. If you do not book an appointment for your annual review, you will receive a second invite roughly 1-2 months after the initial invite.
It is important to attend your review appointment so we can ensure your condition is properly controlled and managed. If you run out of your repeat medication and have not had a review, we may not be to re-authorise your repeat medication.
Learning Disability / Autism Healthchecks
It is really important for everybody with a chronic disease to have an annual check up, please watch the video below to help see what happens at the check up and what to expect.
Books Beyond Words
“Beyond Words” provide wordless picture story books suitable for everyone who can’t read or don’t like written words. They provide an opportunity to open up conversations and may be useful to support understanding of physical and mental health, lifestyle and life stages.
Each story is co-created with and for people who find pictures easier to understand than words. This includes people with learning disabilities and/or autism, people with cognitive or communication difficulties, such as Dementia, people who have difficulty with reading, including some Deaf people, and people who do not use the language of the country where they are living.
Please click the following link to visit the Beyond Words Website
Private Referrals and Shared Care Requests
Can my GP offer “shared care” and provide a prescription that my private consultant has suggested?
Pembroke Medical Group is unable to offer shared care with Private healthcare providers.
If a Private consultant suggests the need for an ongoing specialist medication that requires monitoring then this responsibility would lie with that private clinic and care cannot be shared with NHS GP services. Furthermore, our local commissioners may not recognise shared care arrangements that are not directly commissioned by them even if the provider states this is within NHS provision.
The care would need to continue entirely with the Private clinic until an NHS consultant and GP have accepted to take over shared care.
Torbay GPs are actively involved in discussions to try and improve the NHS services that exist. We are aware that our patients are experiencing very long waits to be seen on the NHS for some services and as a consequence are seeking advice from Private clinics to try and get help. We are trying to support our patients and feedback to health commissioners that our patients need better access to specialist care for some of the worst effected services.
Torbay GPs are keen to work towards a solution for this but for now we are keen that patients are aware of this before they embark on a referral for a Private opinion so that they can make an informed decision.
