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New diabetes care plan

Discussion in 'Type 2 Diabetes' started by Pinkorchid, Mar 1, 2018.

  1. Pinkorchid

    Pinkorchid Type 2 · Well-Known Member

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    Our GP practise has just bought out a diabetes Care and Support plan. When we are due for a review we will first see a nurse who will take the blood, weigh us, test urine, do a foot check etc all this except the blood test was done by the diabetes nurse at our review before the new plan. Now 3 weeks after the tests we will see the diabetes nurse. Before that we have to get a printout of our test results so we can study that to see how we are progressing and chat to the nurse about any worries we have about the tests. She will ask how we get on with our medication do we have any problems with it and what is important to us with regards to controlling our diabetes If we have any worries like depression or need any help like loosing weight or giving up smoking..doesn't apply to me or my husband gave up smoking years ago and we never have been overweight all this will go on our care plan.. This is improvements they are making with regards to diabetic care with more patient interaction.. My husband went for his test results and he sees the nurse tomorrow. His tests look good HbA1c is 40 cholesterol 4.2..he doesn't take statins..urine test and kidneys good, blood pressure was slightly high at 140/75, weight is fine .It does also say monitoring glucose levels is important but I doubt that will result in strips on prescription if our diabetes is already controlled . My review is due in July so hope my results are good to
     
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    #1 Pinkorchid, Mar 1, 2018 at 1:19 PM
    Last edited: Mar 1, 2018
  2. Ross.Walker

    Ross.Walker Type 2 · Well-Known Member

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    My new dr's works a bit like this, the physical results speak for themselves, I suspect it is to catch the mental health of people. I find this encouraging that there are more chances to catch someone who is finding it hard but is scared to speak up.
     
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  3. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Legend

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    This has always been the case at my surgery, or at least it has since I was diagnosed 4 years ago.

    Every 12 months I get a letter asking me to make an appointment with a Health Care Assistant. She does all the basic stuff such as blood pressure, drawing the blood, weight, sends urine sample off to the lab, completes the Q-risk formula after going through all the questions with me in case things have changed since the previous one, and so forth. She fills in all the details on my computer records. It is a 20 minute appointment. I then make an advance appointment with the nurse.

    I get my test results on line within 24 hours, but prior to this being available I obtained a print out 2 days later from reception.

    My nurse does the foot check, plenty of discussion, goes through all the results, and if I were on any meds she would discuss these and alter the prescription if necessary because she is a prescribing nurse. It is a half hour appointment.

    At 6 months I just have the blood tests done by the phlebotomist in the blood clinic at the surgery, and provided the results are normal there is no further need to see a nurse until the 12 month review.
     
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  4. ally1

    ally1 Type 2 · Expert

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    My surgery are so behind. I still have to ring to ask when I get my yearly blood test. Then when result is back then I have to book to see the DN.
     
  5. Pinkorchid

    Pinkorchid Type 2 · Well-Known Member

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    Shame some surgeries are so lax when it comes to diabetes care Mine was not to bad before the new plan never had to wait long for a DN appointment after the blood test but we had to book the appointments our self so sometimes I had forgotten when I had the last one now the surgery phones when our blood test is due and makes an appointment and the nurse who does the blood test and checks books the DN..
     
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  6. Pinkorchid

    Pinkorchid Type 2 · Well-Known Member

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    My husband has just been for his first diabetes review since the new Care and Support plan came into operation at our practice and apparently our blood tests and review with the DN will be 6 monthly from now on instead of yearly
     
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  7. Granny_grump_

    Granny_grump_ Type 2 · Well-Known Member

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    That's a great way of working the diabetic checks, 6 monthly checks are better than 12 months, gives you more of a chance to change anything you need to make adjustments on! K
     
  8. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Legend

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    That is brilliant. Your surgery is now in the 21st century. I wonder if they have now put test results on-line? I know they hadn't done when you last spoke about it. Might be worth a check.

    My surgery still allows me 6 monthly blood tests, but only one nurse review, and quite honestly that is all I need. It is a bit of a waste of time seeing the nurse when there is nothing much to discuss. It would be different if blood test results and/or medication were problematic.
     
  9. Sue192

    Sue192 Type 2 · Well-Known Member

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    So's mine @ally1 - no feet check, no eye check, no recall for second test three months after first so I arrange it. Phoned up the number for results in December; end of January I'm left a message by the 'health care team': "nothing to worry about but can you phone us back". Finally got hold of someone: "you've already had your results??" (in surprised tone.) Yes, says I. Oh. Someone will get back to you. Am still waiting, after leaving several messages. I am reluctant to change surgeries for various reasons, but I will do so after the next test mid-March. It takes about six weeks for records to be changed over, apparently. Is it possible for you do to that, @ally1?
     
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  10. Pinkorchid

    Pinkorchid Type 2 · Well-Known Member

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    No still the same only medication and appointments online they still say it is up to the doctors how much they put on I am not bothered now we can get printouts of our blood tests in seeing my records anyway they would not be very interesting reading as until I was in my 60's when I had my pneumonia jab and my blood pressure was a bit high so saw the doctor I had not been to the doctors in years never had more wrong with me except the odd cold and still much the same now except for the T2 no other medical conditions.
     
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  11. ally1

    ally1 Type 2 · Expert

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    There is one surgery 4 miles away that has just the one gp and one nurse, I asked around and various people say he is ok but people have to wait weeks for an appointment. Another one said I could register but as am out of the catchment area, if I need a home visit, they won,t come. I also asked around and spoke to people who are there, they all said, please Don, t waste time registering as they can,t keep gp,s.
    So I will have to stay where I am
     
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  12. maisiepug

    maisiepug Type 2 · Well-Known Member

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    I have blood test every 6 months and this is followed up by visit to the GP we don't have a DN, every 12 months I have my feet checked when I have the blood test done. Never have seen a DN, results always discussed by the GP.
     
  13. Charly1

    Charly1 Type 2 · Active Member

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    Don’t often contribute as i am still an early T2 diagnosis but have adopted a lowish carb highish fat diet and so far have lost 25 pounds since I was diagnosed at the end of October. I am very fortunate on that I have a very progressive surgery and since diagnosis by a temp GP who basically diagnosed me with every cardio disease known to mankind I have a very good DN. i am on quarterly appointments to start with but all being organised by the surgery they recently emailed me for a check with the health care assistant, bloods foot assessment etc followed by an appointment with the DN the following week who is on board with low carb. I am fortunate that they are prescribing me both strips and lancets hopefully this will continue in the future otherwise I will supply my own. Only problem she has a adverse issue with red wine still I am working on that aspect. The point is some surgeries get the point that support works ! Hopefully others will realise that a little support leads to long gains for both the patient and the NHS.
     
  14. Fleegle

    Fleegle Type 2 · Well-Known Member

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    My GP has just changed the checks process.
    I now go and see the DN who draws blood (or doesn't in my case...) checks feet, BP, weight.
    Normally the blood work comes back in three days and they send you one of three letters - well done, more to do, come and see us basically.

    I was pleased that my feet are good - apparently I have hair growing on them which is good - who knew!
    But unable - after two separate nurses and lots of needles to get any blood. Back on Monday for another go. Apparently if this fails the GP will syringe it out!
     
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  15. Mikey1951

    Mikey1951 Type 2 · Newbie

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    I had my blood test this morning, I see the health care assistant in two weeks time for my foot exam, BP and weight etc. She will give me my results to take home and study, but before I leave she will make an appointment with the DN where I can discuss my results. I have to say I am nervous this time, I have just got over the cough virus, which despite 3 courses of antibiotics took 5 months to clear. Loads of cough mixtures, plus other remedies. My daily tests haven’t been too bad but overall I expect a could do better. I have to say my doctor and his team look after me very well and I try to keep their work to a minimum.
     
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  16. Peterseaford

    Peterseaford Type 2 · Active Member

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    Well we have a gp we really like but he seems a little negligent to me . He diagnosed me with T2 some two years ago and said I should buy a machine at the chemist and check myself
    My grand son has T1 so my daughter is on the ball and sent me to a Diabetes Educator and I learned a lot but had no knowledge of the foot and eye tests so I returned to our gp and that was that
    In August I asked about seeing a podiatrist as at 79 I can no longer bite my toenails and even have difficulty reaching them and he said he could arrange a “plan” for me but nothing eventuates so I found a podiatrists and arranged my own visits.
    Then in October I had a pain in my back and he suggested physiotherapist and said he would arrange a “plan” so naturally I asked if podiatry could be included but he suggested that as I was entitled to five visits a year I should reserve the plan just for my back
    Needless to say despite monthly reminders the “plan” never eventuated so at the start of March and my visit to the gp I asked after the “plan” and as he seemed stunned that nothing had happened
    I asked if I should be seeing a diabetic educator and he said yes so I told him to cancel whatever he had in hand and I would make my own arrangements
    An appointment was made with the diabetes educator and she checked over my two years of readings - referred me to a doctor at her practice and a plan was prepared - I have had blood and urine tests , eye test , foot test and an echocardiogram to cancel out fatty liver and I have been put on a low carb diet to reduce weight
    I will continue to visit my gp for my heart as has been the case for twenty years and will continue to visit the educator and doctor who have shown an interest in my t2 problem

    Have a nice day
    Kind regards
    Peter
     
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  17. Paula62

    Paula62 Type 2 · Member

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  18. Paula62

    Paula62 Type 2 · Member

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    My GP Surgery has been doing it this way since I was diagnosed 5 years ago. The surgery mail me out the blood test requests prior to my diabetic review - this gives me time to have my blood test taken at the local hospital. The nurse will review the results, do the foot checks and ask about depression etc., weight me and so on. All this is logged onto the system for the GP to review. The GP will discuss any anomalies found and medication. I have been off statins for over a year as after 3 years I got an anomaly on my blood work with my liver. This turned out to be caused by the statins. I was put back on them about 6 weeks ago, and straight off i have another anomaly on my liver. My GP is liaising with a specialist at the hospital as to best course of action. Yes, my colestral is now almost reading normal (3.7) on 10mg of statin per day.
    It is good when surgery's give time to those of us dealing with a life long condition. On the whole we plough on, regularly changing our diets, what activities we do, but we also need their support and input.
    The good news for me the other week is that the guidelines for Dietetics have changed, so I no longer need to take the 75mg Aspirin daily - one less tablet to take is always good.
     
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  19. GraceB

    GraceB Type 2 · Member

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  20. GraceB

    GraceB Type 2 · Member

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    I only have yearly checks at our surgery, but we do get all the tests etc and they seem to be fairly on The ball although still pushing carbs!!!!
     
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