6.6 Describe the annual review checks to screen for long term complications

This guide will help you answer 6.6 Describe the annual review checks to screen for long term complications.

Annual review checks are used to monitor ongoing health conditions and to look for signs of possible long term complications. In the UK health and social care setting, these reviews are often part of structured care plans for people with chronic conditions such as diabetes, heart disease, kidney disorders, respiratory illness, and neurological conditions. They help in spotting problems early so that treatment can start quickly and damage can be reduced.

These checks are organised in line with NHS guidelines and specific clinical standards. They may take place in GP surgeries, specialist clinics, or community health centres. Often, they include both physical assessments and discussions about lifestyle, medication use, and any recent health concerns.

By carrying out annual reviews, health staff can compare results from previous years to identify any changes. Each check plays a role in spotting possible complications so that the person can get the right support.

Purpose of Annual Screening

The purpose is to detect subtle signs of long term complications before they become severe. Many chronic health issues worsen slowly over time. Without screening, these changes may be missed until the condition is advanced.

Annual checks:

• Monitor the effectiveness of current treatment
• Identify early changes or damage
• Support health education and self-care
• Give an opportunity for the person to raise concerns
• Guide adjustments in medications or lifestyle advice

Examples of Key Annual Review Checks

Health professionals will choose tests and assessments based on the condition being monitored. Below are examples used for different common long term health conditions.

Blood Pressure Checks

Raised blood pressure can be a complication of many health conditions. It is a major risk factor for heart disease, stroke, and kidney problems. Annual readings allow staff to notice trends. If blood pressure is increasing, medication changes or lifestyle support can be provided.

Blood Tests

These may include:

• Cholesterol levels to assess heart disease risk
• HbA1c testing for people with diabetes to measure long term blood sugar control
• Kidney function tests to look for early damage
• Liver function tests for people taking certain long-term medication
• Full blood count to detect signs of anaemia or underlying disease

Changes in results compared to the previous year may point to complications developing.

Urine Tests

Urine tests can show early signs of kidney damage. In diabetes care, a test for microalbumin checks for small amounts of protein in urine. This is a warning sign of diabetic nephropathy. Other urine tests can detect infection, kidney stones, or other abnormalities.

Eye Examinations

Many conditions can lead to changes in the eyes. Annual eye checks, such as digital retinal screening for people with diabetes, can spot damage to the retina before vision loss occurs. Glaucoma checks may be carried out for people at risk.

Foot Checks

For people with conditions that affect circulation or nerve supply, such as diabetes, foot checks are important. Annual review should include checking skin integrity, sensation, and blood flow to the feet. This can prevent ulcers and infections.

Weight and BMI Measurement

Sudden changes in weight can indicate poor control of a chronic condition or side effects of medication. High body mass index increases the risk of complications in most long term illnesses.

Physical Examination

A systematic examination may be included, looking at skin, joints, heart, lungs, and neurological function. This helps to notice any changes in overall health.

Condition-Specific Annual Screening

Different conditions require specific review checks.

Diabetes

A full annual review for diabetes normally includes:

• HbA1c blood test
• Blood pressure measurement
• Cholesterol and triglyceride levels
• Kidney function blood tests
• Urine microalbumin test
• Digital retinal photograph
• Foot examination for sensation and circulation
• Weight and BMI check
• Review of medication use and side effects

Respiratory Disease

For conditions such as COPD or asthma:

• Review of inhaler technique
• Spirometry (lung function testing)
• Oxygen saturation measurement
• Discussion of symptoms and flare-ups in the past year
• Peak flow monitoring records
• Weight check for signs of muscle loss or malnutrition

Heart Disease

Annual review may include:

• Blood pressure check
• ECG if indicated
• Blood tests for cholesterol and kidney function
• Review of symptoms such as chest pain or breathlessness
• Weight and BMI
• Medication review

Chronic Kidney Disease

Checks may include:

• Blood pressure measurement
• Kidney function blood tests
• Urine protein test
• Review of fluid intake and diet
• Medication review and possible adjustments

Lifestyle and Self-Care Assessment

Annual reviews are not only about medical tests. Lifestyle factors have a strong impact on long term health outcomes. A discussion with the person will cover:

• Smoking status and support to stop if needed
• Alcohol intake
• Diet quality and nutrient balance
• Physical activity levels
• Sleep patterns and any fatigue
• Mental health and coping with the condition

This gives a full picture of factors that may contribute to or prevent complications.

Record Keeping in Annual Reviews

Accurate record keeping is important. Results must be written down clearly in the person’s health record. This allows comparisons between years. It should include both measurements and notes from the discussion.

Good records help:

• Spot gradual changes
• Provide information for other health professionals
• Give evidence for NHS audits and service planning
• Support continuity of care

The Role of Health and Social Care Workers

Workers in the sector may be involved in:

• Taking health measurements
• Offering lifestyle support and education
• Booking and reminding people about their annual review
• Supporting individuals to attend appointments
• Explaining test results in plain language
• Encouraging self-monitoring where possible

These actions help ensure that annual reviews are effective and lead to positive changes.

Follow-Up Actions After Annual Reviews

If a check reveals a possible complication, follow-up actions are needed. This may involve:

• Further testing
• Referral to a specialist
• Adjusting medication dosage or type
• Extra support for lifestyle changes
• Increased monitoring in between annual reviews

The aim is to stop the complication from worsening and avoid unnecessary hospital admissions.

Importance of Early Detection

Spotting complications early often means they can be slowed, stopped, or reversed. For example:

• Detecting protein in urine early allows treatment that may prevent kidney failure
• Finding changes in the retina quickly can prevent vision loss
• Identifying rising cholesterol can help prevent heart disease

Screening each year gives the best chance to avoid major health problems in the future.

Communication with the Individual

Clear communication is needed during the annual review. Health workers should explain:

• What each test or measurement is for
• What the results mean
• What the next steps are if any abnormal results occur
• How the person can act to reduce risk of complications

Using plain language avoids confusion and supports understanding.

Barriers to Completing Annual Reviews

Some people miss their annual review checks. Barriers include:

• Difficulty travelling to appointments
• Language differences
• Fear of bad news
• Lack of understanding of why the review is important
• Poor appointment scheduling

Health and social care services should address these barriers through outreach, suitable booking times, translation services, and clear information.

Supporting Long Term Engagement

Annual reviews are more effective when the person engages with the process over many years. Workers can support this by:

• Building trust during appointments
• Giving small achievable health goals
• Celebrating improvements each year
• Keeping communication friendly and respectful

When the person feels involved and valued, they are more likely to attend reviews and follow recommendations.

Example of a Full Annual Review Process

Pre-appointment checks

• Invite sent by phone or letter
• Information about what will happen during the review

On the day

• Collection of basic measurements such as blood pressure, height, weight
• Taking blood and urine samples
• Conducting any scans or physical examinations
• Reviewing medication
• Discussing symptoms, lifestyle, and mental health

After the appointment

• Recording results in the health record
• Communicating results to the person
• Arranging follow-up if needed

Final Thoughts

Annual review checks are a key part of caring for people with chronic conditions. They are about spotting small changes early, providing advice, and adjusting care plans before more serious problems develop. By covering both medical tests and lifestyle discussions, annual reviews give a complete picture of health.

For health and social care workers, understanding what each check is for and how it links to preventing complications is important. It means they can support people through the process with confidence. Done well, annual reviews can extend healthy life, reduce suffering, and improve quality of care.