Review screening status dietary advice (eg, practice nurse, dietician) Review for the following screening alcohol/drug issues (eg, brief GP opportunities (where indicated and intervention or referral). update where necessary): cervical smear Mental health mammogram counselling for mild to cardiovascular risk status mental health concerns (eg, normal diabetes annual review (‘Get referral criteria apply) Checked’) (if relevant) mental health referral for major ultrasound to detect neural tube psychiatric illness. defects (if relevant). Other specialist referral (normal Management referral criteria apply) Undertake appropriate management of or Genetic advice or counselling referral for any conditions detected. (normal referral criteria apply) Investigations Foetal neural tube defect screening Undertake the following investigations if (if appropriate) indicated by standard evidence based Serum dioxin test. guidelines: lipids and blood glucose Serum dioxin testing is unlikely to serum proteins and immunoglobulin contribute further to patient (if indication of multiple myeloma) management. It is only appropriate when diabetes level of control (eg, HbA1C, the test will assist in improving the etc) patient’s emotional wellbeing. Full full blood count informed consent (including advantages, chest X-ray (if respiratory symptoms and disadvantages) is required. or indications of lymphoma, Hodgkins, lung disease, etc) Discuss the following with the patient: PSA (following an informed limitations of the serum dioxin test discussion about the advantages and testing process and interpretation of limitations of PSA screening for the results asymptomatic men) whether the patient has had a serum other specific tests if clinical dioxin test previously (NB: a serum indications dioxin test should not be provided if Referral Options already undertaken) review for underlying mental health Action referral to any of the following if issues indicated: medical reasons for not taking approximately 90 millilitres of blood. Lifestyle modification smoking cessation exercise/physical activity (eg, green prescriptions)
Review screening status Review for the following screening opportunities (where indicated and update where necessary): cervical smear mammogram cardiovascular risk status diabetes annual review (‘Get Checked’) (if relevant) ultrasound to detect neural tube defects (if relevant). Management Undertake appropriate management of or referral for any conditions detected. Investigations Undertake the following investigations if indicated by standard evidence based guidelines: lipids and blood glucose serum proteins and immunoglobulin (if indication of multiple myeloma) diabetes level of control (eg, HbA1C, etc) full blood count chest X-ray (if respiratory symptoms or indications of lymphoma, Hodgkins, lung disease, etc) PSA (following an informed discussion about the advantages and limitations of PSA screening for asymptomatic men) other specific tests if clinical indications Referral Options Action referral to any of the following if indicated: Lifestyle modification smoking cessation exercise/physical activity (eg, green prescriptions) dietary advice (eg, practice nurse, dietician) alcohol/drug issues (eg, brief GP intervention or referral). Mental health counselling for mild to mental health concerns (eg, normal referral criteria apply) mental health referral for major psychiatric illness. Other specialist referral (normal referral criteria apply) Genetic advice or counselling (normal referral criteria apply) Foetal neural tube defect screening (if appropriate) Serum dioxin test. Serum dioxin testing is unlikely to contribute further to patient management. It is only appropriate when the test will assist in improving the patient’s emotional wellbeing. Full informed consent (including advantages, and disadvantages) is required. Discuss the following with the patient: limitations of the serum dioxin test testing process and interpretation of the results whether the patient has had a serum dioxin test previously (NB: a serum dioxin test should not be provided if already undertaken) review for underlying mental health issues medical reasons for not taking approximately 90 millilitres of blood.
annual-health-check-guidance.docx