Chronic Care at Home

Continuity
you can feel.

Ongoing follow-up for long-term conditions - blood pressure, diabetes, wound management, and the conditions that reward being watched rather than visited once. The same clinical team, returning on a schedule, noticing what a stranger would miss.

Choose a programme

Chronic Care Assessment

The first visit: history, medications, and a baseline to measure against.

A physician reviews your full history and every medication you take, then sets a written plan and a follow-up schedule.

60 minPhysicianWritten care plan
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Monthly Monitoring Visit

A scheduled check, so change is noticed early rather than late.

Vitals, any bloods your plan requires, and a medication review with adjustments made by your physician.

45 minPhysicianRecurring
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Diabetes Care Programme

Ongoing diabetes follow-up, monitored at home.

Recurring visits with HbA1c and glucose monitoring, foot and wound checks where relevant, and a medication review each time.

60 minPhysicianRecurring, with labs
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Hypertension Care Programme

Blood pressure measured where you actually live.

Recurring readings taken at home, with bloods where your plan requires them and medication reviewed at every visit.

60 minPhysicianRecurring, with labs
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Why readings taken at home are different

Blood pressure measured in a clinic is measured after a drive, a lift and a wait - and it often reads higher than the same person's pressure at home. Readings taken where you actually live give your physician a truer picture to adjust medication against. Continuity does the rest: the same team, returning on a schedule, comparing you against your own previous numbers.

How it works

01 Baseline

An assessment visit first.

History, medications and current readings, written up as a plan rather than an opinion.

02 Schedule

Visits set to the condition.

How often depends on what is being watched, not on a standard package.

03 Monitoring

Readings taken at home.

Vitals and bloods collected on the schedule your plan sets, recorded in your app.

04 Adjustment

Your physician acts on it.

Medication reviewed against your own trend, not against a population average.

These programmes support ongoing management and do not replace emergency care. If something changes suddenly, call 998 or go to your nearest emergency department.

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