Long Term Conditions
The East Staffs Clinical Commissioning Group (ESCCG) is working with local practices and the local provider of community health and social care services—The Staffordshire and Stoke on Trent Partnership NHS Trust - to roll out a case management service for patients who are identified by the practice as high risk of hospital admission due to their long term condition. The service provides personalised care planning to patients who are referred by their GP with the aim of supporting patients and their carers to manage their condition. The service is being piloted with a small number of practices in the first instance before being rolled out across East Staffordshire in 2013/14. Barton Family Practice is one of the practices piloting this patient centred care. Barton Family Practice has always worked very closely with the community matron and the district nurse team to deliver the best quality care to patients with Long Term Conditions, helping them to stay independent and prevent unnecessary hospital admissions.
Once you reach the age of 65 you'll continue to
be invited to a variety of NHS health checks,
and there will also be some new ones.
As you get older, you're more likely to develop conditions that are rare in younger people. Because of this, you'll be invited for some new screening and health tests, while the screening that began earlier in adulthood for different types of cancer will continue.
Screening tests in older age
Cervical cancer screening
From 65, women will no longer be sent an invitation for cervical cancer screening unless they've had a previous abnormal screening result from any of their last three screening tests.
If you've never been screened for cervical cancer, you're entitled to request an examination, regardless of your age.
Breast cancer screening
Breast cancer screening continues up to the age of 70 (this is being extended to 73 from 2016).
Once you're over the screening invitation age, you're encouraged to make your own screening appointments every three years. This can be done by contacting your local screening unit.Your GP can give you the contact details of your local screening unit.
Watch a video about breast cancer screening .
Bowel cancer screening
Men and women over the age of 65 continue to be offered bowel cancer screening in the form of a faecal occult blood testing (FOBT) kit in the post every two years until the age of 70. From 70 onwards, you can request bowel cancer screening, but you won't be invited automatically.
If you have diabetes , you should already be attending yearly screening tests for a sight-threatening condition called diabetic retinopathy .
Diabetic retinopathy screening usually takes place at your GP’s surgery, local optometrist or local hospital. If evidence of retinopathy is found, you'll be referred to an eye clinic for treatment to help prevent future damage to your sight.
The NHS Abdominal Aortic Aneurysm (AAA) Screening Programme is being introduced nationwide. The programme's aim is to reduce deaths from abdominal aortic aneurysms (also called ‘AAAs’ or ‘Triple As’) through early detection.
The aorta is the main blood vessel that supplies blood to your body. It runs from your heart down through your chest and abdomen. In some people, as they get older, the wall of the aorta in the abdomen can become weak. It can then start to swell and form an abdominal aortic aneurysm. The condition is most common in men aged 65 and over.
As part of the screening programme, all men will be offered AAA screening when they reach 65 and those over 65 can request it. If you accept the invitation or request screening, a simple and pain-free ultrasound scan of the abdomen will be done to measure the width of the aorta.
Read more about AAA screening .
Medical testing in older age
In addition to the screening programmes discussed above, there are a wide range of medical tests that you may encounter in your middle years, usually at the recommendation of your GP. They may include:
- measure your height and weight
- check your vaccinations are up to date
- ask about your general health
- offer you advice on diet and physical activity, if appropriate
- ask you to provide a sample of urine to check for diabetes . If your test is clear, you won't need a further diabetes test unless you develop symptoms
- test your blood pressure. All adults are advised to have a blood pressure check every five years, or every year if you have high blood pressure. High blood pressure can put you at raised risk of coronary heart disease and stroke . If your blood pressure is found to be high, your GP can advise you on diet and lifestyle changes, as well as medication, that will help to lower it
Cholesterol is a body fat in the blood. It plays a vital part in normal body function, but if the levels of cholesterol are too high then you're at risk from heart disease. This is because fatty deposits build up and clog your arteries.
To check if your cholesterol levels are healthy, cholesterol charity Heart UK recommends that all adults over 40 undergo a blood test. This is particularly important if:
- you have a family history of cholesterol problems or heart disease
- you have high blood pressure
- you are obese
Read more about cholesterol testing and whether you should have a cholesterol test .
If you're suffering from symptoms such as tiredness, faintness and difficulty breathing, it’s possible you may have anaemia . If you’re concerned, your GP can check this by doing a blood test to measure the level of red cells in your blood.
Thyroid function test
The thyroid is a gland that produces hormones that regulate your body’s metabolism (the rate at which it uses energy). If it isn’t functioning properly you may experience health problems.
If you have symptoms of an underactive thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism) , your GP may recommend a blood test to check your thyroid function.
A range of conditions such as asthma can affect your lung or airway function.
To assess your lung function, your GP can perform a peak flow test, where you'll be asked to blow hard into a handheld peak flow meter. If there seems to be a problem, your GP may recommend further tests.
If you suffer from one of a range of heart conditions, your doctor may recommend that you have an electrocardiogram (ECG) . An ECG records the rhythm and electrical activity of your heart.
Prostate cancer test
Your GP can conduct a blood test, called a prostate-specific antigen (PSA) test, that looks for signs of prostate cancer .
Many early prostate cancers cause no symptoms, but if they do occur they can include increased frequency of urination, a weak stream of urine and the sudden, urgent need to urinate. Most men with these symptoms do not have prostate cancer. Two out of three men with a raised PSA level will not have prostate cancer. And a normal PSA level is sometimes found in men with prostate cancer.
How to decide whether to have a PSA test .
Osteoporosis is a condition that causes bones to become brittle and fragile. It's most common in women over 50, and symptoms include a tendency to fracture easily. If you show signs of early osteoporosis , a DEXA bone scan can help determine whether you have the condition or are at risk of developing it.
Kidney disease test
The government recommends that everyone at high risk has a blood test for kidney disease every year. You are at raised risk of kidney disease if you have:
- high blood pressure
- vascular disease (conditions that affect the heart, arteries and veins, such as coronary heart disease or stroke)
- heart failure
- a close relative with kidney disease
Read more about getting your kidneys tested .
Glaucoma occurs when the fluid that travels within the healthy eye becomes blocked and builds up pressure. This can lead to vision becoming damaged, and may eventually cause loss of sight. Most cases of glaucoma are detected at a routine eye check-up.
The NHS offers free sight tests to anyone over 60, those already diagnosed with the condition, and those who are over 40 and are the parent, sibling or child of a person diagnosed with glaucoma.
Read more about NHS eye tests for over-60s .
Because our eyesight changes as we get older, almost all of us will need to wear glasses or contact lenses by the time we’re 65.
If you have regular eye tests, wear the right lenses and look after your eyes, there’s a better chance your sight will remain clear.
Have regular eye tests
What's free on the NHS?
Find out if you're entitled to free NHS eye tests or optical vouchers and how to claim for help.
An eye test is not just good for checking whether your glasses are up to date. It’s also a vital check on the health of your eyes. An eye test can pick up eye diseases, such as glaucoma and cataracts, as well as general health problems, including diabetes and high blood pressure .
The good news is that if you’re 60 or over, you can have a free NHS eye test every two years. You can have a free test every year if you’re 70 or over.
However, a 2011 survey from Age UK showed that nearly 2 million people over 60 did not take advantage of free eye tests in the previous two years.
Helena Herklots, services director at Age UK, said: "It’s worrying that such a high number of older people have not had a sight test recently. Going for regular sight tests and wearing the right glasses will not only improve balance, co-ordination and mobility but will help to maintain general eye health."
If you can’t leave your home because of illness or disability, you can have an NHS eye test at home. Contact your usual optician to find out if they can visit you at home. Otherwise, your local primary care trust (PCT) will have a list of opticians in your area that do home visits.
Find out more about eye tests .
Wear the right lenses
An eye test will establish whether you need a different prescription for your glasses or contact lenses.
It’s important to wear the correct prescription lenses. This will improve your quality of life and reduce the risk of accidents such as falls.
According to Age UK's research, poor vision was a factor in 270,000 falls in people over the age of 60 in the previous two years.
You may be entitled to help with the cost of NHS glasses or contact lenses, so ask your optician about this.
Find a local optician .
Read more about entitlement to free NHS eye tests or optical vouchers .
Eye problems as you get older
As you get older, you become more likely to get certain eye problems:
- Difficulty reading . Eye muscles start to weaken from the age of 45. It's a natural ageing process of the eye that happens to us all. By the time you're 60, you'll probably need separate reading glasses or an addition to your prescription lenses (bifocals or varifocals).
- Floaters . These tiny specks or spots that float across your vision are normally harmless. If they persist, see an optician as they may be a sign of an underlying health condition.
- Cataracts . Easily detected in an eye test, this gradual clouding of the eye's lens is extremely common in over-60s. A simple operation can restore sight.
- Glaucoma . This is related to an increase in pressure in the eye that leads to damage of the optic nerve, which connects the eye to the brain. Left untreated, glaucoma leads to tunnel vision and, ultimately, blindness. However, if it's detected early enough, these complications can usually be avoided with eye drops.
- Macular degeneration . This is a disease of the retina caused by ageing. The retina is the nerve tissue lining the back of your eye. There are two types of macular degeneration. The first type, called dry macular degeneration, gets worse very slowly. The other type gets worse very quickly. This needs to be seen as an emergency in a hospital eye unit for prompt treatment.
How to keep your eyes healthy
As well as having regular eye tests and wearing the correct glasses, you can do several things to keep your eyes as healthy as possible:
- Eat well . Eating a healthy, balanced diet is important for your eyes. Eating plenty of vegetables and fruit will benefit your overall health and may help protect against some conditions such as cataracts and age-related macular degeneration (AMD, see below)..
- Wear sunglasses . Strong sunlight can damage your eyes and may increase your risk of cataracts. Wear sunglasses or contact lenses with a built-in UV filter to protect your eyes from harmful rays.
- Quit smoking . Smoking can increase your chances of developing conditions such as cataracts and AMD.
- Stay a healthy weight . Being overweight increases your risk of diabetes, which can lead to sight loss.
- Use good lighting . To see well, your eyes need three times as much light when you're 60 as they did when you were 20. Increase the daylight in your home by keeping windows clean and curtains pulled back. Make sure you have good electric lighting too, especially at the top and bottom of stairs so you can see the steps clearly. For reading or close work, use a direct light from a flexible table lamp, positioned so the light is not reflected by the page and causing glare.
- Exercise . Good circulation and oxygen intake are important for our eye health. Both of these are stimulated by regular exercise.
- Sleep well . As you sleep, your eyes are continuously lubricated and irritants, such as dust or smoke, that may have accumulated during the day are cleared out. Read the top 10 tips to beat insomnia:
10 tips to beat insomnia:
Simple lifestyle changes can make a world of difference to your quality of sleep.
Following these 10 tips from The Sleep Council will help you have a more restful night.
1. Keep regular hours
Going to bed and getting up at roughly the same time every day will programme your body to sleep better. Choose a time when you're most likely to feel sleepy.
2. Create a restful sleeping environment
Your bedroom should be kept for rest and sleep. Keep it as quiet and dark as possible. It should be neither too hot nor too cold. Temperature, lighting and noise should be controlled so that the bedroom environment helps you to fall (and stay) asleep.
3. Make sure that your bed is comfortable
It’s difficult to get restful sleep on a mattress that’s too soft or too hard, or a bed that's too small or old. If you have a pet that sleeps in the room with you, consider moving it somewhere else if it often makes noise in the night.
4. Exercise regularly
Moderate exercise on a regular basis, such as swimming or walking, can help to relieve some of the tension built up over the day. But don't do vigorous exercise too close to bedtime as it may keep you awake.
5. Less caffeine
Cut down on stimulants such as caffeine in tea or coffee, especially in the evening. They interfere with the process of falling asleep, and they prevent deep sleep. The effects of caffeine can last a long time (up to 24 hours) so the chances of it affecting sleep are significant. Have a warm, milky drink or herbal tea instead.
6. Don’t over-indulge
Too much food or alcohol, especially late at night, can interrupt your sleep patterns. Alcohol may help you to fall asleep initially, but it will disrupt your sleep later on in the night.
7. Don’t smoke
It’s bad for sleep. Smokers take longer to fall asleep, they wake up more frequently, and they often have a more disrupted sleep.
8. Try to relax before going to bed
Have a warm bath, listen to quiet music or do some gentle yoga to relax the mind and body. Your doctor may be able to recommend a helpful relaxation CD.
9. Write away your worries
Deal with worries or a heavy workload by making lists of things to be tackled the next day. If you tend to lie in bed thinking about tomorrow's tasks, set aside time before bedtime to review the day and make plans for the next day. The goal is to avoid doing these things when you're in bed, trying to sleep.
10. Don't worry in bed
If you can’t sleep, don’t lie there worrying about it. Get up and do something you find relaxing until you feel sleepy again, then return to bed.
Please contact the surgery when ever you have any concerns regarding your health. The GPs and Nursing Team are on hand to help you.
Information taken from NHS Choices 22.3.2013