Does this replace my NHS annual review?
No, and it is not designed to. Your NHS practice runs the recall systems for screening, vaccination and the physical checks — diabetic foot and eye screening, spirometry — that cannot be done remotely by anyone.
What this adds is time. Twenty unhurried minutes to go through what your numbers actually mean, whether the dose is right, and the questions that never fit into a ten-minute slot.
Can you change my medication?
We can prescribe privately and we can recommend changes in writing. What we cannot do is alter a prescription issued by your NHS GP or a hospital team — only the prescriber can do that.
The written summary is designed for exactly that conversation, and a reasoned recommendation is usually what has been missing.
What actually gets checked?
Depends on the condition, and it is worth knowing what good looks like:
- Type 2 diabetes — HbA1c, kidney function and urine ACR, lipids, blood pressure, weight, plus foot and eye screening in person
- High blood pressure — home readings, kidney function and electrolytes, cardiovascular risk
- Asthma and COPD — symptom control, exacerbations, inhaler technique, and a written action plan
- Thyroid — thyroid function alongside symptoms, because the two do not always match
- High cholesterol — lipids, liver function, and overall cardiovascular risk rather than the cholesterol number alone
Why do you want to see me use my inhaler?
Because technique is wrong in a large proportion of people who have used one for years, and it is rarely checked after the first prescription.
If the medicine is not reaching the lungs, the dose is irrelevant — and this is one of the few things a video consultation does genuinely better than a telephone one. Have the inhaler and any spacer with you.
My numbers are fine but I still feel unwell.
Worth taking seriously rather than being reassured by the printout. In thyroid disease particularly, symptoms and TSH do not always move together, and a result inside the range does not automatically mean the dose is right for you.
It is also worth checking what has not been looked at — iron, B12, vitamin D and sleep apnoea all produce symptoms attributed to a known condition.
I stopped taking one of them. Should I admit that?
Yes, and it changes the consultation for the better. Stopping a statin because of aches, or a blood pressure tablet because of swollen ankles, is common and usually solvable by switching to something else.
The alternative — a doctor increasing the dose of something you are not taking — is how people come to harm.
I am between practices or have just moved. Can you cover the gap?
Yes, and it is a sensible use of the service — particularly for keeping medication going and monitoring current while you register.
But register. Long-term condition care depends on recall systems for screening and vaccination that no private practice can replicate, and the gap is where things get missed.
How often should a review actually happen?
Annually as a minimum for most stable long-term conditions, and more often after any change — four to six weeks after a blood pressure change, three months after starting a statin, six to eight weeks after a thyroid dose change.
If your condition is not controlled, annual is not enough.