Wellbeing checks

• Depression: Persistent low mood, anhedonia, fatigue, changes in appetite or sleep
• Anxiety Disorders: Excessive worry, restlessness, irritability, physical symptoms like palpitations or sweating
• Stress-Related Conditions: Chronic stress leading to burnout, fatigue, irritability, difficulty concentrating
• Substance Use Disorders: Uncontrolled use of alcohol, drugs, or medications leading to social, occupational, or health problems
• Sleep Disorders: Insomnia, sleep apnea, or other disturbances impacting overall well-being and daily function
• Eating Disorders: Anorexia nervosa, bulimia nervosa, or binge eating disorder affecting physical and mental health

• Hypertension: Often asymptomatic, detected through routine checks, may lead to cardiovascular complications
• Diabetes Mellitus: Polyuria, polydipsia, weight loss, fatigue, blurred vision, detected through blood glucose monitoring
• Obesity: High body mass index (BMI), associated with comorbidities like diabetes, hypertension, and cardiovascular disease
• Cholesterol Disorders: Dyslipidaemia detected through lipid profiles, associated with increased risk of atherosclerosis
• Respiratory Conditions (e.g., COPD, Asthma): Chronic cough, wheezing, breathlessness, detected through spirometry
• Osteoporosis: Detected through bone density scans, particularly in postmenopausal women or those with risk factors

Assess the specific concerns or reasons for the wellbeing check:

• Mental Health Symptoms: Explore mood, anxiety, stress levels, sleep patterns, and any changes in behaviour or emotions
• Physical Symptoms: Enquire about fatigue, weight changes, pain, breathlessness, or any other new or worsening symptoms
• Lifestyle Factors: Diet, exercise, smoking, alcohol use, and substance use, as well as adherence to any prescribed treatments
• Preventive Measures: Vaccinations, cancer screenings (e.g., cervical smear, mammogram), and other routine checks
• Social Support: Assess the patient’s support network, including family, friends, and community resources
• Work and Occupational Health: Explore work-life balance, occupational stress, and any work-related health concerns
• Medication and Treatment Review: Review current medications, adherence, and any side effects or interactions

Gather a detailed background including:

• Past Medical History: Chronic conditions, previous mental health diagnoses, surgical history
• Drug History: Detailed review of all medications, including over-the-counter and herbal supplements
• Family History: Any history of chronic diseases, mental health issues, or genetic conditions in the family
• Social History: Living conditions, relationship status, employment, financial situation, and lifestyle habits
• Developmental History (if relevant): In paediatric or adolescent checks, explore developmental milestones and educational progress

• General Observations: BMI, waist circumference, blood pressure, heart rate
• Cardiovascular Examination: Assess for signs of hypertension, heart disease, or peripheral vascular disease
• Respiratory Examination: Auscultation for wheezes, crackles, and assessment of respiratory rate
• Abdominal Examination: Palpation for masses, tenderness, and organomegaly
• Musculoskeletal Examination: Assess for joint abnormalities, muscle strength, and signs of osteoporosis
• Neurological Examination: Basic neurological assessment, including reflexes, coordination, and mental status
• Mental State Examination: Assess appearance, behaviour, mood, thought process, cognition, and insight

• Full Blood Count (FBC): To assess for anaemia, infection, or other haematological abnormalities
• Electrolytes and Renal Function Tests: To evaluate kidney function and electrolyte balance
• Liver Function Tests (LFTs): To assess liver health, particularly in patients with a history of alcohol use or liver disease
• Lipid Profile: To assess for dyslipidaemia, an important cardiovascular risk factor
• HbA1c and Fasting Glucose: To screen for diabetes or prediabetes
• Thyroid Function Tests (TFTs): To screen for hypo- or hyperthyroidism, particularly if weight changes, fatigue, or mood changes are present
• Urinalysis: To screen for renal disease, diabetes, or urinary tract infections
• Bone Mineral Density Scan (DEXA): If osteoporosis is suspected, particularly in postmenopausal women or those with risk factors
• ECG: To screen for cardiac abnormalities, particularly in patients with hypertension or symptoms of cardiovascular disease
• Mental Health Screening Tools: PHQ-9, GAD-7, or other validated tools for assessing depression, anxiety, or other mental health conditions
• Spirometry: To assess lung function in patients with a history of smoking, asthma, or COPD