Fitting a health assessment into a business trip to London

Where the day fits in your diary

Give the assessment one clear day and treat it as a meeting that cannot move. The executive physical runs from the morning to a review with your physician later in the day, and the final conversation is where most of the value lies, so a day squeezed between commitments tends to shortchange it.

Place it early in the trip rather than on your last day. If a result needs a repeat test or a specialist opinion, a day or two left in London gives room to arrange it before you fly.

If you cross several time zones, allow for the body clock. It shifts by about 1 hour a day after travelling east and about 1.5 hours a day after travelling west [1]. Moving your sleep 1 hour a day toward London time for 2 to 3 days before you travel can shorten the adjustment [1].

What to arrange before you travel

Most of the preparation can be done from your desk at home. Check that your permission to enter covers the trip. An ETA allows a business trip or tourism of up to 6 months, and does not allow work for a UK company [2].

Send your records ahead so the physician has read them before you arrive. If you travel with prescribed medicines, carry a letter showing they were prescribed for you, and keep any controlled drug in your hand luggage [3].

• Previous blood results, ECGs and scan reports, with their dates
• A list of your medicines and supplements, with doses
• Readings from a home blood pressure monitor or a wearable, if you use one
• Your family history of heart disease, stroke, diabetes and cancer, with the age each began
• Comfortable clothes for the examination and measurements
• The questions you most want answered

The morning of the assessment

You will be told beforehand whether to fast. A full cholesterol profile does not have to be a fasting sample [4], while fasting glucose and insulin are, by definition, measured on an empty stomach. If you are asked to fast, drink water as usual and bring something to eat after the blood test.

Keep taking your regular medicines unless the doctor has said otherwise, and if you take medicine for diabetes, ask before you fast. Leave time to arrive unhurried. A blood pressure reading taken after a rush across town is a starting point, and NICE advises that a clinic reading between 140/90 and 180/120 mmHg is confirmed with ambulatory or home monitoring before high blood pressure is diagnosed [5].

Results before you leave

Later in the day the physician goes through each result with you, explains which ones matter for you, and sets out a written plan. When a finding needs a specialist, the doctor says so and explains the next step, which can often be arranged while you are still in London.

Some results need a second look. A borderline value may need a repeat test, and a raised blood pressure may need home readings taken twice a day for at least 4 days, ideally 7 [5], which you can do from home and share with the doctor.

The plan you take home

The plan is written so you and your doctor at home can act on it. It sets out what to change first, which tests to repeat and when, what to measure at home, and who is responsible for each step.

Your results and letters sit in one record you can open from any country, and the doctor writes a letter your own doctor can read. A follow-up by video with the physician who saw you covers repeat results and new questions without another flight.

• Which results need repeating, and where should that happen?
• What should I measure at home, and how often?
• Who do I contact if a later result is abnormal?
• When is my follow-up call, and in which time zone?

Who it suits and who it does not

It suits someone who is well and would rather give one planned day in London than piece together tests across several countries. It also suits someone who visits regularly and wants the same physician to follow their results from one trip to the next.

It is the wrong choice when you feel unwell. New symptoms need a same day GP appointment or a doctor at your hotel rather than a planned assessment. If you have chest pain, sudden breathlessness, severe bleeding or signs of a stroke, call 999 in the UK.

Every assessment has limits, and general health checks offered to whole populations have not been shown to reduce deaths [6], so the value lies in the decisions you make with your doctor, and a normal result is no reason to ignore a symptom later.

How The Wellness can help

Our clinics are on Baker Street in Marylebone and Eccleston Street in Belgravia, open from seven in the morning to nine at night every day, so the day can start early and a follow-up can fit around an evening meeting. A doctor can also come to your hotel in London.

Every doctor is GMC registered, and regulated services are delivered through registered partner clinics and accredited laboratories. If you would rather continue care nearer home, appointments are arranged with partners in 12 city pages beyond London.