Having an understanding of Chronic disease management Maintaining up to date chronic disease registers Monitoring the health of patients with chronic disease and co morbidities Giving advice and support to patients to promote good self-management in line with practice protocol and local formulary. Working in collaboration with the clinical team to optimise QOF, arranging the recall of patients for annual review, and monitor attendance. Contributing to the development of practice protocols and audit. Ensuring knowledge and skills are kept up-to-date in line with current guidelines.