Abscess
Face to face Consultation
Clarify with patient if the issue is dental or not.
If dental direct to dentist. If patient has no dentist advise to call 111 for emergency dentist review.
If not dental in nature book a face to face appointment within a week with clinician.
If the patient is unwell e.g. feverish they will need a same day appointment.
Abdomen Pain
Refer to Community Pharmacy Scheme or Face to Face Consultation
Stomach cramps with diarrhoea/vomiting/bloating:
- Signpost Pharmacy for products to help. If OTC failed/not helped book an Amber appointment
Sudden severe abdominal pain:
- Book a same day face to face appointment.
Repeated/reoccurring stomach problems:
- Book a Green face to face appointment
Acid Reflux
Refer to Community Pharmacy Scheme or Face to Face Consultation
If patient is under 6 years or over 45 years of age make face to face appointment.
If it is mild and short lived and the first episode, refer patient to Community Pharmacy scheme for advice and appropriate products.
If this has already been tried, then this can be booked in for a face to face appointment.
Detail in the booking notes the medication taken to date, the length of time the problem has existed along with the symptoms.
Acne
Community Pharmacy or Face to Face Consultation
Send patient to pharmacy for advice and appropriate products.
- If this has already been tried a number of times, then this can be booked in for a Consultation.
Detail in the booking notes the medication taken to date and length of time existing treatment has been, used.
Acute Medication Request
Follow appropriate flow chart
Create a task with all the details from the patient and confirm that the pharmacist will look into that.
- Advise that if it goes through then the prescription will be available as usual in 2 working days.
If there is any problem with the request, someone will be in touch to discuss further.
Follow “medication requests – acute (including controlled drugs and antibiotics)” flow chart.
ADHD/Autism
Telephone or Face to Face Consultation
Book appointment.
- For all Adults over the age of 16 who suspect a new diagnosis of Autism/ADHD. Send Accurx to patient to complete relevant questionnaire prior to their appointment.
Advanced Care Planning (ACP)
Telephone Consultation or Face to Face Consultation
For patients who wish to discuss advance care planning or this has been requested by their hospital/specialist team.
- Give the patient the option of a telephone or face to face consultation.
A Home Visit can be arranged if the patient is housebound.
Patient can be booked into a 20 minute slot.
ACP appointment include discussions about resuscitation, patients wishes & preferences such as preferred place of care/death.
Alcohol/Drug misuse
Local Drug and Alcohol Services
Provide Patient with details of local Drug and Alcohol Services.
Book an appointment if the patient wishes to see a clinician
Allergies
Refer to Community Pharmacy Scheme
Symptoms of an allergic reaction usually develop within a few minutes of being exposed to something you’re allergic to, although occasionally they can develop gradually over a few hours. The symptoms can vary.
Common symptoms of an allergic reaction include:
- Sneezing and an itchy, runny or blocked nose (allergic rhinitis)Itchy, red, watering eyes (conjunctivitis)
- Wheezing, chest tightness, shortness of breath and a cough.
- A raised, itchy, red rash (hives).
- Swollen lips, tongue, eyes or face.
- Tummy pain, feeling sick, vomiting or diarrhoea.
- Dry, red and cracked skin
The symptoms can vary. Refer to ANAPHYLAXIS information on this page (below Allergies) if symptoms are severe.
Direct to A&E / 999.
Refer to Community Pharmacy Scheme
Symptoms of an allergic reaction usually develop within a few minutes of being exposed to something you’re allergic to, although occasionally they can develop gradually over a few hours. The symptoms can vary.
Common symptoms of an allergic reaction include:
- Sneezing and an itchy, runny or blocked nose (allergic rhinitis)Itchy, red, watering eyes (conjunctivitis)
- Wheezing, chest tightness, shortness of breath and a cough.
- A raised, itchy, red rash (hives).
- Swollen lips, tongue, eyes or face.
- Tummy pain, feeling sick, vomiting or diarrhoea.
- Dry, red and cracked skin
The symptoms can vary. Refer to ANAPHYLAXIS information on this page (below Allergies) if symptoms are severe.
Direct to A&E / 999.
Refer to Community Pharmacy Scheme
Symptoms of an allergic reaction usually develop within a few minutes of being exposed to something you’re allergic to, although occasionally they can develop gradually over a few hours. The symptoms can vary.
Common symptoms of an allergic reaction include:
- Sneezing and an itchy, runny or blocked nose (allergic rhinitis)Itchy, red, watering eyes (conjunctivitis)
- Wheezing, chest tightness, shortness of breath and a cough.
- A raised, itchy, red rash (hives).
- Swollen lips, tongue, eyes or face.
- Tummy pain, feeling sick, vomiting or diarrhoea.
- Dry, red and cracked skin
The symptoms can vary. Refer to ANAPHYLAXIS information on this page (below Allergies) if symptoms are severe.
Direct to A&E / 999.
Face to Face consultation or Emergency Care
Symptoms of a food allergy can affect different areas of the body at the same time.
Some common symptoms include:
- An itchy sensation inside the mouth, throat or ears
- A raised itchy red rash (urticaria, or “hives”)
- Swelling of the face, around the eyes, lips, tongue and roof of the mouth (angioedema)
- Vomiting
The symptoms can vary. Refer to ANAPHYLAXIS information on this page (below Allergies) if symptoms are severe.
Direct to A&E / 999.
Refer to Community Pharmacy Scheme
Hay fever can often be controlled using over-the-counter medication from your pharmacist.
However, if your symptoms are more troublesome your pharmacist may advise you contact your GP, as you may require prescription medication.
You usually only need to see your GP if:
- You can’t control your symptoms with over-the-counter medications.
- You have troublesome side effects caused by the medication.
- You’re experiencing persistent complications of hay fever, such as worsening of asthma or repeated episodes of sinusitis.
- The pattern of your symptoms is unusual, such as occurring during the winter or only at your workplace (it’s likely that another substance other than pollen is responsible).
Refer to Community Pharmacy Scheme
Symptoms of an allergic reaction usually develop within a few minutes of being exposed to something you’re allergic to, although occasionally they can develop gradually over a few hours. The symptoms can vary.
Common symptoms of an allergic reaction include:
- Sneezing and an itchy, runny or blocked nose (allergic rhinitis)Itchy, red, watering eyes (conjunctivitis)
- Wheezing, chest tightness, shortness of breath and a cough.
- A raised, itchy, red rash (hives).
- Swollen lips, tongue, eyes or face.
- Tummy pain, feeling sick, vomiting or diarrhoea.
- Dry, red and cracked skin
The symptoms can vary. Refer to ANAPHYLAXIS information on this page (below Allergies) if symptoms are severe.
Direct to A&E / 999.
Refer to Community Pharmacy Scheme
Adults or children over 2 years with insect bites or stings can get advice and treatment directly from a pharmacy. If there is a lot of swelling and blistering or if there is pus and the pharmacist feels that may be an infection book a Red face to face appointment.
The symptoms can vary. Refer to ANAPHYLAXIS information on this page (below Allergies) if symptoms are severe.
Direct to A&E / 999.
Refer to Community Pharmacy Scheme
Symptoms of an allergic reaction usually develop within a few minutes of being exposed to something you’re allergic to, although occasionally they can develop gradually over a few hours. The symptoms can vary.
Common symptoms of an allergic reaction include:
- Sneezing and an itchy, runny or blocked nose (allergic rhinitis)Itchy, red, watering eyes (conjunctivitis)
- Wheezing, chest tightness, shortness of breath and a cough.
- A raised, itchy, red rash (hives).
- Swollen lips, tongue, eyes or face.
- Tummy pain, feeling sick, vomiting or diarrhoea.
- Dry, red and cracked skin
The symptoms can vary. Refer to ANAPHYLAXIS information on this page (below Allergies) if symptoms are severe.
Direct to A&E / 999.
Face to Face Consultation/A&E
If the patient is informing you that they have had a reaction to a recent prescription and require an alternative, book an amber appointment with a clinician.
The symptoms can vary. Refer to ANAPHYLAXIS information on this page (below Allergies) if symptoms are severe.
Direct to A&E / 999
Refer to Community Pharmacy Scheme
Symptoms of an allergic reaction usually develop within a few minutes of being exposed to something you’re allergic to, although occasionally they can develop gradually over a few hours. The symptoms can vary.
Common symptoms of an allergic reaction include:
- Sneezing and an itchy, runny or blocked nose (allergic rhinitis)Itchy, red, watering eyes (conjunctivitis)
- Wheezing, chest tightness, shortness of breath and a cough.
- A raised, itchy, red rash (hives).
- Swollen lips, tongue, eyes or face.
- Tummy pain, feeling sick, vomiting or diarrhoea.
- Dry, red and cracked skin
The symptoms can vary. Refer to ANAPHYLAXIS information on this page (below Allergies) if symptoms are severe.
Direct to A&E / 999.
Anaphylaxis
Severe allergic reaction (Anaphylaxis)
In rare cases, an allergy can lead to a severe allergic reaction, called anaphylaxis or anaphylactic shock, which can be life-threatening.
This affects the whole body and usually develops within minutes of exposure to something you’re allergic to.
Signs of anaphylaxis include any of the symptoms below, as well as:
- swelling of the throat, mouth and/or tongue
- difficulty breathing
- light-headedness
- confusion
- blue skin or lips
- collapsing and losing consciousness
Anaphylaxis is a medical emergency that requires immediate treatment.
Call 999 immediately
Ankle Pain
Refer to Community Pharmacy Scheme or Appointment with Musculoskeletal specialist or Face to Face Appointment with clinician
Book appointment with MSK specialist or sign post to Moving Well service.
Patients can self refer to a physiotherapist (see external contacts for information).
If the pain started after recent trauma advise to attend urgent care / A&E.
Care
If the patient is not coping with current pain levels and/or there are “medical” causes for the pain or if they are under 16 years of age book a face to face appointment with a clinician.
Book a red face to face appointment if there is a possible infected joint (i.e. sudden severe joint pain, feverish, new red hot swollen joint).
Anorexia
Face to Face Consultation
Book appointment
Animal Bites Scratches and Stings
Refer to Community Pharmacy Scheme or Face to Face Appointment
Animal bites/Scratches that have broken the skin and are showing signs of infection, book a red face to face appointment.
Insect bites and Stings
Adults and children over 2 years with insect bites or stings can get advice and treatment directly from a pharmacy. Refer to Community Pharmacy Scheme or telephone appointment.
If there is a lot of swelling and blistering or if there is pus and the pharmacist feels there may be an infection, book a red face to face appointment.
The symptoms can vary. Refer to ANAPHYLAXIS information on this page if symptoms are severe.
Direct to A&E / 999.
Anxiety ADULT
Face to Face Consultation
Non Emergency:
Book a face to face appointment with ANP/GP:
EMERGENCY CARE: (threat to life/harm)
Direct to Hospital
Alternative Support available to the young person aged 14-25 years:
Anxiety CHILD (under 16)
Face to Face Consultation
Non Emergency:
Book a face to face appointment with ANP/GP:
EMERGENCY CARE: (threat to life/harm)
Direct to Hospital
Alternative Support available to the young person aged 14-25 years:
Arthritis
Musculoskeletal specialist or Face to Face Consultation
Book appointment with MSK specialist or sign post to Moving Well service.
Patients can self refer to a physiotherapist (see external contacts for information).
If the pain started after recent trauma advise to attend urgent care / A&E.
If patient is under 16 book a face to face appointment with a clinician.
Care
If the patient is not coping with current pain levels and/or there are “medical” causes for the pain or if they are under 16 years of age book a face to face appointment with a clinician.
Book a red face to face appointment if there is a possible infected joint (i.e. sudden severe joint pain, feverish, new red hot swollen joint).
Asthma
Face to Face Consultation
Book a routine CDM review with the nurse if they are due their annual asthma review or they wish to discuss their asthma treatment.
If the patient suspects a new diagnosis of asthma, book a green face to face appointment with a clinician.
Book a red face to face appointment with a clinician if they are unwell with their asthma e.g. chest infection/having difficulty breathing.
Athletes Foot
Refer to Community Pharmacy Scheme or Face to Face consultation
Send patients to pharmacy for advice and product purchase.
Consider using the Pharmacy Referral Scheme.
If been seen by the pharmacy and tried numerous over the counter products and still has not cleared to book a face to face appointment.
Pins and Needles/Arm/Face Numbness
Triage Symptoms First
- Face – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have drooped.
- Arms – the person may not be able to lift both arms and keep them there because of weakness or numbness in 1 arm.
- Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake; they may also have problems understanding what you’re saying to them.
- Time – it’s time to dial 999 immediately if you notice any of these signs or symptoms.
- Complete paralysis of 1 side of the body
- Ask the person to stick out their tongue. If the tongue is crooked’ if it goes
to one side or the other. - Sudden loss or blurring of vision
- Dizziness
- Confusion
- Difficulty understanding what others are saying
- Problems with balance and co-ordination
- Difficulty swallowing (dysphagia)
- A sudden and very severe headache resulting in a blinding pain unlike anything experienced before
- Loss of consciousness
- If anyone is with the patient at home ask them to call 999 immediately.
- Send a task message to the clinical team advising them of the patient situation.
- If no one is at home with the patient, ask a colleague to call 999 for you whilst you remain on the phone with the patient.
- Bring the call to the attention of your supervisor.
Face to Face appointment
- Book an amber appointment.
Swollen Feet/Legs/Ankles
Face to Face Consultation
Book a green face to face appointment.
Book a red face to face appointment if they have:
- A single leg (particularly calf swelling) has become swollen especially if sudden onset/recent long haul flight
- Associated with difficulty in breathing
- Associated with chest pain