Ask questions about symptoms to ascertain if urgent care/A+E is needed. If so advise to call 999 or attend A+E. See sections below for more detail.
If problem not listed below book a red face to face appointment for the child.
For all children consider SEPSIS. Please see relevant heading below for more details and when to consider calling 999.
Autism/ADHD
Book a green appointment
Chicken Pox
Pharmacy or face to face appointment
Send to pharmacy for advice and product purchase.
More information on chicken pox can be found on Chickenpox – NHS
If the child is reported to be very unwell or there are signs of infected lesions book a red face to face appointment.
Colic
Pharmacy/Health Visitor/Face to face appointment
Direct to pharmacy and/or health visitor for support and advice.
If ongoing concerns book a green appointment with a clinician.
Conjunctivitis
Pharmacy/Face to face appointment
Children aged > 2 years can be directed to the pharmacy
Children < 2 years book a red face to face appointment
Ear Infection
Pharmacy or face to face appointment
If aged 1 years and over refer to community pharmacy scheme (Excludes: recurrent ear infections ( 3 or more episodes in 6/12), systemically unwell, high risk of complications such as heart/lung/liver/renal conditions, children born prematurely)
For all children under 1 years old and excluded from pharmacy scheme book a red face to face appointment.
Eye problems
Pharmacy/face to face appointment
Conjunctivitis – See ‘Conjunctivitis’ above
Eye trauma – Direct to A+E/urgent care
Foreign body in eye – Direct to A+E/urgent care
Light sensitivity (photophobia) – See ‘Meningitis,’ ‘Sepsis’ to screen for concerning features and direct to A+E if indicated. For all others book a red face to face appointment
Red and or painful eye – Book a red face to face appointment
Squint (eyes in different directions/lazy eye) – Book a green face to face appointment
Sudden change in vision – If sudden loss/change in vision book a red face to face appointment.
Visual changes – If old enough direct to optician. If optician will not see book a green appointment with a clinician.
Watery eye – Book green face to face appointment
Hand, Foot & Mouth
Pharmacy or face to face appointment
Direct to pharmacy for advice.
If child is reported to be very unwell book a red face to face appointment
Headlice
Send to pharmacy or face to face appointment
Send all children over 6 months of age to the pharmacy for product purchase
Children under 6 months will need a red appointment as pharmacy can’t supply products in this age group
Impetigo
Pharmacy or face to face appointment
Children ages 1 and above direct to community pharmacy scheme (Excludes: Bullous impetigo, recurrent impetigo (2 or more episodes in 1 year))
Children under 1 or excluded from the pharmacy scheme book a red face to face appointment.
Measles
Book a red face to face appointment
Nappy Rash
Pharmacy or face to face appointment
Direct to pharmacy for advice and product purchase.
If rash looks infected, causing severe pain or OTC products have not been helping book a red face to face appointment
Rash
Pharmacy or face to face appointment
RED FLAG SYMPTOMS
- A stiff neck
- Bothered by light/light sensitivity
- Confusion
- A high temperature
- The rash does not fade when you press a glass against it (advise glass test for meningitis)
- Difficulty breathing (you may noticed grunting noises or their tummy sucking under their ribs)
- Breathlessness or they are breathing very fast
- Their skin, lips or tongue looks pale, blue, grey or blotchy
These can be signs of meningitis. If a child has ANY of these symptoms advise to call 999 immediately.
If the patient does not have any red flag symptoms:
Age >2 years: Send to pharmacy for advice and product purchase
Age <2 year, advised by pharmacist to see GP or are reported to be unwell (but no red flags) book a red face to face appointment.
Sepsis
CALL 999
Symptoms of sepsis include:
- Blue, pale or blotchy skin, lips or tongue
- A rash that does not fade when you roll a glass over it
- Difficulty breathing (you may notice grunting noises, their stomach sucking under their ribcage, sucking in between their ribs), breathlessness or breathing very fast
- A weak, high pitched cry that’s not like their normal cry
- Not responding like they normally do or not interested in feeding or normal activities
- Being sleepier than normal or difficult to wake
- Not had a wee or wet nappy in 12 hours or more
Patients may not have all these symptoms, consider sepsis if any symptom is reported and advise the parent/guardian to ring 999 immediately.
Slapped Cheek Syndrome
Pharmacy or face to face appointment
Direct to pharmacy/ NHS website for advice. Most cases will improve without treatment within 3 weeks.
Book a red face to face appointment if:
- Immunocompromised e.g. on chemotherapy, immunosuppressant medications
- Has a blood disorder e.g. sickle cell disease, Thalassaemia
- Reported to be very unwell
Nursery/school exclusion advice: Once the rash develops the child should no longer be infectious and it is not necessary for the child to stay off school or nursery
Sore Throat
Pharmacy or face to face appointment
Direct to community pharmacy scheme (Excludes: patients with signs or symptoms of Scarlett fever, quinsy or glandular fever, signs or symptoms of cancer, immunosuppressed)
For patients who do not meet the criteria for the community pharmacy scheme book a red face to face appointment
Teething
Pharmacy or face to face appointment
Direct to pharmacy for advice and product purchase.
In children who are reported to be very unwell, unable to swallow or have sores inside mouth book a red face to face appointment.
Urine Infection
Face to face appointment
Book a red face to face appointment.
Ask the parent/guardian if possible to bring a urine sample to the appointment.