Catarrh/Mucus
Community Pharmacy or Face to Face Consultation
Refer to community pharmacy.
Book a green appointment if OTC treatments have not worked.
Cancer/Chemo Patients
Face to Face Consultation
Book a red appointment.
Carpal Tunnel Syndrome
Musculoskeletal Specialist (16 years +) or Face to Face Consultation
Book appointment with MSK specialist.
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 an amber 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).
Cellulitis
Face to Face Consultation
Cellulitis is a skin infection that makes the skin painful, red, hot and swollen.
Book a red appointment.
Chest Pain
999/ Face to Face Consultation
Tell the Patient to call 999 immediately if any heart attack symptoms are present.
If they are unable to do so, get a colleague to make the call for them.
Symptoms of a heart attack
Chest pain – a feeling of pressure, heaviness, tightness or squeezing across your chest
Pain in other parts of the body – it can feel as if the pain is spreading from your chest to your arms (usually the left arm, but it can affect both arms), jaw, neck, back and tummy.
Other symptoms that can come on with the above are:
- feeling lightheaded or dizzy
- sweating
- shortness of breath
- feeling sick (nausea) or being sick (vomiting)
- an overwhelming feeling of anxiety (similar to a panic attack)
- coughing or wheezing
If the patient currently has chest pain as described above with or without any of the associated symptoms or has had these symptoms within the last 24 hours ring 999/direct to A+E. Tell the patient not to drive themselves to hospital.
For all other patients presenting with chest pain complete the chest pain protocol in EMIS and take to the Duty Clinician.
Chicken Pox
Community Pharmacy or Face to Face Consultation
Direct to community pharmacy for advise and product purchase.
Book a red appointment if:
- Pregnant
- Signs or symptoms of infected lesions e.g hot, red, swollen, pus
- Immunocompromised e.g. on chemotherapy, organ transplant patient, HIV
Cholesterol
NHS Health Check or Face to Face Consultation
If patient is making a general enquiry about having their cholesterol checked – Check if the patient is eligible for the NHS health check in the EMIS alerts box or on the diary screen.
If YES book a blood test appointment and then an NHS health check appointment.
If NO book a green appointment with a clinician to discuss having a blood test.
If the patient has been advised to book an appointment to discuss a cholesterol result – check if the patient is eligible for the NHS health check:
If YES book an NHS health check appointment.
If NO book an appointment with the nurse.
Chronic Fatigue
Face to Face Consultation
Book a green appointment.
Symptoms of chronic fatigue include extreme tiredness that does not improve with rest or sleep that has lasted AT LEAST 3 months.
This can be associated with difficulties with concentration, memory, thinking, muscle and joint pains.
Cold/Flu/Coughs
Community Pharmacy or Face to Face consultation
Send patients to pharmacy for advice and product purchase
Book a green appointment if OTC products have not helped.
Cold & Flu Symptoms
Colds and flu have similar symptoms
Typically flu symptoms come on more quickly within a few hours, high fever, affects more than just the nose and throat and makes you feel exhausted and too unwell to carry on as normal
Both can be treated at home
With both patients can expect to start to feel better within 1-2 weeks
See chest infection for more information
Coil Insertion or Removal
Face to Face Consultation
For patients requesting a coil inserted or replacement direct to family planning services/Worden Medical Centre
For patients requesting coil removal only and no other alternative contraception book a double green appointment with the relevant clinician
If they would like coil removing and another contraception, book with a practice nurse first to discuss their options
Cold Sores
Community Pharmacy or Face to Face Consultation
Direct to community pharmacy for advice and product purchase.
Book a green appointment if issues with recurrent coldsore, OTC treatment not helping after 7-10 days, children aged under 6 years or doubt about diagnosis.
Confusion
Face to Face Consultation
Discuss symptoms with patient or their carer.
Book an amber appointment if the confusion is not new.
Book a red appointment if new onset confusion.
Use the questions available under ”STROKE”
Conjunctivitis
Community Pharmacy or Face to Face Consultation
Send patients to pharmacy for advice and product purchase
Book a green appointment if OTC treatment has failed.
Constipation
Community Pharmacy or Face to Face Consultation
Send patients to pharmacy for advice and product purchase.
Book a green appointment if OTC treatment has not worked or it is a chronic problem.
Book an amber appointment if aged over 60 years of age and there is an new unexplained change in their bowel habit.
See Abdominal Pain for more information if reported.
Contact Dermatitis
Community Pharmacy or Face to Face Consultation
Direct to pharmacy for advice and product purchase.
Book a green appointment if OTC treatments have failed or pharmacy have directed back to GP.
Contraception (Routine)
Face to Face Consultation
If the patient wants to discuss starting/amending/reviewing current contraception book a face to face appointment with the correct practice nurse.
Contraception (Emergency)
Community Pharmacy or Face to Face Consultation
Send patients to pharmacy for advice and product purchase.
The window for directing to the pharmacy is 72 hours
Patients can also be directed to local family planning/GUM services
Book a red appointment if the time for pharmacy review has passed or aged under 16 years old
Contraceptive Implants
Face to Face Consultation or Family Planning Services
For patients requesting information about a first time procedure or would like a routine insertion/removal, book a green appointment with Dr Nair to discuss first.
If a patient wants a removal or refit, send a task to Dr Nair with all the details and ask when they would like them to be booked in.
Alternatively, patients can be signposted to local family planning clinics.
Cough/Chest Infection
Community Pharmacy or Face to Face Consultation
Not all coughs are infection. There are various causes to consider. Screen for other symptoms of infection with the cough and see relevant heading (cold/flu, chest infection). For all other coughs see cough heading below.
Cough
Direct to pharmacy for advice and product purchase.
Send accurx link.
GREEN APPOINTMENT
If they have been to the pharmacy and have none of the symptoms below.
AMBER APPOINTMENT
A cough persisting for more than 3 weeks (if never been seen before, if known longstanding cough that has been investigated book a green).
Associated losing weight for no reason.
RED APPOINTMENT
Coughing up blood.
Associated with difficulty breathing.
Associated with chest pain (see chest pain).
Chest Infection
See Cough, cold & flu headings first
For suspected chest infection book an an amber appointment.
Book a red appointment if:
Coughing up blood.
Immunocompromised e.g. having chemotherapy, organ transplant patients.
Pregnant.
Having breathing difficulties e.g. are they talking in full sentences to you, do they sound breathless.
They have an ACTIVE respiratory condition e.g. COPD, asthma, bronchiectasis, cystic fibrosis, lung cancer.
Any SEPSIS symptoms.
Coughing up blood (haemoptysis)
Face to face Consultation
Screen for chest infection (see section above)
If no symptoms of infection, book a red appointment.
Cuts
Urgent Care or A&E
If the patients thinks they need stitches refer to Urgent Care/A&E.
For dressings only direct to the treatment room.
Cyst
Face to Face Consultation
Book green appointment.
Book a red appointment if it has signs of infection:
- Red, hot to touch, swollen
- Discharging pus
Cystitis In Men
Follow bladder infection under ‘B‘
Cystitis In Children
Follow bladder infection under ‘B‘