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
Musculoskeletal Specialist or Face to Face Consultation
Book appointment with MSK specialist
Care
Book an amber appointment 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 red appointment if there is a possible infected joint (i.e. sudden severe joint pain, feverish, new red hot swollen joint).
Cellulitis
Cellulitis is a skin infection that makes the skin painful, red, hot and swollen
Book a red appointment
Chest Pain
999
Follow the chest pain protocol
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
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
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 face to face 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 OTC has failed, children under 6 years or they are getting very frequently
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 Bowel Problems under ‘B’ for more information
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 appointment
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 Appointment
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‘