C - Telephone Signposting Toolkit

Catarrh/Mucus

Refer to Community Pharmacy Scheme or Face to Face Consultation

Refer to Community Pharmacy scheme/ face to face appointment. If OTC products have not worked over 1-2 weeks book a face to face appointment.

Cancer/Chemo Patients

Face to Face Consultation

Book appointment

Carpel Tunnel

Musculoskeletal Specialist (16 years and over)

Book appointment with MSK specialist or sign post to Moving Well service.

Patients can self refer to a physiotherapist (see list of external contacts for details).

If patient is under 16 years please book a telephone consult with a clinician.

Care

If the patient is not coping with current pain levels, book a telephone consultation with a clinician.

Ensure there are no other ‘medical’ causes for the pain:

If there are then book in a face to face consultation with a clinician instead.

Cellulitis

Book a red face to face appointment

Chest Infection

Refer to Pharmacy or Face to Face Consultation

Book at the ARI Hub (for any cough/chest infection symptoms) or patients can be directed to the community pharmacy/NHS website at Chest infection – NHS for more information on self care.

Book a red face to face appointment for the following

Persistent cough lasting more than 3 weeks
Are unwell with a high temperature (≥ 38◦)
Is having breathing difficulties (e.g. unable to speak in full sentences/appears breathless)
Is coughing up blood (haemoptysis)
Has an underlying respiratory condition (e.g. Asthma, COPD, bronchitis, lung cancer)
Is immunocompromised (e.g HIV positive, on chemotherapy, organ transplant patient)
Is pregnant
Is a child under 5 years

Chest Pain

A&E/Ambulance

Tell the Patient to call 999 immediately if any of the following symptoms are present. If they are unable to do so, get a colleague to make the call for them.

Symptoms of a heart attack can include:

Chest pain – a sensation of pressure, tightness or squeezing in the centre of the chest.
Feeling lightheaded or dizzy.
Pain in other parts of the body – it can feel as if the pain is traveling from the chest to the arms (usually the left arm is affected, but it can affect both arms), jaw, neck, back and tummy (abdomen).
Sweating.
shortness of breath.
feeling sick (nausea) or being sick (vomiting).
an overwhelming sense of anxiety (similar to having a panic attack).
coughing or wheezing.

Chicken Pox

Refer to Pharmacy or Face to Face Appointment

Refer to Pharmacy.

Book a red face to face appointment if the patient is reported to be very unwell or there is concerns of infected chicken pox lesions

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 a telephone 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

Refer to pharmacy or face to face consultation

If the patient reports a cough, Book in the ARI hub, If ARI Hub full please see below.

Send patients to pharmacy for advice and product purchase

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.

Check Chest Infection also to see if they have any of those related symptoms. Go to relevant information on this page (above)

If they report to be very unwell book a red face to face appointment.

Coil/Implant or Removal

Refer to Clinic or Face to Face Consultation

For patients requesting a coil inserted or replacement direct to family planning services/Worden Medical Centre.

For patients requesting coil/implant removal only and no other alternative contraception book a double face to face appointment with the relevant clinician.

If they would like coil/implant removing and another contraception, please book face to face with a practice nurse first to discuss their options.

Cold Sores

Refer to Pharmacy or Face to Face Consultation

Refer to Community Pharmacy.

Patients under 6 years of age will need a green face to face consultation with a clinician.

Confusion

Face to Face Consultation

Discuss symptoms with patient or their carer.

If longstanding book an amber appointment

If reported as a new onset confusion (within hours to days) book a red appointment.

Use the questions available under ”STROKE”

Conjunctivitis

Refer to Pharmacy or Face to Face Consultation

Send patients to pharmacy for advice and product purchase

If the patient is under 2 years of age, has glaucoma or diabetes, book an green appointment with a clinician.

If patient is over 2 years old: Send to pharmacy for advice and product purchase (as per sticky/sore eye guidance – go to ‘S‘ toolkit page for more information)

Constipation

Refer to Pharmacy or Face to Face Consultation

Send patients to pharmacy for advice and product purchase.

If the patient is under 12 years old or has long term constipation, book a green face to face appointment with a clinician.

See Bowel Problems under ‘B’ for more information.

Contact Dermatitis

Refer to Pharmacy or Face to Face Consultation

Refer to Pharmacy. Book a face to face appointment for those who have tried OTC products already/been advised by pharmacist.

Contraception (Routine)

Face to Face Consultation

If the patient wants to discuss starting/amending/review contraception book a face to face appointment with the correct practice nurse.

Contraception (Emergency)

Direct to (not referral) 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.

If this time has passed, then book in for a red face to face consultation.

Under 16 book a red face to face appointment.

Contraceptive Implants

Face to Face Appointment or Local Sexual Health Clinic

For patients requesting information about a first time procedure or would like a routine insertion/removal, book a green face to face 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.