Haemorrhoids (Piles)
Community Pharmacy or Face to Face Consultation
Send patients to pharmacy for advice and product purchase.
If OTC treatments have failed after 7 days or recurrent issue book a green appointment.
Book a red face to face appointment if:
- If patient is unwell with a fever
- Has pus leaking from piles
Hand Pain
Musculoskeletal Specialist (over 16s only)
Book appointment with the MSK specialist, or signpost to self-referral option.
If the pain started after recent trauma advise to attend urgent care / A&E.
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 and/or there are ‘medical’ causes for the pain or if they are under 16 years of age book 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).
Hand, Foot & Mouth
Community Pharmacy
Send all patients to the pharmacy for advise and product purchase.
Patients can be directed to NHS website for more information: Hand, foot and mouth disease – NHS
Book an amber appointment if:
No improvement within 7-10 days
Reported to be very unwell
very high temperature
Are pregnant
Hay Fever, Grass and Tree Pollen
Community Pharmacy Scheme or Telephone Consultation
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).
Headlice
Community Pharmacy
Send patients to pharmacy for advice and product purchase
Headache
Community Pharmacy or Face to Face Consultation
Send patients to pharmacy for advice and guidance if simple headache.
If OTC medication has been tried book an amber face to face consultation with a clinician
Book a red appointment if patient has a severe headache and:
- Jaw pain when eating
- Blurred or double vision
- A tender temple region
- Pain wakes them up from sleep at night
- Vomiting
CARE
Consider serious causes of a headache. If uncertain discuss with duty clinician. Examples include:
- Headaches associated with a fever, neck stiffness or rash (see sepsis guidance – 999)
- Headaches associated with stroke features such as slurred speech or limb weakness (see FAST guidance or Stroke: Signs and Symptoms
- Headache following head trauma – 999/A+E
Hearing Reduction (non wax)
Face to Face Consultation
This is not a suspected build up of wax (see ”ear wax”).
If patient is 55 years or older book in for a hearing test with Scrivens at the surgery.
If under 55 years old, book a green appointment.
Book a red appointment if:
- Sudden hearing loss in one or both ears
Heartburn
Community Pharmacy or Face to Face Consultation
If patient is under 6 years or over 45 years of age make green face to face appointment.
If it is mild and short lived and the first episode, send patient to pharmacy for advice and appropriate products.
If this has already been tried, then this can be booked in for a green face to face appointment.
Consider checking Chest Pain information under letter ‘C‘
Hernia
Face to Face Consultation
Book an amber face to face appointment
Herpes
Sexual Health Clinic or Pharmacy
Genital Herpes:
- Give the patient details for the local sexual health clinic.
Cold sores:
- Sent patients to pharmacy for advise and product purchase.
Hip Pain
Musculoskeletal Specialist (over 16s only)
Book appointment with the Physiotherapist specialist, or signpost to self-referral option.
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 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)
Hospital Discharge
Check if the practice has received the discharge summary.
If the summary has been received, the Medicines coordinator will make medication changes. Check how much medication the patient has been sent home with. If needed within the next few weeks, book onto a medicines management slot for the clinical pharmacist to update.
If an urgent prescription is required, please send a medicines management request to duty clinician.
For clinical concerns please book a green telephone appointment with a clinician to discuss.
Housebound/Home Visit Request
Housebound – Home Visit request
Check patient is on Housebound Register, if not then ask why patient is now housebound and add to booking notes.
Add the patient to the home visit list for triage. (Home visits are only needed if the patient needs to be seen face to face. For other queries telephone consults can be considered – use care navigation to guide).
Any requests before 11.30 put on the home visit triage list and tell the patient they will get a call that morning
Any thing deemed as urgent (EOL etc) after 11.30am, put on the late home visit for duty clinician (inform duty clinician you have done this) tell the patient they will get a phone call at some point before 6pm
If the patient requests to be coded housebound – send a task to Becky/Emily to look at this
Consider District Nursing Team for Wound Care and other appropriate treatment.
HRT
Face to Face Consultation
Book a green face to face appointment with a clinician.
Provide the patient with links below for further reading and information on HRT:
https://www.menopausematters.co.uk
https://www.balance-menopause.com
https://patient.info/womens-health/menopause/hormone-replacement-therapy-hrt