I – Telephone Signposting Toolkit

Immunocompromised Patients (weakened immune system)

Telephone or Face to Face Consultation

Book a red appointment

Examples of immunocompromised patients:

  • HIV/AIDs
  • patients having chemotherapy 
  • organ/bone marrow transplant patients
  • on treatments such as long term steroids/biological therapy
  • blood cancer

Impetigo

Refer to pharmacy first service or Face to Face Consultation

Refer to community first service (Exclusions: bullous impetigo, recurrent impetigo (2 or more episodes in the same year), pregnant individuals under 16 years).

For those not suitable for pharmacy first scheme then book an amber face to face appointment

Impotence (Erectile dysfunction)

Face to Face Appointment

Book a green appointment

Incontinence

Face to Face Appointment

Book a green appointment.

Consider UTI if new onset of incontinence – see Bladder Infection

Indigestion

Community Pharmacy or Face to Face Appointment

Send patient to pharmacy for advice and appropriate products.

If patient is under 6 years, over 45 years of age or OTC treatments have not worked, make a green face to face appointment.

Infection

Face to Face Consultation

Ask the patient where the infection is and go to relevant guidance page.

If patient is unsure of source but presents with a high fever, feels hot & shivery, new or increasing confusion, drowsiness or significantly unwell book a red appointment

Ingrowing Toe Nail

Community Pharmacy or Face to Face Consultation

Send patients to pharmacy for advice and product purchase.

If OTC products have not worked, book a green appointment.

Book a red appointment if:

  • the toe is swollen
  • the toe is red and hot to touch
  • there is pus or discharge

Insect Bite / Sting

Refer to pharmacy first service or Face to Face Consultation

Refer to pharmacy first service if aged 1 year or over (Excludes: Pregnant individuals under 16 years).

Check ANAPHYLAXIS information.

Insomnia

Community Pharmacy or Face to Face Appointment

Direct patients to pharmacy for advice and product purchase.

Signpost website Support:

https://www.nhs.uk/conditions/insomnia

https://www.nhs.uk/live-well/sleep-and-tiredness

Book a green appointment with a clinician if patients have tried sleep hygiene measures & OTC products for at least a few weeks, the issue has lasted several months or the insomnia is affecting daily life in a way that makes it hard for them to cope.

Irritable Bowel Syndrom (IBS)

Face to Face Consultation

Book green appointment

Itching

Community Pharmacy or Face to Face Consultation

Send patients to pharmacy for advice and product purchase.

If patient has already tried OTC products book a green appointment with clinician.