Pain
Face to Face Consultation or Physio
Talk to patient where the pain is and what part of the body it is affecting.
Telephone Consultation
Check location of pain, go to relevant tab if available. Otherwise follow as below.
Book an amber appointment.
Face to face Consultation or Musculoskeletal specialist (16 years and over)
Check location of the pain, go to relevant tab if available. Otherwise follow as below.
Book appointment with MSK specialist or sign post to Moving Well service.
Patients can self refer to a physiotherapist (see external contacts for information).
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)
Palpitations
Face to Face Consultation
Book amber appointment.
Check patient has no red flag symptoms, see ‘chest pain’ below
Chest Pain
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.
- 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). - Feeling lightheaded or dizzy.
- 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.
Panic Attack
Telephone or Face to Face Consultation
Book a green appointment with clinician.
Periods – Delaying them
Community Pharmacy or Face to Face Consultation (16 years +)
16 years and over: Direct patients to pharmacy. The medication may be obtain from some pharmacy’s on private basis.
(not available at Rowlands Pharmacy)
Under 16 years or when pharmacy have rejected the request: Book a green appointment
Periods – Heavy
Face to Face Consultation
Book a green appointment
Periods – Painful
Community Pharmacy or Face to Face Consultation
Direct to community pharmacy for pain relief.
If OTC pain killers are not helping book a green appointment.
Piles (haemorrhoids)
Community Pharmacy or Face to Face Consultation
Send patients to pharmacy for advice and product purchase.
If OTC treatments have failed or recurrent issue book a green consultation with a clinician.
Book a red appointment if:
- Fever
- Pus leaking from piles
Pins and Needles/Arm/Face/Numbness
Triage Symptoms First
- Face – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have drooped.
- Arms – the person may not be able to lift both arms and keep them there because of weakness or numbness in 1 arm.
- Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake; they may also have problems understanding what you’re saying to them.
- Time – it’s time to dial 999 immediately if you notice any of these signs or symptoms.
- Complete paralysis of 1 side of the body
- Ask the person to stick out their tongue. If the tongue is crooked’ if it goes to one side or the other
- Sudden loss or blurring of vision
- Dizziness
- Confusion
- Difficulty understanding what others are saying
- Problems with balance and co-ordination
- Difficulty swallowing (dysphagia)
- A sudden and very severe headache resulting in a blinding pain unlike anything experienced before.
- Loss of consciousness
If anyone is with the patient at home ask them to call 999 immediately.
Send a task message to the clinical team advising them of the patient situation.
If no one is at home with the patient, ask a colleague to call 999 for you whilst you remain on the phone with the patient.
Face to face Consultation
Book an amber appointment.
Postnatal Depression
Face to Face Consultation
Book an amber appointment.
EMERGENCY CARE: (threat to life/harm)
Discuss with an available clinician on action to be taken (i.e. same day red face to face appointment/999/crisis team)
Pregnancy
Face to Face Consultation or Midwives
If the patient is only calling to advise us of her new pregnancy, signpost her to the Midwife Team (See external contacts for details).
For pregnancy related issues e.g. UTI/abnormal bleeding/high BP: Book a red appointment with a GP
Pregnancy Termination
Signpost
Most terminations in England are carried out before 24 weeks of pregnancy.
The patient is able to self refer to a clinic if they would like to. See details below.;
If the patient would like to speak to a GP, book them in for a telephone consultation.
Patients do not require a GP consultation for terminations.
Self Referral details
See external contact details for RPH termination clinic
Support is available via a self referral clinic:
https://www.msichoices.org.uk/
Telephone lines open: 0345 300 8090
7AM to 11PM
https://www.bpas.org/
Telephone lines open: 03457 30 40 30 Monday to Friday – 7 am to 7 pm
Saturday – 8 am to 4 pm
Sunday – 9.30 am to 2.30 pm
Sore Private Parts
Community Pharmacy or Face to Face Appointment
Women:
If suspected thrush or bacterial vaginosis (BV), direct patients to pharmacy for advice and product purchase. Once tried, book green appointment if no better.
If suspected STI, signpost to GUM clinic.
For all other symptoms book a green appointment.
Men:
If suspected STI, signpost to GUM clinic.
For all other symptoms book a green appointment.
Children (6-16 years):
Book green appointment.
Prostate
Face to Face Consultation
Book a green appointment.
Psoriasis
Face to Face Consultation
Book a green appointment.
Book a red appointment if signs of infected psoriasis:
- Fever
- Psoriasis has become blistered, weeping or pus seen
- The psoriasis has become painful, swollen or feels hot to touch
- The psoriasis suddenly gets worse or gets bigger/spreads
PTSD – Post Traumatic Stress Disorder
Telephone or Face to face consultation
Book a green appointment.
EMERGENCY CARE: (threat to life/harm)
Discuss with an available clinician on action to be taken (i.e. same day red face to face appointment/999/crisis team)
Pubic Lice
Redirect
Give Patients the details of the local Sexual Health Clinic.
Refer to external contact information.