QR – Telephone Signposting Toolkit

Rash, Spots and Skin Problems

Send all patients to pharmacy for advice and product purchase.

If over the counter treatments have not worked over time book a green appointment with a clinician

  • Fever
  • Pus and discharge from rash/spots
  • Hot to touch
  • Swollen
  • Spreading redness

If the patient has a rash check for any of these symptoms and immediately advise calling 999:

  • A stiff neck.
  • Bothered by light.
  • Seems confused.
  • A high temperature.
  • Their rash does not fade when you press a glass against it (do the glass test for Meningitis).
  • Difficulty breathing (you may notice grunting noises or their tummy sucking under their ribs).
  • Breathlessness, or they’re breathing very fast.
  • Their skin, lips or tongue look pale, blue, grey or blotchy.

It can be harder to see a change in skin colour on brown and black skin.

Check the soles of the feet, palms, lips, tongue and inside the eyelids for colour changes.

Rectal Bleeding

Book a green appointment.

Book a red appointment if:

  • Passing large amounts of fresh red blood/passing blood clots.
  • Passing jet black, sticky stools that looks like tar.
  • Unwell with bleeding e.g. feeling lightheaded, collapse, short of breath, chest pain.
  • Experiencing significant associated pain or have a an extremely painful lump in back passage.
  • Experiencing associated symptoms such as unintentional weight, aged 60 years or older with a new change in bowel habit for >3 week

Rectal Irritation

Community Pharmacy or Face to Face Consultation

Send patients to pharmacy for advice and product purchase.

If over the counter treatments have been tried and the patient has ongoing issue book a green appointment.

Reflux

Community Pharmacy or Face to Face Consultation

If patient is under 6 years or over 45 years of age book a green 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 appointment.

Ringworm

Community Pharmacy

Ringworm is a fungal infection of the skin causing a rash

Send patients to pharmacy for advice and product purchase.

If OTC treatment has failed or advised by pharmacy to see GP, book a green appointment.

Rosacea

Face to Face Consultation

Book a green appointment.