Scarlet fever
Face to Face Consultation
Book an amber appointment
Seizure
Call 999 or Face to face consultation
If patient is having seizure at time of call: Ring 999
If patient is known to have a seizure condition e.g. epilepsy and wants to discuss this, book a green appointment.
For all other new, recent, recurrent seizure activity book a red appointment.
Sepsis
Call 999
Sepsis is a life-threatening reaction to an infection
Refer to surgery SEPSIS protocol
If in doubt regarding a possible sepsis diagnosis speak with a clinician for advice as soon as possible.
Sexually Transmitted Infection (STI)
Redirect
Give Patients the details of the local Sexual Health Clinic.
Refer to external contact information.
If patient declines to attend GUM, book a green appointment with an appropriate clinician.
If under 16 for red face to face appointment if declines GUM clinic.
Patients (16 and over) can order home testing kits from Online Ordering Options │ Blackpool and Lancashire Sexual Health Services
Shingles
Face to Face Consultation
Book Appointment within ideally 3 days of noticing the rash.
Book a red appointment if:
- Pregnant
- Breastfeeding and the rash is on the breast
- Rash is on the eye or nose
- New changes in vision
- Have a weakened immune system e.g. chemotherapy, on immunosuppressant drugs
- Are 17 years old or younger
You can not catch shingles from someone else. However, you can get chickenpox from someone who has shingles if you haven’t had chickenpox before.
Shortness of Breath
Face to Face Consultation or 999
Book a red face to face appointment for new or worsening SOB
Consider ringing 999 if the SOB is severe such as can’t complete a sentence on the phone/in person or gasping for breath, lips and skin turning very pale/blue.
See chest infection or other relevant page for associated symptoms reported for further guidance
Book a green appointment for patients who report shortness of breath on exertion such as walking up the stairs/exercising
Shoulder Pain
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 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 a face to face appointment with a clinician.
Book a same day face to face appointment if there is a possible infected joint (i.e. sudden severe joint pain, feverish, new red hot swollen joint).
Sinusitis
Community Pharmacy or Face to Face Consultation
12 years and above: Send to pharmacy first scheme (Exclusions: immunocompromised e.g. on chemotherapy, pregnant individuals under 16 years, chronic symptoms that have lasted more than 12 weeks)
Book a green appointment for anyone else or if treatment from the pharmacy has failed.
Skin Lesion
Face to Face Consultation
Book an amber appointment
Slapped cheek syndrome
Community Pharmacy or Face to Face Consultation
Community Pharmacy. Send all patients to pharmacy for advice and product purchase.
Patients can be directed to NHS website for more information: https:// www.nhs.uk/conditions/slapped-cheek-syndrome.
If child not improving to make a face to face appointment with clinician.
Sleeping difficulty
Refer to Community Pharmacy Scheme or Telephone Appointment
Send all 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 telephone 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.
Snoring / Sleep Apnea
Face to Face Consultation
Book appointment
Sore Private Parts
Community Pharmacy or Face to Face Appointment
Women:
Send patients to pharmacy for advice and product purchase. Once tried, book appointment if no better.
Men and Children:
Book appointment
Sore Throat
Community Pharmacy or Face to Face Consultation
Send patients to pharmacy for advice and product purchase.
Advise most sore throats will resolve without treatment within 7-8 days. Self care advice can be found at: https://www.nhs.uk/conditions/sore-throat.
Book a face to face appointment if there is no improvement despite OTC products and self care advice or patient becoming more unwell.
If patient significantly unwell follow SEPSIS guidance.
Sports injury
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 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 a face to face appointment with a clinician.
Spots, Rash and Skin problems
Community Pharmacy or Face to Face Consultation
Send all patients to pharmacy for advice and product purchase.
If over the counter products have not worked over time; Book appointment, detail information in booking notes.
See below for worrying features of a rash in children.
Rash in Children
If the child 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.
These can be signs of Meningitis.
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.
Spots on Penis
Redirect or Face to Face Appointment
Give patient the details for the local Sexual Health Clinic.
If the problem is not a sexual health issue or the patient declines to attend the GUM clinic, book a face to face appointment.
Spots on Vulva
Redirect or Face to Face Appointment
Give patient the details for the local Sexual Health Clinic.
If the problem is not a sexual health issue or the patient declines to attend the GUM clinic, book a face to face appointment.
Sprains
Musculoskeletal Specialist (16 years and over)
Book appointment with MSK specialist or sign post to Moving Well service.
If patient is under 16 years please book a telephone consult with a clinician.
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 a face to face appointment with a clinician.
Sticky/Sore Eye
Community Pharmacy or face to face Consultation
Patients over 2 years old:
Send patients to pharmacy for advice and product purchase
If the patient is under 2 years of age, has glaucoma or diabetes, book a face to face appointment with a clinician.
Stomach Ache/Pain
Community Pharmacy Scheme or Face to Face Consultation
Stomach cramps with bloating:
- Signpost Pharmacy for products to help
Sudden stomach cramps with diarrhoea:
- Signpost Pharmacy for products to help
Sudden severe abdominal pain:
- Book a same day face to face appointment.
Repeated/Reoccurring stomach problems:
- Book a routine face to face appointment.
Strains
Musculoskeletal Specialist (16 years and over)
Book appointment with MSK specialist or sign post to Moving Well service.
If patient is under 16 years please book a telephone consult with a clinician.
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 a face to face appointment with a clinician.
Stress
Telephone Consultation
Book Appointment
Provide patient with information for Mindsmatter service and advise they can self refer (see external contacts for details) – For over 16’s only.
Stings, Bites, Scratches
Community Pharmacy Scheme or Face to Face Appointment
Animal bites/Scratches
That have broken the skin and are showing signs of infection, book patient in for a face-to-face assessment.
Insect bites and Stings
Adults and children over 2 years with insect bites or stings can get advice and treatment directly from a pharmacy.
If there is a lot of swelling and blistering or if there is pus and the pharmacist feels there may be an infection, book a face-to-face appointment.
Stroke
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.
Bring the call to the attention of your supervisor.
Book face to face appointment within a week.
Book appointment.
Styes
Community Pharmacy
Send Patient to pharmacy for advice and product purchase.
Subdermal Contraceptive Implants
Telephone Consultation or Face to Face Appointment
For patients requesting information about a first-time procedure or would like a routine insertion/removal, book a telephone appointment with the clinician who will be performing the procedure to discuss first.
If a patient wants a removal and or refit, send a task to the clinician who fits the device 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.
Sunburn
Community Pharmacy
Send Patient to pharmacy for advice and product purchase.
Suicidal
Face to Face Consultation
Same day consultation.
Discuss with available clinician as the urgency.
Difficulty Swallowing
Telephone Consultation
If patient has any symptoms of sore throat/tonsillitis please refer to the guidance first.
if NO symptoms of sore throat please book a consultation.
Excessive sweating
Community Pharmacy
Send patients to pharmacy for advice and product purchase.
Swollen feet, legs, ankles
Refer to Community Pharmacy Scheme or Face to Face Consultation
Refer to Community Pharmacy Scheme if suitable.
For all other patients book a face to face appointment.