Tennis Elbow
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.
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).
Testicular Problems
Face to face consultation
Pain
Direct to A+E or call 999 if:
- Sudden, severe pain in a testicle
- Testicular pain associated with feeling sick, vomiting or abdominal pain
- Testicular pain that has lasted more than 1 hour or continues when at rest
Book a red appointment for all other testicular pain
Lump or swelling
Book an amber appointment
If associated pain see above
If concerns related to sexually transmitted infection direct to GUM services (see relevant page)
Change in testicle
Book an amber appointment
Other changes that may be reported in testicles include:
- A change in the shape of the testicles
- A change in how the testicle feels
- One testicle has become bigger than the other
Thread Worm
Community Pharmacy or Face to Face Consultation
Send patients to pharmacy for advice and product purchase.
Book a green appointment if OTC treatment has failed or directed back by the pharmacy
Thrush
Community Pharmacy or Face to Face Consultation
ORAL
Book a green appointment
GENITAL
Send patients to pharmacy for advice and product purchase.
If OTC treatments have failed or not suitable for pharmacy (e.g. Pregnant/breastfeeding, under 16 years or 60 years and older) book a green appointment with clinician
Tinnitus (Ringing in ears)
Face to Face Consultation
Book a green appointment
Book a red appointment if:
- Tinnitus that is only affecting one ear
- Suicidal
- Tinnitus that beats in time with your pulse/heartbeat (if feels they can hear their heartbeat in their ears)
Direct to A+E if:
- Tinnitus started following head injury
- Tinnitus is associated with sudden hearing loss, weakness in the muscles of your face, or a spinning sensation (vertigo)
Tonsillitis
Pharmacy First or Face to Face Consultation
Refer to pharmacy first scheme (Exclusion: Pregnant individuals under 16 years, immunocompromised)
Book an amber appointment for those patients who pharmacy can’t see or treatment has not worked
If patient significantly unwell follow SEPSIS protocol
Any patient informed by the pharmacy they have possible Quinsy need to attend A+E and those with suspected epiglottitis need an ambulance/999
Toothache
Redirect to dentist or NHS 111
Advise patient to call their registered dentist for an appointment.
If the patient does not have a registered dentist, then tell them to call NHS 111 where they will be directed to local care. This includes pain relief / antibiotics.
Send all patients to pharmacy for advice and product purchase, including pain relief.
Travel Advice
Travel Advice
Request patients research countries being visited by accessing website:
www.fitfortravel.nhs.uk/destinations
This includes all stops if cruising.
Should they wish to have the NHS vaccinations available for free, they need to access the travel form on the practice website and return that to us at least 6 weeks before traveling to enable the vaccination course to be administered in time.
Should they wish to access vaccinations not available on the NHS, they will need to access those via an independent travel clinic.