V – Telephone Signposting Toolkit

Vaginal Bleeding

Face to Face Consultation

Book a green appointment for women with abnormal vaginal bleeding such as between periods or after sex (double appointment needed if examination expected)

Book an amber appointment if:

  • Post menopausal bleeding

Book a red appointment if:

  • They are pregnant (If they have an allocated midwife advise patient to inform them also)
  • Have a new heavy bleed (i.e. soaking through clothing, using multiple pads/tampons per hour)
  • Foul smelling blood indicating possible infection
  • New abnormal bleeding that is associated with abdominal/pelvic pain/shoulder tip pain and there is suspicion of pregnancy (confirmed or missed period)

Direct to A+E/call 999 if:

  • Are unwell with the bleed such as feeling faint, collapsing, short of breath, chest pain, feverish
  • Are having heavy bleeding and are pregnant

Vaginal Discharge

Community Pharmacy or Face to Face Consultation

Send patients to pharmacy for advice and product purchase

Book a green appointment if OTC treatment has been unsuccessful or directed back by pharmacy.

See thrush if suspected.

Varicose Veins

Face to Face Consultation

Book a green appointment

If patient is wanting referral for surgery for cosmetic reasons (e.g. appearance), inform this is not available on the NHS.

Vasectomy

Book a green appointment

Vertigo / Dizziness

Face to Face Consultation

Book a green appointment

Book a red appointment if:

  • Associated with collapse/loss of consciousness
  • Vertigo with a severe headache
  • Vertigo so severe they are struggling to walk
  • Associated with vomiting
  • Associated with a high fever

Caution: If sudden onset of symptoms, symptoms are so severe they are unable to walk consider stroke, see relevant page to screen for symptoms – Advise to ring 999 immediately

Verrucae

Community Pharmacy

Send patients to pharmacy for advice and product purchase.

Book a green appointment if OTC treatments have failed

Vomiting

Community Pharmacy

Send patients to pharmacy for advice and product purchase.

Book a green appointment if OTC treatments have failed.

Book a red appointment if:

  • With severe symptoms and can’t keep any fluids down
  • With symptoms of severe dehydration (confusion, passing little or no urine, dry tongue/lips)

Vomiting and Diarrhoea

Community Pharmacy or Face to Face Consultation

Send patients to pharmacy for advice and product purchase

Book a green appointment if OTC treatment has been tried but symptoms are ongoing

Book an amber appointment for patients over 60 years with a new change in bowel habit that is not resolving within a couple of weeks

Book a red appointment for those:

  • With severe symptoms and can’t keep any fluids down
  • With symptoms of severe dehydration (confusion, passing little or no urine, dry tongue/lips)
  • Blood diarrhoea/rectal bleeding
  • High fever
  • Associated with severe abdominal pain