Vaginal Bleeding
Face to Face Consultation
Book a face to face appointment (double appointment needed if examination expected).
Consider same day urgent 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).
- Are unwell with the bleed such as feeling faint, collapsing, short of breath, chest pain, feverish, foul smelling blood indicating possible infection.
- Post menopausal bleeding.
Vaginal Discharge
Community Pharmacy Scheme or Face to Face Consultation
Send patients to pharmacy for advice and product purchase.
If OTC treatment have been unsuccessful book a double appointment with a clinician to discuss and for examination/swab.
Varicose Veins
Face to Face Consultation
If patient is wanting referral for surgery for cosmetic reasons (e.g. appearance), inform this is not available on the NHS.
Vertigo / Dizziness
Face to Face Consultation
Book appointment
Verrucae
Community Pharmacy
Send patients to pharmacy for advice and product purchase.
If the problem persists following over the counter treatment book an appointment to consider referral for cryotherapy – Detail in the booking notes the medication taken to date, the length of time the problem has existed along with the symptoms.
Vomiting
Community Pharmacy
Send patients to pharmacy for advice and product purchase.
If the problem persists following over the counter treatment book a telephone appointment with a clinician.
Vomiting and Diarrhoea
Community Pharmacy Scheme or Face to Face Consultation
If patients present with an episode of diarrhoea lasting 7 or more days book a routine face to face appointment.
Consider a same day face to face appointment in patients presenting with:
- New bloody diarrhoea.
- Jet black and sticky stools.
- Vomiting blood or black ‘coffee grounds’.
- Report being significantly unwell such as high temp >38, can’t keep any fluids down, reduced urine output, dizzy or lightheaded.
- Severe abdominal pain.
- Have inflammatory bowel disease (Crohn’s disease or Ulcerative Colitis) or another bowel condition such as diverticular disease.