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 (does not need double appointment)
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) – consider directing to A+E if very heavy and unwell with this (see below)
- 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 relevant pages on thrush and Bacterial Vaginosis (BV) if this is suspected for more information.
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 (Male Sterilisation)
Face to Face Consultation
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 (Temp 38 or more)
Caution: If the patient has sudden onset of symptoms or 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 or Face to Face Consultation
Send patients to pharmacy for advice and product purchase.
Book a green appointment if OTC treatments have failed.
Vomiting
Community Pharmacy or Face to Face Consultation
Send patients to pharmacy for advice and product purchase.
Book a green appointment if OTC treatments have failed.
Book a red appointment if the vomiting is:
- With severe symptoms and they 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