Reception Signposting- What to expect
Booking an appointment - Explanation of Reception Signposting
When you telephone the surgery to book an appointment, the receptionist will ask you the follow question:
- “To help you make the correct appointment, I need to know a little more about why you need the appointment.”
The receptionist may also ask both/either/none of the following two comments, depending on the response…
- It is not always necessary to see the Doctor, a nurse/Healthcare Assistant may be more appropriate
- Whatever you say will be treated in the strictest of confidence
This is because the receptionist has a number of alternative types of appointments available to her, and she needs to offer you the most appropriate appointment to deal with your problem. The most appropriate appointment may be with the GP for example, or perhaps with another member of the practice team.
In this way, on the occasion when you really do need to see a GP, there is more likely to be a free appointment for you. The following table may help you understand more clearly the choices available.
- The left hand side of the table describes the details of the presenting problem
- The right hand side of the table guides the receptionist’s response.
We very much hope that this system will make best use of the services available both at the practice and in the wider community, and by doing so indirectly increase the number of available GP appointments, so that you can more easily secure this when it is necessary.
OPTION 1 |
· Unconscious or collapse · Fitting · Severe chest pain · Severe shortness of breath · Short of breath intermittent · Severe headache · Sever abdominal pain | A&E/999 Loss of consciousness, blue lips, lethargic - A&E New symptoms with vomiting/dizziness/SOB – A&E Ongoing issue – Urgent on the day GP appointment Advise patient to go to A&E Can the patient speak in full sentences? No – A&E Yes – Urgent on the day appointment with a GP *Always ask the patient: How long have you had these symptoms? * |
OPTION 2 |
· Elderly or infirm with mobility problems | · Community services are ideal for elderly patients with mobility issues, please call Urgent Community Response 0300 373 0600 – GP#s must call this number |
OPTION 3 |
· Unexpected death | Let usual GP or on-call GP know straight away |
OPTION 4 |
· Babies & Children · Non blanching rash · Not keeping food down | Offer face to face appointment with usual GP or any available doctor as soon as possible if requested or offer telephone appointment with GP if requested. *Always ask the parents: How long have these symptoms been ongoing? *
A&E |
OPTION 5 |
· Medication review | Check medication review to ensure that it truly is overdue. Then check diary dates. Book an appointment with the practice clinical pharmacist. |
OPTION 6 |
· Results | Most results can be given out as per GP’s comments on the computer. The GP would comment if appointment required – either telephone appointment or face to face. Book appointment as directed with appropriate GP |
OPTION 7 |
· Eye injury resulting in pain/affected vision | Opticians or Queens Hospital eye emergency department. |
· Earaches | If new onset or had for a few days book with Julia – Julia to ask GP’s for advice if required – if Julia full, patient to walk in centre *Always ask the patient: How long have you had these symptoms? * |
OPTION 8 |
· Immunisations/Travel · Dressings/operation wounds · Smear · Contraceptive pill /HRT follow up/rpt prescription · Emergency contraception – to be seen that day · Chronic disease recall · Vaginal swabs (pre coil fit) | Travel form into Karens tray Confirm appointment date and time Notes - For travel advice, advise patient to arrive early to complete a travel questionnaire at reception before seeing the nurse. If patient has ran out of routine contraceptive pill, offer them a 1 month supply to collect and routine appointment with nurse. If patient requires emergency contraception – book a same day appointment with Julia |
OPTION 9 |
· Scheduled blood test · · Suture removal · ECG · Blood Pressure check · NHS Health Check | Book appointment with Health Care Assistant (HCA) Confirm appointment date and time book with nurse or HCA ECG book with Becky (HCA if Becky not in). ECG patients can go home – GP will review later. Blood Pressure check book with HCA. If blood pressure is high 180/110, re-check in 20 mins then send to GP if still high. If BP 160/100 – send a task to pool NHS Health Check book with HCA |
OPTION 10 |
Adult 3 days or less of · fever only symptoms · sore throat · dry cough · cystitis · Thrush · Hay fever · Infections · Post op suspected infections of the bone or post op care | Book with Julia – if Julia is full – advise the patient to go to the walk-in centre. *for cystitis – please ask the patient if they have any pain, they are pregnant, if they have a fever or a catheter* Direct patient hack to the department at the hospital where they came from |
Adult 3 days or more of · Constipation · vomiting · diarrhoea | Book a 1- or 2-day release appointment with Julia/GP Safety net the above to advise that if patients experience worsening symptoms, they should call 111 or go to A&E *Always ask the patient how long have you had these symptoms? * |
· Headlice · Sore throat · Teething pain (over 3 months old) · Toothache · Vaginal thrush · Threadworms | Advise that Pharmacy can offer treatments over the counter for these types of complaints. |
· Sleep problems | 1-, 2- or 3-day release appointment with a GP if the patient is really struggling and it is affecting their mood – please ask the patient, how long have you had these symptoms? If the patient has had for a long time and there is no deterioration in their mood, an appointment in 1 – 2 weeks is appropriate. |
· Musculosketal problems | FCP is the better option for the patients – if the patient needs pain relief whilst waiting for physio appointment GP appointment 1 day release to discuss pain relief. |
OPTION 11 |
Acute injury where fracture suspected | · Suggest attend Accident & Emergency (A&E) and arrange transport when and if required – e.g., elderly, and infirm |
OPTION 12 |
Acute injuries/cuts/burns | Suggest Urgent Care Centre and give address: |
OPTION 13 |
Smoking cessation advice | · Becky/ HCA |
OPTION 14 |
Sick note request | · Advise self-certificate (SC2) for 1st 7 days of illness – available from employer or post office or on-line · Med 3 – 1st doctors note after 7 days sickness · Extension – follow up sick note or 3rd party sick note – To be requested in writing and allow 1 week for completion |
OPTION 15 |
· Acute abdominal pain or chest pain · Persisting skin rash+/- fever · Shortness of breath/cough with spit · Suicidal thoughts or agitation · Excessive bleeding | These are all urgent Please advise A&E or 999 – for mental health please advise crisis team, numbers available un F12 pathfinder ‘Mental Health’. If patient can’t keep themselves safe, advise A&E. |
OPTION 16 |
Sexual Health Screening / Services | Book appointment Practice Nurse · Or suggest visit Nottingham Integrated Sexual Health Services clinics at Stapleford, Victoria Health Centre and Nottingham City Emergency · Contact 01159 627 627 (between 08:30-19:00 Monday - Friday, 09:30-14:00 Saturday) |