This protocol will:
- support care navigators or reception staff in care navigating and signposting
- provide team members with information about red flag symptoms and advice to give patients regarding these symptoms whilst awaiting urgent attention
- consistently record care navigation and signposting activity for audit purposes
What does it actually do?
The protocol performs the following functions:
- Allows users to identify and see information about "Red flag" symptoms
- Allow users to navigate patients safetly to "Pharmacy first", ARRS staff or other community based resources where appropriate
- Allow users to record "general symptoms" and choose disposition for these patients - where patients don't have symptoms that are suitable for care navigation or signposting
- Allows users to record where patients don't want to discuss details
- Allows users to record a variety of signposting options
What does it look like?
Initially the user is presented with the following options:
Red flag symptoms
Where the user chooses "Red flag Symptoms" they are presented with some information about action that should be taken for red flags and then a list of complaints that would be identified as red flags.
By clicking on any of the red flag options, guidance and information is shown to the user. For example for shortness of breath, the following information would be displayed:
The option to code the red flag symptom is given to the user:
The user is safety netted to record how the patient is taking urgent action:
For all pathways chosen, the user is reminded to check with the patient that they understand what action is recommended:
And then are notified that the signposting has been completed:
Care Navigation
Care navigation should be used in the absence of red flag symptoms. It allows for:
- Screening of pharmacy first options
- Screening of problems that are suitable for ARRS staff
- Screening for other community services that may be useful for the patient
Screening for Pharmacy first options
Where the user chooses one of the Pharmacy first options, the "Care Navigation and Signposting" protocol will go through the NHSE approved pathway to identify those patients who need to be seen by the surgery versus those that can be safetly signposted to the pharmacy. For example - for UTI the following pathway will show:
The patient is first screened for pyelonephritis:
They are screened for pregnancy and immunosupression:
They are screened for genitourinary symptoms:
Then they are asked about the number of symptoms the patient is experiencing:
Depending on the option chosen, different information is shown:
No symptoms would show this:
and then if answered no, this:
2 or 3 symptoms would show this:
This will ensure that appropriate patients are signposted to pharmacies and that the numbers who are returned for GP practice management are low.
General symptoms
If the user decides that the patient does not have red flags and that there are no suitable care navigation or signposting. options, they are able to use the "General symptoms" to record more detail about why the patient has contacted the surgery and is requesting an appointment. This can be useful data to collect so practices and PCNs fully understand the demand that they are dealing with.
The user is initially asked if they want to record things in the care record, or within a consultation:
And then a list of options for symptoms is shown:
When an option is chosen a range of disposition options are shown:
Patient does not wish to discuss details
If the patient declines to discuss details, this option can be chosen to record this information. The following information will be shown:
Record signposting
If the user wishes to simply record signposting, they can choose this option and then select the appropriate option:
The appropriate code is added to the record, and the user is informed:
System Dependencies:
The use of this protocol depends on the user being aware of its existence and the practice or PCN choosing to use it as a way of standardising the recording of their signposting and care navigation activity.
System Trigger
System Trigger: Manual launch
Fitting your practice
Your team need to discuss and be clear about how you are consistently recording care navigation and signposting.