Alkaline Phosophatase
Clinical Biochemistry in Primary Care
Creatinine Kinase
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Lipid Advice & Guidance Service
Advice & Guidance Service
Axillary masses
Breast Implants (non-cancer)
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Family History of Breast Cancer
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Pancreatic Cancer Surveillance Programme
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Angina
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Coronary Artery Calcification
ECG - Open Access
ECHO - requesting
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NT Pro BNP Testing
Pacemakers
Postural Orthostatic Tachycardia Syndrome (PoTS)
Rapid Access Chest Pain Clinics
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Assistive Technology Service
Falls & Balance
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Frailty
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Live Longer Better
Movement Disorders
NHS@home - Frailty pathway
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Acute Assessment
COVID Medicine Delivery Unit (CMDU)
COVID Oximetry @ Home Virtual Ward
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TeamNet and Latest updates
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Advice & Guidance and guidelines
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Community Diabetes Specialist Service
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Local Services
Malnutrition & Oral Nutritional Supplements
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Alcohol Misuse
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Anosmia
Audiology (adult)
Dizziness and Vertigo
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ENT HOT Clinic
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Snoring
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Stop over medication (STOMP)
Advice & Guidance Service
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First Seizure Clinic
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Community Nursing - Bristol
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Lymphoedema
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Cholestasis of Pregnancy
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Early Pregnancy Assessment Clinic
Family Nurse Partnership
Folic acid and Vitamin B12 in pregnancy
Group B Strep in Pregnancy
Hyperemesis Gravidarum
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Maternity Services
Perinatal Mental Health
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Acute Angle Closure Glaucoma
Advice & Guidance Service
Allergic Eye Disease
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Pre-septal and Post-septal Cellulitis
Referral Guidance & Tips
Subconjunctival Haemorrhage
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Acute knee & shoulder clinics
Advice & Guidance Service
Back pain/ Spinal pathway
Carpal Tunnel Syndrome
Dupuytren's Contracture
Foot and Ankle Problems
Fracture Clinics
Funding Policies for Orthopaedics
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getUBetter app
Hand problems
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Advice & Guidance - Pain Management
Back Pack
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Spinal Cord Stimulation Service
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Alternative Medicine
Antibiotics
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Medication to avoid in dementia patients
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Psychotropic Medication Monitoring
Toxbase
Vitamin D
Advice & Queries
Direct Access Radiology (adults)
Image Guided Steroid Injections
MRI considerations
Radiology Guidelines for Primary Care
Spinal Imaging in Primary Care
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Air pollution and health
Asthma (adults)
Breathing Pattern Disorders
Bronchiectasis
Chronic Breathlessness Support
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Community Respiratory Service
Fit to Fly Assessments
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HOT Clinics (Respiratory)
Interstitial Lung Disease
Long-term Ventilation (LTV) Service
myCOPD App
NHS@home - Respiratory pathway
Obstructive Sleep Apnoea
Pleural Services
Pulmonary Rehabilitation
Respiratory Triage Services (RAS)
Smoking Cessation
Spirometry and Lung Function Tests
Tuberculosis
Targeted Lung Health Check (TLHC) program
Advice & Guidance Service
Axial Spondyloarthritis (including ank spond)
Early Inflammatory Arthritis
Fibromyalgia
Giant Cell Arteritis
Gout (Crystal Arthropathy)
Hypermobility and EDS
Osteoporosis
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Polymyalgia Rheumatica (PMR)
Psoriatic Arthritis (PsA)
Raynaud's Phenomenon
Sjorgren's Sydrome
Systemic Lupus Erythematous
Young Adult Rheumatology Service
Better Health North Somerset
Exercise on referral
HOPE programme
Live Longer Better
Musculoskeletal (MSK) self-help
One You South Gloucestershire
Self Care
Smoking Cessation
Advice & Guidance Service
Chronic Pelvic Pain Syndrome (men)
Contraception
Emergency Contraception
Gonorrhoea
HIV
LARC
LARC Complex referrals
Loss of Libido
Monkeypox
Pelvic Inflammatory Disease
Post Birth Contraception
Psychosexual Service
Sexual assault/ abuse support
Sexual Health Guidelines and Referral
Syphilis
Circadian Rhythm Disorder
Insomnia
Obstructive Sleep Apnoea (OSA)
Parasomnias
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Advice & Guidance Service
Cosmetic Treatment (including scar revision)
Foreign Body Removal (soft tissue)
Hernias (adults)
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Pre-operative assessment
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Dementia Wrap Around Care - North Somerset
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Neonatal milk & vitamin guideline
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Speech and Language Therapy
Audiology
Bell's Palsy
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ENT HOT Clinic (paediatric)
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Nasal problems
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Chicken Pox - parents guide
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Asylum & Refugee Clinic (ARC)
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Hep B vaccine for at risk infants
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Sacral dimples and pits
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Bell's Palsy
Febrile Convulsions
Fits, Faints and Funny Turns
Headache
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Tics and Tourette's in children
Accurx templates for CYP
Bronchiolitis - parents guide
Chicken Pox - parents guide
Common Childhood Illness - HandiApp
Constipation - A guide for parents
Cough - parent information
Croup - parents guide
Diarrhoea and vomitting - parents guide
Febrile Convulsions - parents guide
Feverish Illness - parents guide
Gastro-oesophageal Reflux - parents guide
Head Injury - parents guide
Healthier Together - Parent Advice
Increasing Iron Intake
Sore Throat - parents guide
Swallowing Pills Advice
Umbilical Granuloma - parents guide
Vulvovaginitis
Weaning to a Cows milk free diet
Wheezy action plan
Advice & Guidance - Respiratory
Asthma in Children- acute (including wheeze)
Asthma in Children - Chronic
Bronchiolitis
Community Acquired Pneumonia
Cough (including PBB)
Croup
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Be Safe
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Children in Care and Care Leavers (also known as Looked After Children)
ADHD Care Pathway for school age children
Auditory Processing Disorder (APD)
Autism spectrum disorder (ASD)
Dyslexia
Early Years Support Practitioner (SEND) Service (BRISTOL)
SEND
Sleep Disorders
Stop over medication (STAMP)
Burns (children)
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Rapid Access Clinic
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Continence
Haematuria
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Surgery & Urology
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Obsolete pathways
Anaemia - iron deficiency - draft
Back pain/ Spinal pathway - Draft
Cauda Equina Syndrome - DRAFT
Community Urology Service - GP Care (DRAFT)
Consumer Genetic Testing - DRAFT
Haematuria in Children - draft
ICE System (Draft)
Needlestick injury - DRAFT
Normal Pressure Hydrocephalus - Draft
Paediatric Rheumatology - Draft
Papilloedema - Draft
Pulmonary Hypertension - DRAFT
Septicaemia - Draft
Sexually Transmitted Infections - guide to swabs - DRAFT
Vitamin B12 - interim guidelines DRAFT
Shared Decision Making DRAFT
Hyperemesis Gravidarum DRAFT
Lymphadenopathy (Benign) in Children - Draft
General Geriatrics - Draft
Pyogenic Granuloma - Draft
Premature Ovarian Insufficiency (Menopause <40y) DRAFT
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Alternatives and Adjuncts to HRT (DRAFT)
Post-menopausal bleeding - not on HRT (DRAFT)
Contraception (DRAFT)
Referral - Menopause (DRAFT)
Resources for patients (DRAFT)
Anaemia in Pregnancy _ Draft
Second Opinions - Draft
Employment Support (DRAFT)
Overactive Bladder - Draft
Family History of Breast/ Ovarian Cancer (DRAFT)
Formulary Process
Joint Formulary Paperwork
Purpose and Format of the Joint Formulary
The Traffic Light System and Classification of Medicines
Non-formulary and Unlicensed Medicines
Shared Care
Meeting dates
APMOC Paperwork
1. Gastro-Intestinal System
2. Cardiovascular System
3. Respiratory System
4. Central Nervous System
5. Infections
6. Endocrine System
7. Obstetrics, Gynaecology and Urinary-tract Disorders
8. Malignant Disease and Immunosuppression
9. Nutrition and Blood
10. Musculoskeletal and Joint Diseases
11. Eye
12. Ear, Nose and Oropharynx
13. Skin
14. Immunological Products and Vaccines
15. Anaesthesia
16. Palliative Care
17. Miscellaneous Preparations
1. Gastro–intestinal System Guidelines
2. Cardiovascular System Guidelines
3. Respiratory System Guidelines
4. Central Nervous System Guidelines
5. Infections Guidelines
6. Endocrine System Guidelines
7. Obstetrics, Gynaecology and Urinary-tract Disorders Guidelines
8. Malignant Disease and Immunosuppression Guidelines
9. Nutrition and Blood Guidelines
10. Musculoskeletal and Joint Diseases Guidelines
11. Eye Guidelines
12. Ear, Nose and Oropharynx Guidelines
13. Skin Guidelines
14. Immunological Products and Vaccines Guidelines
16. Palliative Care Guidelines
17. Polypharmacy
18. Care Homes
19. Other
20. Appliances and Part IX
Botulinum Toxin A Pathways
Community Pharmacy Minor Ailment PGDs
Healthcare professionals working in primary care PGDs
NHSE PGDs
BNSSG-wide PGD Policy and Process
BNSSG PGD templates
Formulary Process
Joint Formulary Paperwork
Purpose and Format of the Joint Formulary
The Traffic Light System and Classification of Medicines
Non-formulary and Unlicensed Medicines
Shared Care
APMOC Paperwork
1. Gastro-intestinal System
2. Cardiovascular system
3. Respiratory System
4. Nervous system
5. Infections
6. Endocrine system
7. Obstetrics, gynaecology, and urinary-tract disorders
8. Malignant Disease and Immunosuppression
9. Nutrition and Blood
10. Musculoskeletal and joint diseases
11. Eye
12. Ear, Nose and Oropharynx
13. Skin
14. Immunological products and vaccines
15. Anaesthesia
16. Palliative Care
17. Miscellaneous Preparations
1. Gastro–intestinal system Guidelines
3. Respiratory System Guidelines
4. Nervous System Guidelines
5. Infections Guidelines
6. Endocrine system Guidelines
9. Blood and nutrition Guidelines
13. Skin Guidelines
20. Appliances and Part IX
Specialist Falls Service
South Glos - Memory Service & Dementia Support
South Glos - Active Ageing
Assistive Technology Service
Pain clinic - NBT
Back Pack - NBT & WGH
NBT - Cognitive Disorders Clinic
Endocrinology NBT
Arts on Referral for Chronic Pain - NBT
Falls Service : NBT
Neuropsychiatry Sleep Disorders clinic - NBT
Arts on Referral for Neuromuscular Condition - NBT
Bristol - Psychosis Early Intervention
South Glos - Psychosis Early Intervention
North Somerset - Psychosis Early Intervention
Primary Care Liaison Service
This is typically a sudden onset of severe eye pain and reduced vision. Patients often complain of an entire headache centred around the eye. Certain signs in angle closure glaucoma can be:
Please see diagnostic photograph
This case should be urgently referred to the BEH Emergency department or, if out of hours, to the on-call ophthalmologist, for immediate review.
Cases should be urgently referred to the BEH Emergency department or if out of hours to the on-call ophthalmologist, for immediate review
Analgesia and anti-emetics can be given, however there is no immediate treatment which can be given in primary care.
Refer to BEH Emergency Department
These guidelines have been written by Rhys Harrison, consultant ophthalmologist at Bristol Eye Hospital, with thanks to the patients who have kindly given consent to use their photos.
For full ophthalmology guidelines see: Primary Care Ophthalmology Guidance Document
Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.
Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.