Alkaline Phosophatase
Clinical Biochemistry in Primary Care
Creatinine Kinase
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Lipid Advice & Guidance Service
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Axillary masses
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Targeted Lung Health Check (TLHC) program
Advice & Guidance Service
Cancer and Severe Mental Illness (SMI)
LD & Cancer
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Toxicity Risk Assessment Tool
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Angina
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Coronary Artery Calcification
ECG - Open Access
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Heart Failure
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NT Pro BNP Testing
Pacemakers
Postural Orthostatic Tachycardia Syndrome (PoTS)
Rapid Access Chest Pain Clinics
Syncope and TLOC (non-traumatic)
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Advice and guidance - Care of the Elderly
Assistive Technology Service
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Live Longer Better
Movement Disorders
NHS@home - Frailty pathway
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Acute Assessment
COVID Medicine Delivery Unit (CMDU)
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TeamNet and Latest updates
Acne vulgaris
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Alopecia
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Bowens Disease
Community Dermatology Service
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Skin Camouflage
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Tissue Viability/Wound Care Service
Unusual Appearance - Outlook
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Community Diabetes Specialist Service
Diabetes & Nutrition
Diabetes Advice and Guidance
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Non-diabetic Hyperglycaemia and the National Diabetes Prevention Program
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Local Services
Malnutrition & Oral Nutritional Supplements
Vitamin D Deficiency
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Alcohol Misuse
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Gynaecomastia
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Male hypogonadism
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Advice & Guidance Service
Anosmia
Audiology (adult)
Dizziness and Vertigo
Ear wax and microsuction
ENT HOT Clinic
Epistaxis
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Nasal Treatment
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Otitis Externa
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Snoring
Speech & Language
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Anaemia (Gastroenterology)
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Endoscopy
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Stoma care
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Alpha 1 Antitrypsin Deficiency (AATD)
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Vitamin B12
Warfarin monitoring
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Genetic Haemochromatosis
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Advice & Referrals - Infectious Diseases and Microbiology
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Adult Learning Disability Health Service
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Stop over medication (STOMP)
Advice & Guidance Service
Cleft Lip and/or Palate (adult)
Dental Care
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Salivary Gland Problems
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Alternatives and Adjuncts to HRT
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Referral - Menopause
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Advice & Guidance - Neurology/HOT Clinic
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First Seizure Clinic
Head Injury Therapy Unit
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Allergic Eye Disease
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Advice & Guidance Service
Back pain/ Spinal pathway
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Dupuytren's Contracture
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Funding Policies for Orthopaedics
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getUBetter app
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MSK Foot & Ankle service
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Advice & Guidance - Pain Management
Back Pack
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Respiratory Physio
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Alternative Medicine
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Prescribing in pregnancy and breastfeeding
Psychotropic Medication Monitoring
Toxbase
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Advice & Queries
Direct Access Radiology (adults)
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Air pollution and health
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Breathing Pattern Disorders
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myCOPD App
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Smoking Cessation
Spirometry and Lung Function Tests
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Targeted Lung Health Check (TLHC) program
Advice & Guidance Service
Axial Spondyloarthritis (including ank spond)
Early Inflammatory Arthritis
Fibromyalgia
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Hypermobility and EDS
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Better Health North Somerset
Exercise on referral
HOPE programme
Live Longer Better
Musculoskeletal (MSK) self-help
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Self Care
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Sleep Disorders
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Audiology
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Cleft lip and / or palate
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ENT HOT Clinic (paediatric)
Epistaxis
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Motion sickness
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Chicken Pox - parents guide
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Self-harm in Children and Young People
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Bronchiolitis - parents guide
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Common Childhood Illness - HandiApp
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Cough - parent information
Croup - parents guide
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Febrile Convulsions - parents guide
Feverish Illness - parents guide
Gastro-oesophageal Reflux - parents guide
Head Injury - parents guide
Healthier Together - Parent Advice
Increasing Iron Intake
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Swallowing Pills Advice
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Wheezy action plan
Advice & Guidance - Respiratory
Asthma in Children- acute (including wheeze)
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Bronchiolitis
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ADHD Care Pathway for school age children
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SEND
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Continence
Haematuria
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Surgery & Urology
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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
General Geriatrics - Draft
Pyogenic Granuloma - Draft
Unscheduled bleeding on HRT (DRAFT)
Post-menopausal bleeding - not on HRT (DRAFT)
Anaemia in Pregnancy _ Draft
Employment Support (DRAFT)
Overactive Bladder - Draft
Family History of Breast/ Ovarian Cancer (DRAFT)
Abscesses, Boils and Carbuncles (DRAFT)
Formulary Process
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1. Gastro-Intestinal System
2. Cardiovascular System
3. Respiratory System
4. Central Nervous System
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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
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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
Contact lens wear increases the risk of infection of cornea. This is one of the most common conditions which presents to the BEH Emergency Department. A light sensitive and painful red eye in a contact lens wearer is typically an ulcer (an infection). These do not respond to chloramphenicol and require broader spectrum antibiotics (first-line: levofloxacin). On examination, you may see:
Please see diagnostic photographs
The patient should be reviewed in the BEH Emergency Department, the same day.
If the patient is out of hours, please discuss with the on-call ophthalmologist
Red eye and light sensitivity in a contact lens wearer should prompt suspicion of a corneal infection, this cannot be adequately diagnosed or excluded without a slit-lamp.
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.