REMEDY : BNSSG referral pathways & Joint Formulary
Covid -19 Specific information
Decision Support Tools Patient Information & Safety-netting Bone & Soft Tissue - USC (2WW) Brain & CNS - USC (2WW) Breast - USC (2WW) Cancer of Unknown Primary - USC (2WW) Children & Young People – USC (2WW) Family History of Cancer Gynaecology - USC (2WW) Haematology - USC (2WW) Head & Neck incl Thyroid - USC (2WW) Lower GI - USC (2WW) Lung - USC (2WW) Non-Specific Symptoms - USC (2WW) Pancreas - USC (2WW) Skin - USC (2WW) Upper GI - USC (2WW) Urology - USC (2WW)
Advice & Guidance for GPs
Advice & Guidance Services Advice and Guidance Best Practice Triage Service (RAS) on e-Referral
Biochemistry
Alkaline Phosophatase Clinical Biochemistry in Primary Care Creatinine Kinase Hyperkalaemia Hyperlipidaemia Hypomagnesaemia Lipid Advice & Guidance Service
Breast
Advice & Guidance Service Axillary masses Breast Implants (non-cancer) Breast Pain Breast Surgery Breastfeeding Family History of Breast Cancer Male Breast Symptoms Mastitis and Breast Abscess Nipple conditions
Cancer Screening
Bowel Cancer Screening Breast Cancer Screening Cervical Cancer Screening Pancreatic Cancer Surveillance Programme Targeted Lung Health Check (TLHC) program
Cancer Support
Advice & Guidance Service Cancer and Severe Mental Illness (SMI) LD & Cancer Living with and beyond cancer (LWBC) Nutrition in cancer Physio for NBT Cancer patients Post cancer - Digital Remote Monitoring and Personalised Stratified Follow Up Rehab / prehab Toxicity Risk Assessment Tool
Cardiology
Advice & Guidance Service Angina Arrhythmia Atrial Fibrillation and Flutter Cardiac Rehabilitation Cardiac Rhythm Analysis Coronary Artery Calcification ECG - Open Access ECHO - requesting Heart Failure Hypertension Inherited Cardiac Conditions NT Pro BNP Testing Pacemakers Postural Orthostatic Tachycardia Syndrome (PoTS) Rapid Access Chest Pain Clinics Syncope and TLOC (non-traumatic) Thoracic Aorta Disease
Care of the Elderly
Active Ageing - South Glos Advice and guidance - Care of the Elderly Assistive Technology Service Falls & Balance Fracture Liaison Service Frailty Hearing Services Live Longer Better Movement Disorders NHS@home - Frailty pathway Rapid Assessment Clinic For Older People
Community Therapy
Community Therapy
COVID-19
Acute Assessment COVID Medicine Delivery Unit (CMDU) COVID Oximetry @ Home Virtual Ward COVID Testing Long COVID TeamNet and Latest updates
Dementia
Dementia - Assessment & referral Dementia Prescribing Mental Capacity & Best Interest Decisions
Dermatology
Acne vulgaris Actinic Keratosis Advice & Guidance and guidelines Alopecia Basal Cell Carcinoma Benign Skin Lesions Bowens Disease Community Dermatology Service Cosmetic skin treatments Eczema Hidradenitis Suppurativa Hyperhidrosis Leg Ulcer Mole Mapping/Surveillance Pityriasis Rosea Pityriasis Versicolor Polymorphic Light Eruption Pruritis Psoriasis Rosacea Scabies Seborrhoeic Dermatitis Skin Camouflage Tinea Tissue Viability/Wound Care Service Unusual Appearance - Outlook Urticaria Vulval Skin Care Warts and Verrucas
Diabetes
Community Diabetes Specialist Service Diabetes & Nutrition Diabetes Advice and Guidance Diabetes Foot Care Diabetes Mellitus - Guidelines Diabetes self-management Diabetes Structured Education Diabetic Eye Screening Monogenic Diabetes Neuropathic Pain (Diabetic) Non-diabetic Hyperglycaemia and the National Diabetes Prevention Program Pregnancy and diabetes Rapid Access Diabetes Clinic Type 2 diabetes management Type 2 Path to Remission Programme
Dietetics & Nutrition
Advice & Guidance Service Local Services Malnutrition & Oral Nutritional Supplements Vitamin D Deficiency Weight management
Drug and Alcohol Misuse
Alcohol Misuse Opiate Dependence Non-opiate drug dependence Bristol Drug and Alcohol Service North Somerset Drug & Alcohol Service South Gloucestershire Drug & Alcohol Service Bristol Shared Care Breaking Free (Bristol & South Glos)
DVT and PE
DVT and SVT Pathway Pulmonary Embolus (suspected) Secondary Care DVT Services Unprovoked DVT
Enablement
Bristol Centre for Enablement Wheelchair Services
End of Life Care and Hospice
Bereavement support Death Certification and Medical Examiner End of Life Care End of life care - community support ReSPECT Plus SR1 Form (formerly DS1500) St Peters Hospice Weston Hospice
Endocrinology
Adrenal incidentaloma Adrenal insufficiency Advice and Guidance (Endocrinology) Endocrinology Services - UHBW and NBT Gynaecomastia Hirsutism Hyperprolactinaemia Hyperthyroidism Hyponatraemia Hypothyroidism Male hypogonadism Polyuria Primary hyperparathyroidism (PHPTH) Secondary hypertension Sub Clinical hyperthyroidism Sub Clinical hypothyroidism Thyroid Disease and pregnancy Thyroid eye disease
ENT
Advice & Guidance Service Anosmia Audiology (adult) Dizziness and Vertigo Ear wax and microsuction ENT HOT Clinic Epistaxis Hearing Problems Middle ear problems Moulded Ear Plugs Nasal Treatment Neck Lumps (including Goitre) Otitis Externa Rhinosinusitis & Nasal Polyps Snoring Speech & Language Tinnitus Tonsils Uvula
Fertility
Advice & Guidance Service Infertility Semen Analysis
Gastroenterology and Colorectal Surgery
Advice & Guidance Services Anaemia (Gastroenterology) Anal FIssure Barrett's oesophagus Coeliac Disease Colon Polyps Community Gastroenterology Clinic - InHealth Constipation in Adults Dyspepsia and Reflux Endoscopy Eosinophilic Oesophagitis Faecal Calprotectin FIT (Faecal Immunochemical Test) Gallstones (and polyps) Haemorrhoids and anal lesions Hiccups Inflammatory Bowel Disease (Confirmed) Inflammatory Bowel Disease (suspected) Irritable Bowel Syndrome Microscopic Colitis Pancreatitis (Acute) Pancreatitis (Chronic) and PEI Rectal Bleeding Stoma care Upper GI Bleed Urgent Gastroenterology Services
Gender Identity Genetics
Alpha 1 Antitrypsin Deficiency (AATD) Family History of Breast/Ovarian Cancer Family History of Colorectal Cancer Genetic Haemochromatosis Genetics - general Monogenic Diabetes
Gynaecology
Advice & Guidance Service Abnormal vaginal bleeding Cervical Conditions Dyspareunia Early Pregnancy Assessment Clinic Emergency Gynaecology Endometriosis Female Cosmetic Surgery Female Genital Mutilation Female Genitalia Surgery Female Urinary Incontinence Fibroids Hyperemesis Gravidarum Menopause Menstrual Disorders Mesh Complications Open Access Gynae Imaging Ovarian Conditions PCOS Pelvic Inflammatory Disease Pelvic Organ Prolapse Persistent Pelvic Pain (women) Premature Ovarian Insufficiency Recurrent Miscarriage Termination of Pregnancy Vaginal Discharge Vulval Skin Conditions
Haematology
Advice & Guidance Service Anaemia Blood Transfusions & Iron infusions Genetic Haemochromatosis Guidelines for Primary Care Leucocytosis (including neutrophilia and lymphocytosis) Lymphadenopathy (adults) Macrocytosis Polycythaemia Sickle Cell & Thalassaemia Vitamin B12 Warfarin monitoring
Hepatology
Advice & Guidance Hepatology Service Genetic Haemochromatosis Liver disease Viral Hepatitis Urgent Hepatology Service
Homeless and Migrant Healthcare
Asylum Seeker and Refugee Health Homelessness Support
Imaging - see Radiology
Immunology
Immunology & Allergy Advice & Guidance Services Immunology & Allergy Guidelines
Infectious Diseases and Microbiology
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Investigations
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Learning Disabilities
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Lifestyle advice
Lifestyle advice
Max Fax and Dental
Advice & Guidance Service Cleft Lip and/or Palate (adult) Dental Care Reconstructive Prosthetics Services Salivary Gland Problems Temporomandibular Joint Disorders Trigeminal Neuralgia
Menopause
Alternatives and Adjuncts to HRT Cardiovascular conditions and HRT Contraception and Menopause Diagnosing menopause Early menopause - under 45 Genitourinary symptoms Gynaecology conditions and HRT Hormone Replacement Therapy (HRT) HRT and breast conditions HRT and Migraines HRT in over 60s Hormone sensitive cancers Premature Ovarian Insufficiency (Menopause <40y) Referral - Menopause Side effects and risks of HRT Testosterone for low libido VTE and HRT Resources for patients
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Neurology
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Neurosurgery
Advice & Guidance (Neurosurgery) Cauda Equina Syndrome Neurosurgery Spinal Surgery Trigeminal Neuralgia
Nursing
Community Nursing - Bristol Community Nursing -North Somerset Community Nursing - South Glos Lymphoedema
Obstetrics
Advice & Guidance Service Cholestasis of Pregnancy Diabetes in Pregnancy Early Pregnancy Assessment Clinic Family Nurse Partnership Folic acid and Vitamin B12 in pregnancy Group B Strep in Pregnancy Hyperemesis Gravidarum Hypertension in pregnancy Maternity Services Perinatal Mental Health Post Natal Care Termination of pregnancy Thyroid Disease and Pregnancy Vaccination in Pregnancy
Oncology
Advice & Guidance Service BHOC Acute Care Cancer Support Oncology Referrals
Ophthalmology
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Orthopaedics
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 Ganglion getUBetter app Hand problems Hip Pain Knee Pain Meralgia Paraesthetica MSK Foot & Ankle service Musculoskeletal (MSK) self-help Musculoskeletal Interface (MSKI) Service Periprosthetic hip infection Shoulder Problems Sports Injuries Steroid injections Trigger Finger
Pain Management and CFS
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Physiotherapy
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Podiatry
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Prescribing
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Radiology imaging
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Respiratory
Advice & Guidance Service Air pollution and health Asthma (adults) Breathing Pattern Disorders Bronchiectasis Chronic Breathlessness Support Chronic cough Chronic Obstructive Pulmonary Disease Community Respiratory Service Fit to Fly Assessments Home oxygen ordering 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
Rheumatology
Advice & Guidance Service Axial Spondyloarthritis (including ank spond) Early Inflammatory Arthritis Fibromyalgia Giant Cell Arteritis Gout (Crystal Arthropathy) Hypermobility and EDS Osteoporosis Osteoporotic Vertebral Fracture Polymyalgia Rheumatica (PMR) Psoriatic Arthritis (PsA) Raynaud's Phenomenon Sjorgren's Sydrome Systemic Lupus Erythematous Young Adult Rheumatology Service
Safeguarding
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Self Care
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Sleep Medicine
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Social Prescribing Speech & Language
Speech and language therapy (SLT) - community and outpatient services
Surgery
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Urgent Care
Admission protocols Dementia Wrap Around Care - North Somerset Frailty - ACE Frailty - Urgent Care HOT Clinics & Rapid Access Live UEC Dashboard Medical Assessment/Admission and Weekday IUC Professional Line NHS@home Sirona Professional Lines Surgical Emergency Care Transport to Hospital Urgent Care, MIU & WIC Urgent Community Response - Sirona Urgent Urology Pathway
Urology
Acute Prostatitis Advice & Guidance Service Bladder & Bowel Self Care App Bladder & Bowel Services Chronic Prostatitis Circumcision in adults Erectile Dysfunction Female Urinary Incontinence Haematospermia Haematuria Hydrocele LUTS in men Mesh complications Penile Disorders Prostate - including PSA Renal Calculi Scrotal Swellings & Testicular Lumps & Pain Sterile Pyuria Trial Without Catheter (TWOC) Urgent Care and Admissions (Urology) - under review Urinary Tract Infections Urodynamics UTIs in Care Homes Varicocele Vasectomy
Vascular
Advice & Guidance Service Abdominal Aortic Aneurysm Aortic Dissection Arterial Leg Ulcers Carotid Artery Stenosis NHS Health Check Peripheral Arterial Disease Varicose Veins and Venous Leg Ulcers Vascular Hot Clinic Vascular Nurse Specialist Clinic
Weight Management
Digital Weight Management Introduction and Tier 1 Weight Management Low Calorie Diet Pilot Non-diabetic Hyperglycaemia and the National Diabetes Prevention Program (NDPP) Tier 2 Weight Management Services Tier 3 & 4 Weight Management Service - BNSSG Post Bariatric Surgery Monitoring
Advice and Guidance
Advice & Guidance
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Bristol Royal Hospital for Children guidelines
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ME/CFS
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COVID-19
COVID Medicine Delivery Unit (CMDU) Long COVID in children
Dental & Oral Health
Dental Referrals Mouth ulcers
Dermatology
Advice & Guidance - Dermatology Benign skin lesions in children Community Dermatology Services Dermoid Cysts Eczema Henoch-Schonlein Purpura Pilomatricoma
Development
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Diabetes
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Drug and Alcohol Misuse
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Care Pathway
Education
Bristol Hospital Education Service (BHES)
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End of life care - children When a child dies
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ENT
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Gastroenterology
Chronic Abdominal Pain and IBD Coeliac disease (children) Constipation Diarrhoea and vomiting Faltering Growth Milk Related Problems Neonatal milk & vitamin guideline Reflux Disease
Gender Identity
Gender Incongruence in children and young people
Gynaecology
FGM in children (<18) Gynaecology (paediatric and adolescent) The Star Clinic Vulvovaginitis
Haematology
Anaemia Immune Thrombocytopenia (ITP) Neutropenia Paediatric Sickle Cell & Thalassaemia
Immunisation
Hep B vaccine for at risk infants Paediatric Immunisation TB screening and BCG
Infectious Diseases
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Mental Health
Asylum & Refugee Clinic (ARC) Mental Health Resources for Children and Young People CAMHS mental health 24/7 emergency line CAMHS Referral information Happymaps Self-harm in Children and Young People
Milk Related Problems
Milk Related Problems
Neonatal
Hep B vaccine for at risk infants Jaundice Neonatal milk & vitamin requirements Sacral dimples and pits Umbilical Granuloma
Nephrology
Henoch-Schonlein Purpura
Neurology
Bell's Palsy Febrile Convulsions Fits, Faints and Funny Turns Headache Head injury Neuromuscular Neurosurgery Tics and Tourette's in children
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Advice & Guidance Referral Guidance Orbital Cellulitis
Orthopaedics
Back pain Hip Dysplasia Limping - acute limp in children Lower Limb Urgent & Non-urgent Referrals
Pain Management
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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
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Paediatric Phlebotomy
Physiotherapy
Community physiotherapy MSK Physiotherapy
Plagiocephaly
Plagiocephaly and Craniosynostosis
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Advice & Guidance - Respiratory Asthma in Children- acute (including wheeze) Asthma in Children - Chronic Bronchiolitis Community Acquired Pneumonia Cough (including PBB) Croup Sleep Apnoea in Children Tuberculosis (children)
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Home > Formulary : Adult > Chapters > 3. Respiratory System >

BNSSG Adult Joint Formulary

3.4 Cough and congestion

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Last edited: 24-10-2024

First line drugs Second line drugs Specialist drugs Secondary care drugs

 

Cough suppressants

Pholcodine (TLS Green)

Dextromethorphan sugar-free (TLS Green)

  • Non Sugar-free is non-formulary and blacklisted nationally
  • Should be prescribed as Robitussin Dry Cough®

Alternative:

Codeine linctus (TLS Blue)

Morphine sulfate modified release tablets (TLS Red)

  • for refractory chronic cough only

Specific indications: (TLS Blue)

Methadone linctus

  • Cough in terminal disease

Morphine

  • Cough in terminal disease

 

Expectorant and demulcent cough preparations

Simple linctus (TLS Green)

Specific indication: (TLS Red)

Gabapentin

  • For the treatment of chronic cough in idiopathic pulmonary fibrosis patients who have failed with routine first line treatment (dextromethorphan/codeine). Consultant use only, NBT only. Unlicensed indication

Thalidomide

  • For the treatment of chronic cough in idiopathic pulmonary fibrosis patients who have failed with routine first line treatment and gabapentin. Consultant use only, NBT only. Unlicensed indication

 

Systemic nasal decongestants 

  • Systemic decongestants should be used with caution in diabetes, hypertension, hyperthyroidism, raised intraocular pressure, prostate hypertrophy, hepatic impairment, renal impairment and ischaemic heart disease and should be avoided in patients taking monoamine oxidase inhibitors

 

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