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NHS Pathways system update - clinical release note - release 44.2.0

Release 44.2.0 was made available to suppliers and providers on 16 July 2024.

Page contents

NHS Pathways make changes to content based on:

  • new or emerging clinical evidence
  • change requests
  • feedback from our providers or wider stakeholders

NHS Pathways identifies areas of content that would benefit from enhancement. The aim of these enhancements is to provide clarity for users, and to benefit both users’ and patients’ experiences, thus ensuring that triage is as safe, effective, and efficient as possible.

What we've changed

The enhancements to Main Telephony made by NHS Pathways for Release 44.2.0 are highlighted below.

Release 44.2.0 was made available to suppliers and providers on 16 July 2024.

Allergic Reaction Restructuring

Following stakeholder feedback and work completed in Release 34, further enhancements were required to restructure and simplify the Allergic Reaction pathway.

The following changes were made
  • The Pathway has now been separated into specific age groups, with two new Pathways created, for toddlers and infants/neonates, to simplify triage and shorten where appropriate.

Deep Vein Thrombosis Assessment in toddlers

Following stakeholder feedback, a review of the Lower Limb Pain or Swelling pathways for toddlers with suspected Deep Vein Thrombosis (DVT) was required.

The following changes were made
  • If a whole leg is painful and swollen this previously received a Category 3 ambulance outcome but will now receive a ‘Refer to Treatment Centre within 1 hour’ outcome, as it is more appropriate to be referred to a treatment centre that can undertake a full assessment. This would include services such as same day emergency care services.

Covid-19 assessment amendments

As part of the review to reduce the focus on COVID-19, NHS Pathways were required to make further changes to the system.

Within the Cold or Flu Symptoms pathways changes have been made to reduce the focus on COVID-19 to ensure patients are triaged for their main presenting symptom:

The following changes have been within the Cold or Flu Symptoms pathways
  • Patients who are over 65 years of age will receive an additional question (where applicable) to check if they have any new or worsening breathlessness before receiving symptom management advice. If the patient answers positively to breathlessness they will now receive a ‘To Contact a Primary Care Service within 24 hours’ outcome.
  • Those with a predetermined management plan will no longer receive the therapeutic COVID-19 assessment questioning as this is managed within the Health Information pathway

Chest Pain and Acute Coronary Syndrome

Following stakeholder feedback, enhancements to the Chest and Upper Back Pain pathways were required to better identify those who may have Acute Coronary Syndrome (ACS) symptoms.

The following changes were made
  • A new question has been added, ‘Have you had any of these types of pain IN THE LAST 24 HOURS?’ for patients who answer negatively to current pain spreading from the chest, upper back or upper abdomen, to assess whether any ACS pain has been present in the last 24 hours.
  • Those answering positively will follow the same triage as other patients with ACS symptoms, allowing the opportunity to reach a Category 2 ambulance response for ACS.
  • Changes have also been made to the Pathways so that patients over 35 years of age with new aching pain in the arm, neck, jaw or shoulder that doesn’t spread, will not receive an outcome less urgent than ‘Speak to a Primary Care Service within 1 hour’, to align with other routes in the system.

Fever and Moderate Impairment

Following internal review, changes were required in the Fever pathway to improve consistency across the system.

We made the following change
  • Patients within the Fever pathways who are moderately impaired will now be asked the triage questions for potential Pulmonary Embolism

Head Injuries and Urgent Treatment Centres

To ensure alignment with new NICE guidance, NHS Pathways were required to review the relevant eye, head and nose Pathways.

We made the following change
  • A new question ‘Do you take anti-platelet medication?’ has been added to improve identification of a specific group of patients with head injuries who are at increased risk of bleeding.

Last edited: 17 December 2024 12:19 pm