Skip to main content

NHS Pathways system update - clinical release note - release 50.2.0

Release 50.2.0 was made available to suppliers and providers on 22 December 2025.

 

Page contents

NHS Pathways make changes to content based on new or emerging clinical evidence, change requests, and 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. 

The enhancements to Main Telephony made by NHS Pathways for Release 50.2.0 are highlighted below. Release 50.2.0 was made available to suppliers and providers on 22 December 2025.

What we've changed

NHS Pathways have made changes to how patients who are actively hanging, strangled or suffocating are triaged and their outcome.

Unconscious and Breathing Strangulation Ambulance category

The following changes were made
  • All calls for patients who are unconscious and non-noisy breathing are now asked “Has the caller declared hanging, strangulation or suffocation right now?" Those who answer “Yes” will now reach an Emergency Ambulance outcome for Pre-arrest (Category 1) outcome.

Following stakeholder feedback, changes were made to the assessment of patients with a predetermined management plan for Addison's or adrenal and sickle cell crisis.

Addison's Crisis, Adrenal Crisis or Sickle Cell Crisis

The following changes were made
  • A new question has been added for patients who have a specific care plan to call 999 if their condition reaches a crisis level, allowing these patients to be routed to an Ambulance outcome mapped to Category 2. Those who answer “No” to the new question will continue their assessment as before, reaching a Category 3 or 4 Ambulance outcome.

NHS Pathways were required to make changes to the guidance for drug overdose kit administration.

Suspected drug overdose or supporting callers to administer Naloxone

The following changes were made
  • Prompts to callers about the presence of a drug overdose kit have been intentionally widened to include all suspected drug overdoses rather than just opioids:
  • Callers who have declared a suspected drug overdose for a patient who is unconscious or has stopped breathing will be asked “Is there a drug overdose treatment kit available for use in an emergency?”
  • If the caller answers “Yes” they will now be asked “What type of treatment kit is it?”
  • If the kit is nasal the caller will be directed straight to the instruction to administer it with relevant guidance.
  • If the kit is injection-based or the caller is unsure they will be asked “Is there someone willing and able to use the overdose treatment kit?”
  • Callers who are willing and able to administer the kit will continue to the relevant guidance.

NHS Pathways have made changes to Primary Care medication dosage outcomes. 

Primary Care changed medication dosage outcome review

The following changes were made
  • Changes have been made for those who have started or changed dosage of medication in the past 2 weeks, or hormone or contraceptive medication in the past 4 weeks, or started or changed medication and had hiccups for less than 48 hours:
  • For these populations when asked “When is the next dose due?” the answer options “Within the next 2 hours” and “Within the next 6 hours” have been removed, meaning the disposition will be either a “Speak to a primary care service within 12 hours” or a “Speak to a primary care service within 24 hours” dependent on when the next dose is due. This is a widescale change across multiple pathways to reduce pressure where possible on primary care services.
  • Adults with suspected locked jaw who have started new medication or have changed their dosage of medication will now get a “To contact a primary care service within 2 hours” outcome. They will also be given guidance relating to next dose of medication. Patients who have stopped medication will now reach a “To contact a primary care service within 2 hours” instead of a 1 hour outcome.

Following work completed in Release 49.2.0 changes were made to guidance given for reimplanting a tooth for children who are 6 years old.

Dental under 6 reimplantation

The following changes were made
  • Children aged 6 may have a second avulsed (knocked out) tooth therefore the age for reimplantation advice has been lowered. This ensures patients over the age of 6 will receive advice for a second tooth where appropriate:  
  • The question “Is the patient less than 7 years old” has now been changed to “Is the patient less than 6 years old”.

Last edited: 17 December 2025 10:31 am