Exam Pass Notes

Download (Word)

Key Takeaways

• Active signposting means giving a patient a specific, current and usable next step.
• It is not a vague suggestion, a way to block GP access or a substitute for escalation.
• Good signposting explains why the route may help, how to use it and what to do if it fails.
• The route must be realistic for the individual patient, not just correct in theory.
• Local protocols and current service information determine which routes are appropriate.

Directories and Usability

• Use approved sources: check the practice directory, pathway or service information rather than relying on old leaflets or memory.
• Check eligibility: age, location, registration status, referral source and local rules can affect access.
• Check availability: opening hours, online forms, phone access, temporary closures and same-day limits can make a signpost unusable.
• Check usability: language, disability, digital access, transport, distress, confidence and safe contact can prevent the patient using the route.

Common Signposting Routes

• Community pharmacy: supports medicines-related questions and Pharmacy First-style routes where local pathways allow.
• Urgent routes: NHS 111-style services, urgent treatment centres, Phone First, out-of-hours and emergency services are needed when routine signposting would be unsafe.
• Social prescribing and self-referral: helps with non-medical, practical and wellbeing needs, but should not feel like abandonment.
• Other primary care routes: dentistry, optometry and other local services should be presented as appropriate routes to the right expertise.

Safety-Netting, Recording and Improvement

• Safety-net clearly: tell the patient what to do if the route cannot help, the concern changes or symptoms worsen.
• Escalate uncertainty: if you are unsure whether signposting is safe, pause and use the agreed escalation route.
• Record what happened: note the route offered, any barriers, safety-netting and any escalation.
• Report failed signposts: feed pathway problems back into directory updates, staff briefings and service improvement.