Explaining, safety-netting, recording and failed signposts

How you explain a signpost affects whether the patient accepts and can follow it. Keep explanations brief, respectful and practical. Say what the route is, why it is being suggested under the practice process, how the patient should use it, and what to do if it does not work.^[1][2]

Close the loop

Safety-netting must be specific and actionable. Depending on the situation and local protocol this may mean asking the patient to contact the practice again, use NHS 111 or the local urgent route, seek emergency help, return if the service refuses or cannot help, or ask for assistance if they cannot complete the next step.^[4][5]

Recording matters because it documents what the patient asked for, the route suggested, any barriers, any safety-netting advice and any escalation. Records also help the practice spot failed signposts, outdated pathways or unequal access.^{[6][1] [3][9]}

A failed signpost is feedback, not a nuisance: bring it back into the practice system so the patient gets a next step and the pathway can improve.

If a patient returns because a service refused them, was closed, did not answer, gave conflicting advice or was impossible to access, do not blame the patient. Re-check the route, decide whether escalation is needed, and report the pathway problem through the local process.^[3][1]

Recording and Feedback