Exam Pass Notes

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Core Boundary

• Follow the agreed process for managing appointment requests; do not make informal clinical triage decisions.
• Record patient descriptions such as "routine" or "urgent" but handle the request according to local process.
• Use current scripts, templates and escalation routes for phone, online and front-desk contacts.
• Escalate when a request is urgent, worrying, unclear, outside the process or unsafe to treat as routine.

Same-Day and Routine Requests

• Same-day work must have a clear owner for today: a clinician, a team, a list, a task or an approved pathway.
• Routine work requires a clear plan, timeframe or next step.
• Do not move same-day or urgent requests into routine slots because capacity is tight.
• Do not leave routine patients in a repeated "try again tomorrow" loop without a plan.

Full Lists and Call-Backs

• A full same-day list is not a safe endpoint; apply the full-capacity or escalation process instead.
• Call-backs require accurate contact details, notes on safe contact and communication needs, and a plan for missed calls.
• A task is not safely escalated until the correct person or workflow owns the next action.
• Record repeat contacts, failed calls, blocked routes and capacity problems so the practice can review and improve processes.

Urgency, Continuity and Records

• Use emergency and urgent routes in line with local policy and national arrangements.
• Continuity matters for frailty, complex conditions, mental health, learning disability, repeated contacts and recent hospital care.
• Continuity can be through a named person, a small team, a care coordinator, a planned review route or a clear shared record.
• Records should state what the patient said, which process was used, what was escalated and who owns the next step.