Exam Pass Notes

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A Simple Safety Memory Aid

• Notice the warning words
• Stay within role
• Use the local route
• Record the facts
• Hand over clearly
• Close the loop

Recognise

• Red flags are specific signs that a contact may need urgent clinical review or emergency care.
• Chest pain, severe breathing difficulty, collapse, focal neurological signs or anaphylaxis should interrupt routine work immediately.
• Possible sepsis, sudden confusion, acute profound weakness, severe pain, markedly reduced urine output or rapid deterioration need urgent escalation.
• Babies, young children, pregnant or recently pregnant people often need a lower threshold for escalation.
• Suicide risk, self-harm, threats to others, domestic abuse and safeguarding concerns require prompt clinical ownership via local routes.
• Medication-related contacts can be urgent when they involve overdose, the wrong medicine, interruption of high-risk medicines or allergic reaction.

Respond

• Use the local urgent escalation route as soon as concerning wording is clear.
• Do not diagnose or triage clinically from reception, care navigation or call-handling roles.
• Do not give clinical reassurance or say it is safe to wait when urgent wording is present.
• Escalate uncertainty rather than attempting to manage unsafe symptoms yourself.
• Seek senior support when there is refusal, conflict, failed contact or an unclear escalation route.

Record and Handover

• Record exact words, time, contact method, patient location and a safe call-back number.
• Record relevant context, for example child age, pregnancy status, medicine names/doses, current safety risks or who is calling.
• Record action taken, including who accepted ownership and which urgent route was used.
• Document complications such as refusal, failed call-back, disconnection, online delay or remaining uncertainty.
• Keep urgent wording visible instead of reducing it to vague phrases like "unwell", "wants advice" or "prescription query".

Practice Systems

• Staff need visible prompts, clear scripts, named urgent clinical contacts and backup routes.
• Online requests and routine queues should be monitored so urgent wording is not missed.
• Failed-contact rules should state what to do when calls drop, patients leave, or urgent ownership is delayed.
• Near misses should prompt local learning and system changes, not only individual reminders.