Exam Pass Notes

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Core memory spine

• Notice: take reported symptoms, safety concerns, distress and worrying patterns seriously.
• Ask: gather clear factual information to pass on safely.
• Pause: stop routine booking, selling or admin when an issue could be urgent.
• Escalate: involve the registrant, manager, safeguarding lead or emergency services as appropriate.
• Record: note exact words, times, actions, contacts and who took over.
• Follow up: ensure urgent messages and tasks have a named owner and are completed.

Red-flag categories

• Eye symptoms: sudden loss or change of vision, new flashes or floaters, a curtain or shadow, painful red eye, light sensitivity, new double vision, severe headache with eye signs or any postoperative concern.
• Injury and contact lens: chemical splash, penetrating injury, high-speed impact, vision change after injury, severe pain, retained foreign body or a red painful contact lens eye.
• Whole-person emergencies: collapse, chest pain, breathing difficulty, stroke signs, seizure, severe allergic reaction, serious fall, head injury, diabetic emergency or acute severe confusion.
• Safeguarding and distress: controlling companion, fear, disclosure, unexplained injuries, neglect, indicators of domestic abuse, child or adult vulnerability, threats or immediate danger.
• Service failures: missed urgent message, delayed referral, wrong-patient record, data breach, equipment failure, complaint suggesting harm or repeated unsafe shortcuts.

Role boundaries

• Support staff may listen, ask factual questions, explain processes and pass concerns to the correct route.
• Support staff must not diagnose, interpret clinical risk, provide reassurance that downgrades symptoms, or decide referral urgency alone.
• Busy clinics, full appointment books or patient reluctance do not make red flags routine.
• If you are unsure, escalate. It is safer to pass on a concern that turns out to be low risk than to miss urgent care.

Handover and records

• Use a clear handover: who, what, when, level of risk, action and owner.
• Record exact words, times, contact details, route used, who accepted responsibility and follow-up steps.
• Do not rely on memory, informal chat, private messages or loose paper notes for urgent concerns.
• Escalate complaints, candour issues, safeguarding matters, personal-safety risks and data concerns through the correct route.
• Close the loop by checking that callbacks, urgent tasks and handovers have been completed.