Exam Pass Notes

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A Simple Safety Memory Aid

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

Recognise

• Red flags are words or descriptions that indicate a medicines contact may need urgent clinical, pharmacy or emergency ownership.
• Requests for urgent supplies of insulin, anti-seizure drugs, anticoagulants, steroids, transplant or palliative medicines should not be treated as routine.
• Overdose, wrong medicine, wrong dose, double dose, severe side effect or severe allergic reaction all require escalation.
• Children, pregnant people, frail adults, care-home residents and those who need help with medicines usually need a lower threshold for escalation.
• Unclear discharge instructions, repeated failed requests or missed doses can create unsafe situations, especially with high-risk medicines.

Respond

• Use the local urgent medicines route as soon as concerning wording is identified.
• Do not advise on dose, stopping, restarting or side-effect management from reception or admin roles.
• Do not give clinical reassurance or tell the patient it is safe to wait when urgent wording is present.
• Escalate uncertainty rather than attempting to resolve unsafe medicines issues yourself.
• Follow local protocols for pharmacy, NHS 111, 999, specialist, maternity, palliative or safeguarding routes when directed.

Record and Handover

• Record exact words, medicine names if known, timing, symptoms, contact method and safe call-back details.
• Record relevant context such as age, pregnancy status, vulnerability, care-home involvement or recent discharge.
• Record action taken, including who accepted responsibility and which urgent route was used.
• Document complications such as refusal, failed call-back, disconnection, unclear instructions, online delay or remaining uncertainty.
• Keep urgent wording visible rather than reducing it to vague phrases like "medication query" or "repeat prescription request".

Practice Systems

• Staff need visible prompts for high-risk medicines, clear scripts, named urgent owners and backup routes.
• Prescription and online queues should be monitored so urgent medicines wording is noticed promptly.
• Near-closing-time and failed-contact rules should state what staff do when urgent medicine ownership is delayed.
• Near misses should trigger system learning and changes, not only individual reminders.