Exam Pass Notes

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Why No Can Be Safe

• Saying yes to an inappropriate request can breach confidentiality, fairness, role boundaries or clinical safety.
• A safe refusal protects patients, staff and the practice process.
• Start with empathy: acknowledge the request, then set the boundary.
• Do not promise exceptions the practice cannot deliver or repeat safely.

Common No Boundaries

• Unavailable appointments or preferred clinicians: explain the limit and give the correct route for booking.
• Clinical advice or unsafe reassurance: route the concern to a clinician rather than offering an opinion.
• Confidential information requested by unauthorised callers: verify authority before sharing anything.
• Queue-jumping, favours and personal contact outside work: direct the person to the official channels.

Alternatives and Escalation

• Offer realistic next steps when available.
• Check whether the suggested alternative is usable for the patient.
• Escalate if there is no safe route or if urgency is unclear.
• Follow local staff safety procedures if distress becomes threatening or abusive.

Records

• Record what was requested, what was declined and why.
• Document any alternative, complaint route or escalation offered.
• Use factual wording and avoid judgemental labels.
• Make clear who is responsible for the next steps.