Exam Pass Notes

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First-Contact Anxiety

• Anxiety can present as rapid speech, repeated questions, tearfulness, anger, silence or difficulty explaining.
• Avoid diagnosing, labelling or dismissing the person.
• Open calmly, ask one question at a time and give short summaries.
• Record the patient's words and the practical next steps rather than judgemental shorthand.

Reassurance Boundaries

• Reassure about the parts of the process you control, such as appointment arrangements or how the practice will follow up.
• Do not give clinical reassurance, interpret results or state that symptoms are definitely harmless.
• Use consistent phrasing when a patient contacts the service repeatedly.
• Escalate if you are unsure about the level of distress or risk.

Urgent Concerns

• Self-harm, suicidal thoughts, unsafe thoughts, overdose, domestic risk or any immediate danger require urgent escalation.
• Do not manage crisis-level distress alone.
• Follow local crisis, emergency and safeguarding procedures.
• Record the patient's exact words, any failed attempts to contact them and the actions you took.

Access and Support

• Check whether the route of care offered is usable for the patient.
• Record communication needs, accessibility barriers and any reasonable adjustments made.
• Use interpreters or alternative communication methods when needed.
• Ask for support from colleagues after distressing or repeated anxious contacts.