Out-of-hours special patient notes

In 2011, an out-of-hours service in central London reviewed its system for special patient notes (SPNs) - a main mechanism to communicate valuable information about patients to the clinicians who cover two-thirds of the week when day-time general practices are closed. This revealed that: * half of frequent callers did not have an SPN. * about half of existing SPNs were out of date * day-time general practitioners (GPs) respond well to requests by out-of-hours doctors to provide an SPN * providing SPNs was low on the list of priorities of day-time GPs who were too busy reacting to everyday problems.