Private GP follow-up note
1Since the last visit
- What has changed since the last visit, in the patient's words.
- Results received since the last visit, and whether they were discussed.
2Examination
- Temperature, pulse, blood pressure and oxygen saturation where relevant.
- Findings on examination of the system involved, including relevant negatives.
3Review
- The working diagnosis, and the differentials still being considered.
- The clinician's reasoning, in a sentence or two.
4Plan
- Investigations requested, and who follows up the result.
- Treatment agreed, as prescribed in the prescribing record.
- Any referral, and whether a letter to the registered GP is needed.
5Next review
- What should prompt the patient to get back in touch, and how.
- When the next review is due.
