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 SPNabout half of existing SPNs were out of dateday-time general practitioners (GPs) respond well to requests by out-of-hours doctors to provide an SPNproviding SPNs was low on the list of priorities of day-time GPs who were too busy reacting to everyday problems.