The Symptom Library is the core of the Signposting Toolkit. It provides a structured, searchable collection of symptoms with clinically-approved instructions for care navigation.

Overview

The library includes over 200 pre-loaded symptoms covering common primary care presentations. Each surgery can use these as-is, modify them to suit local practice, or create entirely new symptoms.

Base Symptoms

Base symptoms are the standardised, centrally-maintained symptoms included with the toolkit. They provide a consistent starting point for all practices.

Characteristics

• Pre-loaded and ready to use
• Clinically structured with clear instructions
• Cover common presentations across primary care
• Organised by age groups: Under 5, 5-17, and Adult

Using Base Symptoms

Base symptoms work immediately without configuration. Staff can search, filter, and view them straight away.

Local Overrides

Surgery-specific customisation allows practices to modify any aspect of a base symptom without affecting the central library.

What Can Be Overridden

• Title/Name — Change how the symptom appears
• Wording — Modify instructions to match local pathways
• Age Groups — Adjust which age ranges apply
• Icons — Customise visual indicators
• Highlight Rules — Add or modify colour coding
• Instructions — Full control over care navigation guidance

Override Badge

When a symptom has been locally modified, a “Practice Customised” badge appears, making it clear the content differs from the base version.

Benefits

• Maintain local clinical standards
• Reflect surgery-specific pathways
• Adapt to regional services
• Keep base updates available for future adoption

Custom Symptoms

Surgeries can create entirely new symptoms that exist only in their library. These are marked as “Practice Created” and are completely independent of the base library.

Use Cases

• Local referral pathways not covered by base library
• Surgery-specific protocols
• Community-specific presentations
• Temporary or trial symptoms

Management

Custom symptoms are managed entirely by the surgery and will not be affected by central base library updates.

Highlight Rules

The highlight engine automatically colours key phrases in symptom instructions to draw attention to important information.

Built-in Colours

• Orange slot — Standard appointments requiring booking
• Red slot — Urgent appointments
• Pink/Purple — Specific service types
• Green — Community or pharmacy pathways

Custom Highlight Rules

Surgeries can create custom highlight rules to colour-code any phrase they choose. This helps emphasise local preferences, services, or critical information.

See the High-Risk & Highlighting page for more details.

Icons

Icons can be displayed on symptom cards and instruction pages to provide visual context.

Icon Features

• Per-symptom configuration
• Customisable sizes (small, medium, large)
• Surgery-specific or global icons
• Accessibility-friendly with alt text support

Age Filters

Symptom library supports three age groups:

• Under 5 (U5) — Paediatric presentations
• 5-17 (O5) — School-age children and adolescents
• Adult — Adult presentations

Age Group Filters

Staff can filter the symptom library by age group to quickly find relevant guidance. Each symptom displays its applicable age groups as coloured badges.

Search

The symptom library includes powerful search functionality:

• Text search — Search by symptom name or keywords
• Alphabet filter — Quick navigation by first letter
• Age group filter — Show only relevant age groups
• High-risk quick buttons — Instant access to urgent symptoms

Search Features

• Instant results as you type
• Highlights matching terms
• Searches across all visible symptoms
• Respects clinical review status

Card Layouts

Symptoms are displayed as cards in a clean, NHS-styled grid layout.

Card Information

• Symptom name
• Age group badges
• Source indicator (Base/Customised/Custom)
• Brief instruction preview
• Icon (if configured)
• High-risk indicator (if applicable)

Preferences

Users can customise card appearance:

• Modern white cards or Classic blue cards
• Quick-scan mode for minimal display
• Compact or detailed views

Clinical Review Status

All symptoms must pass clinical review before being fully available. See the Clinical Governance page for details on the approval workflow.

Symptoms awaiting review appear in the library but show a pending status indicator.

What’s Changed

The What’s Changed page shows recently modified symptoms so that staff and admins can stay aware of updates to the symptom library.

Access it from the symptom library via the What’s changed link.

What It Shows

• Recently approved changes — Symptoms that have been newly added or updated within a configurable time window (default: 30 days), or since a baseline date if one has been set.
• Change type badges — Each symptom is tagged as either New (green) or Updated (amber).
• Age group badges — Shows the age group (Under 5, 5–17, or Adult) for each changed symptom.
• Brief instruction preview — A one-line summary of the symptom’s current brief instruction.
• Approval date — When the change was clinically approved.

Filters

You can filter the list by:

• All — Show all recent changes
• New — Show only newly added symptoms
• Updated — Show only updated symptoms

Each filter chip shows a count so you can see at a glance how many changes fall into each category.

A summary footer shows the total number of new symptoms and updates in the time window.

Practice Handbook Changes

The Practice Handbook has its own What’s Changed view at the Handbook level, following the same pattern — showing recently modified handbook items with change type badges and date information.

Engagement Tracking

The system tracks which symptoms are viewed, helping practices understand usage patterns and identify training needs.

• View counts per symptom
• High-risk vs low-risk usage
• User activity patterns

See the Analytics page for the surgery-wide analytics dashboard.

Related Pages

• Clinical Governance — How symptoms are reviewed and approved
• High-Risk & Highlighting — Highlight rules and visual indicators
• AI Features — AI tools for improving symptom instructions
• Analytics — Usage analytics
• Admin Guide — Admin features including suggestions and image icons

Screenshots

Symptom Library – admin view

Symptom detail – instructions and AI Suggested Questions

Last updated: February 2026