Urgent routes and when signposting is not enough

Some requests should not be handled by routine signposting. If a patient may need urgent help, immediate emergency care, safeguarding support, urgent mental health support or rapid clinical review, follow your practice's escalation process.^[1][5]

When to escalate

Reception and care navigation staff are not expected to make clinical diagnoses. You should recognise when a request does not feel safe to redirect, when a protocol requires escalation, or when the person's words, distress, deterioration or inability to use a route indicate they need more support.^[1][2]

Urgent routes vary across the UK. They include 999 for life-threatening emergencies, NHS 111 or NHS 24, urgent treatment centres, GP out-of-hours services, local Phone First pathways, emergency dental routes, crisis mental health services, or your practice's same-day escalation process.^{[3][8][6][7] [1][5]}

If you are unsure whether signposting is safe, pause and escalate through the agreed urgent route instead of trying to decide alone.

Good signposting includes safety-netting, but safety-netting does not replace escalation when there is existing risk. Telling a very unwell, distressed or confused person to "call back if it gets worse" may leave them without necessary support.^[5]

Urgent Route Differences