Care Navigation Boundaries for GP Receptionists and Care Navigators

Safe routing, role boundaries, escalation and clinician review in general practice

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Red flags, uncertainty and escalation

GP practice reception desk with staff and patient

Red flags are agreed triggers that tell you to stop routine routing and follow the practice escalation process; they are not a test of clinical knowledge.

If the patient gives worrying information, does not fit the template, sounds acutely distressed or cannot safely use the suggested route, escalate rather than attempt to resolve the problem alone.

Escalate when

  • The protocol says to escalate.
  • The patient may need urgent help.
  • The patient mentions severe distress, deterioration or immediate risk.
  • There is a safeguarding concern.
  • The route is unclear, blocked or unsafe.
  • You are unsure what the safe next step is.

Uncertainty is a valid reason to escalate; it is not a personal failure.

What happens when you call 999 and how you can help us help the patient

Video: 2m 49s · Creator: London Ambulance Service. YouTube Standard Licence.

This London Ambulance Service video explains what happens when someone calls 999 and why call handlers ask questions. It describes 999 as the route for life-threatening emergencies, with examples such as chest pain, difficulty breathing and accidents where the severity is unclear.

The video describes how call handlers keep callers calm, ask focused questions and may give instructions while arranging help. Questions about breathing, consciousness, what happened and the patient's location are used to send the right resource, not to delay care. Callers may be asked for extra location details when the address is not straightforward.

Practical preparation includes turning on outside lights if it is dark, arranging for someone to meet the ambulance crew if safe, and gathering medication or GP details. Dispatch staff and clinicians review calls so an appropriate response is sent. Call 999 back if the patient's condition worsens, the location changes, the patient moves, or the ambulance is no longer needed.

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Scenario

A patient gives a long, unclear explanation and then says, "I do not know if this can wait, but something feels very wrong today." The template does not give an obvious route.

What should you do with the uncertainty?

 

Ask Dr. Aiden


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