Explaining escalation to patients, parents and carers

Patients, parents and carers may feel frightened, guilty, embarrassed or worried about wasting time. Clear, simple wording helps staff explain that escalation is a safety measure, not a barrier to care.

Urgent escalation should be calm, direct and practical. Staff should avoid arguing about the cause of symptoms, offering personal reassurance that overrides clinical judgement, or making the caller feel dismissed. The point to convey is that the information given requires faster or more appropriate clinical attention than routine administration can provide.

Helpful wording

• "Because you have said your baby is floppy and not feeding, I need to follow our urgent safety process."
• "I cannot assess that clinically, but I do need to get urgent help involved."
• "I am going to alert the duty clinician now."
• "Reduced movements need the maternity route, so I need you to follow that advice now."
• "If the line cuts off, we will use this number to call back."

What to avoid

• Do not say it is probably nothing or suggest the patient can safely wait.
• Do not tell a parent they are over-worried when they describe warning signs.
• Do not debate the diagnosis with the patient, parent or caller.
• Do not present escalation as rejection: avoid wording that sounds like "we cannot help you".
• Do not leave refusal unresolved: escalate refusal, conflict or uncertainty through the local route.

Communication note

Escalation should be explained as a safety step, not as a refusal to help.