Responding to disclosure, fear or immediate danger

A disclosure may be short: "I am scared", "He will find out", "I cannot go home" or "Please don't tell anyone." Your first response should reduce shame, avoid increasing risk and direct the concern to the appropriate route.

Respond calmly and clearly

A calm reply helps the patient stay engaged. Avoid shock, disbelief, blame, jokes, minimising language or pressing for a full account. The patient may be checking whether it is safe to say more.

• Acknowledge: "I am glad you told us" or "I am taking this seriously."
• Be honest: do not promise secrecy if safeguarding action may be needed.
• Check immediate danger: use local wording to determine if the patient is unsafe now.
• Protect contact: ask only what is needed to avoid unsafe messages or calls.
• Escalate promptly: involve the safeguarding lead, a clinician or emergency services as appropriate.

Do not confront the alleged abuser

Confronting an alleged abuser, asking why they are controlling the patient, or telling them a disclosure was made can increase risk. If the alleged abuser is present or nearby, follow local discreet processes and avoid visible actions that could put the patient at greater risk.

Immediate danger changes the response

If there is a threat to kill, a weapon, strangulation, stalking, forced marriage, sexual violence, severe control, child risk, suicide threats, or the patient says they cannot stay safe, this is not routine appointment administration. Use urgent safeguarding, clinician or emergency procedures.

High-risk indicators

If a patient may be in immediate danger, do not treat the contact as routine appointment administration.