Reading List

A curated Reading List to support safe first-contact escalation when patients are described as deteriorating, worsening or not themselves.

The sources below are grouped around urgent-care routes, care navigation, and deterioration-related public or professional guidance. Follow local protocols alongside national guidance.

1. Core Urgent Care and General Practice Sources

• NHS - When to call 999
  Core public guidance on life-threatening emergencies and when emergency ambulance help is needed. Useful for recognising symptoms that require immediate emergency action.
  https://www.nhs.uk/nhs-services/urgent-and-emergency-care-services/when-to-call-999/

• NHS England - How to improve care navigation in general practice
  General practice care-navigation guidance, including safe processes, red flags and the boundary between navigation and clinical decision-making.
  https://www.england.nhs.uk/long-read/how-to-improve-care-navigation-in-general-practice-2/

• NHS England - You and Your General Practice
  Patient-facing expectations about general practice access, explaining why staff may ask for information so care can be directed appropriately.
  https://www.england.nhs.uk/long-read/you-and-your-general-practice-english/

• NHS 24 Scotland - When to phone 111
  Scotland guidance on NHS 24, urgent care and when to call 999. Useful where reception staff signpost to Scottish urgent-care routes.
  https://www.nhs24.scot/111/

• NHS 111 Wales - Health advice and information
  Wales urgent-care and health-advice route for non-emergency urgent health concerns.
  https://111.wales.nhs.uk/

• HSCNI - Phone First FAQs
  Northern Ireland information on Phone First and urgent-care pathways. Useful for understanding local routing where Phone First is used.
  https://online.hscni.net/our-work/no-more-silos/phone-first-faqs/

2. Deterioration and Sepsis Awareness

• NHS England - Managing acute physical deterioration through the PIER approach
  Professional guidance on prevention, identification, escalation and response for acute physical deterioration. Explains why clear systems, family or carer concern and reliable handover matter.
  https://www.england.nhs.uk/patient-safety/managing-acute-physical-deterioration-through-the-prevention-identification-escalation-response-pier-approach/

• RCGP - NEWS2 score for assessing patients at risk of deterioration
  General practice guidance on physiological measurements, NEWS2 and communication for patients at risk of deterioration. Clarifies that NEWS2 supports but does not replace clinical judgement.
  https://www.rcgp.org.uk/representing-you/policy-areas/news2

• NICE - Suspected sepsis in people aged 16 or over
  Guidance noting that sepsis can present with non-specific concerns such as feeling very unwell. Relevant when deterioration is described without clear focal symptoms.
  https://www.nice.org.uk/guidance/NG253

• NICE - Suspected sepsis in under 16s
  Guidance on recognising, assessing and managing suspected sepsis in children and young people under 16. Relevant when callers describe a child who is sleepier, not drinking, breathing differently or not responding as usual.
  https://www.nice.org.uk/guidance/NG254

• NHS - Symptoms of sepsis
  Public symptoms list for babies, children and adults. Useful for first-contact recognition of deterioration linked to infection, including confusion, mottled skin, breathlessness and reduced urine.
  https://www.nhs.uk/conditions/sepsis/

• NHS - Is your baby or toddler seriously ill?
  Public guidance on warning signs in babies and toddlers. Highlights changes in feeding, responsiveness, breathing, colour and wet nappies that need prompt escalation.
  https://www.nhs.uk/baby/health/is-your-baby-or-toddler-seriously-ill/

Use these sources to inform local protocols, staff training, escalation scripts and reflection on first-contact safety in general practice.