Escalation, early help and child protection routes

Reception staff should know who to contact when a concern is urgent, when they need advice, and who to approach if the safeguarding lead is unavailable. Escalation is the process that ensures a child's safety is considered by the appropriate people.

Different concerns follow different routes. Some require immediate emergency action. Some need same-day review by a clinician or safeguarding lead. Others may lead to early help, a social care discussion, liaison with health visitors, or a practice safeguarding meeting.

Possible routes

• Practice safeguarding lead or deputy for concerns, patterns, disclosures and advice.
• Duty GP, clinician or practice manager where urgent clinical or operational action is needed.
• Local early help or child protection routes where the practice process indicates external advice or referral is required.
• Police, ambulance or emergency services if a child may be in immediate danger or needs urgent medical help.
• Health visitor, school nurse or other known professional where local information-sharing routes make this appropriate.

When urgency changes

If a child appears to be in immediate danger, if a disclosure suggests risk after leaving, or if a child is seriously unwell, do not rely on routine safeguarding discussion. Follow the urgent route and ensure the concern is owned by someone who will act.

Professional challenge

If a concern is minimised, delayed or left without an owner, use the local escalation or professional challenge process. Be respectful and factual: state what was heard, what was seen, why it concerns you, who has been told, and what response you need.

Professional challenge

Escalation is not an accusation; it is the route for making sure a child's safety is considered by the right people.