Offering safe alternatives and escalation

A clear no should direct the patient to a safe, realistic next step. Alternatives may include a different appointment, a callback, a task for staff, a clinician review, an urgent route, a complaints route or supervisor input.

What makes an alternative safe?

An alternative helps only if it exists, is accessible, and suits the patient’s need. It must be usable by that patient - for example, a digital form is not a safe alternative if the patient cannot use digital services, cannot read the language, or has unmet disability-related access needs.

Alternatives must also follow local policy. Staff must not invent routes, promise clinician action, or suggest inappropriate services.

Check alternatives are

• Real and available: the option actually exists at that time.
• Appropriate: the route matches the type and urgency of the request.
• Usable: the patient can use the phone, online form, language, transport or communication method.
• Recorded: the next step is clear to the patient and the practice.
• Escalated: when no safe alternative is available.

Escalation is part of the alternative

If the patient cannot use the offered route, or the route does not match the concern safely, escalate. That may mean contacting a supervisor, duty clinician, safeguarding lead, using an accessibility process or offering the complaints route.

An alternative is only helpful if the patient can actually use it and it is safe for the request.

Accessibility