Immediate safety and context
Start here. If the situation is immediate danger, do not delay for forms.
Emergency boundary
If the patient is rapidly deteriorating, struggling to breathe, hard to wake, having chest pain, showing stroke-like symptoms, severely bleeding, suicidal, or showing sudden major change, call staff urgently. Escalation records can come later.
The concern in one sentence
A clear concern is easier to act on. Try to keep the first version simple.
Name the risk
Escalate the risk, not just the frustration. Specific risk is harder to dismiss.
Timeline and pattern record
Patterns are harder to ignore than isolated irritation. Record facts, not just feelings.
| Date/time | What happened | Who was told | Response/action | What happened next? |
|---|---|---|---|---|
Evidence, documents, and supporting material
Keep this factual. You are not trying to overwhelm the reader. You are gathering the material that helps the concern be understood and followed up.
What action are you asking for?
A concern is not properly owned until someone can say who is responsible, what will happen next, and when you should expect an update.
Escalation route used or needed
Use the right route. Acronyms are written out clearly to prevent confusion.
Martha’s Rule / Call for Concern
Use this when deterioration is not being heard or acted on and the hospital has a local route available.
Ask locally
“Does this hospital have Martha’s Rule or a Call for Concern number? Where is it displayed? Who responds? What happens after we call?”
Patient voice, family context, and capacity
Family context can be vital, especially when the patient is confused, frightened, exhausted, or not being understood.
Safeguarding, neglect, abuse, or serious vulnerability
Some concerns are not only communication problems or dissatisfaction. If there is possible neglect, abuse, coercion, serious vulnerability, unsafe discharge, or a person unable to protect themselves, ask what safeguarding route applies.
Safeguarding boundary
If someone is in immediate danger, get urgent help first. If the concern is safeguarding-related but not immediate danger, ask for the hospital or local safeguarding route rather than treating it as a routine complaint only.
Patient Advice and Liaison Service, complaints, and regulator routes
Use the correct route for the situation.
Acronym check
- PALS: Patient Advice and Liaison Service. Support with unresolved concerns, communication problems, information, and navigating the organisation while care is ongoing.
- NHS: National Health Service.
- CQC: Care Quality Commission. Regulator feedback route in England, not usually the route to solve an individual complaint in the moment.
Outcome record and next step
Finish by recording what changed, what remains unresolved, and who owns the next step.
Escalation repeat-back
“What I understand is that [person/team] is responsible for [action]. The concern is [risk]. The next step is [action] by [time]. If that does not happen, I should contact [route]. Is that correct?”