Treatment Escalation Plans
A Treatment Escalation Plan (TEP) is a tool which records and communicates the personalised and realistic goals of treatment. It should reflect the values and preferences that are important to the person receiving care if their condition should deteriorate.
"Making it easier to do the right thing" "No DNACPR without a TEP"
Treatment Escalation Plans
Dr Joanne Mackie explains more about treatment escalation plans in this induction video. This includes a practical guide to decision making around TEPs, having the conversation and completing the TEP on TRAK.
Realistic Conversations: Part 1
This is a video developed by NHS Greater Glasgow and Clyde, where Dr Chris McNally (Acute Physician) demonstrates a treatment escalation planning discussion with a simulated patient
Realistic Conversations: Part 2
This is a video developed by NHS Greater Glasgow and Clyde, where Dr Chris McNally (Acute Physician) demonstrates a treatment escalation planning discussion with relatives over the phone
How to Use the TEP training video
TEP Having the Conversation under pressure
TEP Guidance Notes
The Evidence: relevant literature on the topic of TEPs
Useful TEP Resources
The REDMAP approach to conversations with unstable patients
In this video by Dr Kirsty Boyd, Reader in Palliative Care, University of Edinburgh, provides a framework for holding conversations if a patient is seriously ill and there are threats to recovery. Developed during the COVID emergency, the video still provides useful training in communication.
Helpful resources on conversations from Healthcare Improvement Scotland ihub including a set of helpful ACP conversation prompt cards
NHS Education for Scotland have developed really useful resources on having realistic conversations, treatment escalation planning and using REDMAP here https://learn.nes.nhs.scot/60446
What to do at 3am? Comprehensive education module
This series of videos was developed by Dr. Jack Fairweather under the auspices of the Royal College of Physicians and Surgeons of Glasgow. This is quite a substantial module, but it is covers lots of relevant issues and is well worth while.
You will need to register free of charge at:
The Royal College of Physicians and Surgeons of Glasgow | Difficult Discussions at 3am (rcpsg.ac.uk)
After registration you will click on “My Digital Learning” and arrive at: https://community.rcpsg.ac.uk/account/dashboard/learning#area
There are two modules available:
- Ethics and the Law, and where this fits with national policy and
- Practical and clinical approaches
There is a specific section in module 2 which covers Treatment Escalation Plans (section 6)
St Mungo’s Podcast
A discussion with Professor Robin Taylor led by Dr Eoghan Colgan, an ED consultant and the producer of St. Mungo’s broadcasts. A good easy-to-digest introduction to the TEPs topic.
This is a series of podcasts led by Dr Calvin Lightbody, an ED consultant in Hairmyres Hospital. The topics covered are:
- Addressing the death taboo*
- Critical Illness, prognosis, hope and truthfulness*
- Spiritual pain at the end of life*
- Things go better with planning*
- Dementia - a realistic conversation
- Palliative Care - myths, mysteries and reality
- Focus on Frailty I
- Focus on Frailty II
- Mairi’s story – the experience of a dementia patient’s family in an acute care hospital
* = relevant to Treatment Escalation Planning
This is a short crisp cartoon-style video produced by NES about conversation skills and content for situations where the patient may be dying.