we have designed this Recall advice tool to help you with the recall advice section of the ePCR when you leave someone at home, to ensure everything is watertight in the event something should go pear shaped.
Recall & Safety Netting Advice Tool v3
Patient-facing recall advice wording plus a gold standard ePCR documentation framework for common non-conveyance scenarios.
This is the paramedic gold standard structure for defensible non-conveyance documentation. It reads cleanly, makes sense, and covers the bits reviewers always go looking for.
Opening narrative lineWe were called to you today following a report of [insert presenting complaint / concern].
Assessment summaryFollowing assessment at the time of attendance, no immediate life-threatening findings were identified and you were considered safe to remain at home based on the clinical picture at that time.
Capacity statementYou were assessed as having capacity to understand the information given, retain it, and make decisions regarding your care.
Advice givenWe explained that your condition may still change after we leave and that you should seek further help if symptoms worsen, change, or if anything does not feel right.
Recall / escalationYou were advised to call 999 immediately for any sudden deterioration, severe or increasing pain, breathing difficulty, chest pain, collapse, seizures, confusion, reduced consciousness, or other red-flag symptoms relevant to the presenting complaint. You were advised to contact NHS 111 or your GP for non-urgent worsening or ongoing concerns.
Confirmation of understandingYou confirmed that you understood the advice given and what action to take if your condition changes.
Opening narrative lineWe were called today following a report of [insert presenting complaint / concern] involving this patient.
Assessment summaryFollowing assessment at the time of attendance, no immediate life-threatening findings were identified and the patient was considered safe to remain at home based on the clinical picture at that time.
Capacity statementThe patient was assessed as lacking capacity, or having limited ability, to reliably retain and act upon safety-netting advice. Advice was therefore provided to the responsible adult / carer present.
Advice givenIt was explained to the responsible adult / carer that the patient's condition may still change after the crew leaves and that further help should be sought if symptoms worsen, change, or any concern arises.
Recall / escalationThe responsible adult / carer was advised to call 999 immediately for any sudden deterioration, severe or increasing pain, breathing difficulty, chest pain, collapse, seizures, confusion beyond baseline, reduced consciousness, or other red-flag symptoms relevant to the presenting complaint. They were advised to contact NHS 111 or GP for non-urgent worsening or ongoing concerns.
Confirmation of understandingThe responsible adult / carer confirmed understanding of the advice given and agreed to monitor the patient and seek help if the condition changes.
Core wording for standard adult non-conveyance where the patient themselves is receiving the advice.
We were called to you today following a report of your symptoms. After assessment at the time of attendance, you were considered safe to remain at home.
We explained that your condition may still change after we leave and that you should seek further help if your symptoms worsen, change, or if anything does not feel right.
You were advised to call 999 immediately if you develop severe or increasing pain, breathing difficulty, chest pain, collapse, seizures, confusion, reduced consciousness, or any sudden deterioration.
You were advised that if symptoms worsen but are not immediately life threatening you should contact NHS 111 or your GP for further advice.
You confirmed that you understood the advice given.
Head injury jobs go bad on paper when the documentation is vague. Keep it explicit.
We were called to you today following a head injury. After assessment at the time of attendance you were considered safe to remain at home.
We explained that symptoms after a head injury can develop later and you should seek urgent help if any concerning symptoms occur.
You were advised to call 999 immediately if you develop worsening headache, repeated vomiting, increasing drowsiness, confusion, seizure activity, visual disturbance, weakness, collapse, reduced consciousness, or any sudden deterioration.
You were advised to contact NHS 111 or your GP if symptoms worsen but are not immediately life threatening.
You confirmed that you understood the advice given.
Chest pain wording needs to be blunt and clear. No soft edges.
We were called to you today following chest pain. After assessment at the time of attendance you were considered safe to remain at home.
We explained that chest symptoms can change and that you should seek urgent help if your symptoms return or worsen.
You were advised to call 999 immediately if chest pain returns, becomes worse, spreads, or is associated with breathing difficulty, sweating, vomiting, collapse, palpitations, reduced consciousness, or any sudden deterioration.
You were advised to contact NHS 111 or your GP if symptoms persist or worsen but are not immediately life threatening.
You confirmed that you understood the advice given.
Falls notes should show that you anticipated delayed pain, reduced mobility, and deterioration.
We were called to you today following a fall. After assessment at the time of attendance you were considered safe to remain at home.
We explained that pain and symptoms following a fall can worsen later and that you should seek further help if your condition changes.
You were advised to call 999 immediately if pain becomes significantly worse, you become unable to mobilise, develop new weakness or numbness, confusion, breathing difficulty, significant bleeding, chest pain, reduced consciousness, or any sudden deterioration.
You were advised to contact NHS 111 or your GP if symptoms worsen or if you are struggling to manage safely at home.
You confirmed that you understood the advice given.
These sections are separated properly so the wording matches who is actually making the decision: patient, attorney, or clinician acting in best interests.
Patient has cognitive impairment and safety-netting advice was therefore provided to the responsible carer. Patient was considered safe to remain at home based on findings at the time of attendance.
It was explained to the carer that the patient's condition may still change after the crew leaves and that further help should be sought if symptoms worsen, change, or any concern arises.
Carer was advised to seek urgent help via 999 if any deterioration, severe pain, breathing difficulty, chest pain, collapse, seizures, confusion beyond baseline, reduced consciousness, or sudden change occurs.
Carer was advised to contact NHS 111 or GP for non-urgent worsening.
Carer verbalised understanding and agreed to continue monitoring the patient.
Patient was assessed and found to have capacity to understand, retain, and weigh information relevant to decisions regarding conveyance at the time of attendance.
Clinical findings, risks, benefits, and the recommendation for hospital attendance were explained to the patient. Patient declined conveyance at this time.
It was explained that the patient's condition could still change after the crew leaves and that further help should be sought without delay if symptoms worsen, change, or any concern arises.
Patient was advised to seek urgent help via 999 for any deterioration, severe pain, breathing difficulty, chest pain, collapse, seizures, confusion, reduced consciousness, or other significant concern.
Patient was advised to contact NHS 111 or GP for non-urgent worsening.
Patient confirmed understanding of the advice given.
Patient was assessed as lacking capacity to make decisions regarding conveyance at the time of attendance. Clinical findings, risks, benefits, and the recommendation for hospital attendance were discussed with the attending decision-maker.
The attending decision-maker stated they hold relevant legal authority to make this decision on the patient's behalf, or a valid advance decision relevant to this situation was identified. Conveyance was declined on that basis.
It was explained that the patient's condition could still change after the crew leaves and that close monitoring is required.
The decision-maker was advised to seek urgent help via 999 for any deterioration, severe pain, breathing difficulty, chest pain, collapse, seizures, worsening confusion, reduced consciousness, or any other significant concern.
The decision-maker was advised to contact NHS 111 or GP for non-urgent worsening.
The decision-maker confirmed understanding of the advice given.
Patient was assessed as lacking capacity to make decisions regarding conveyance at the time of attendance. Clinical findings were discussed with the attending carer.
Conveyance to hospital was considered. Following discussion with the attending carer and consideration of the patient's presentation, a best interests decision was made for the patient to remain at home at this time.
It was explained that the patient's condition could still change after the crew leaves and that the patient should be monitored closely.
Carer was advised to seek urgent help via 999 for any deterioration, severe pain, breathing difficulty, chest pain, collapse, seizures, worsening confusion, reduced consciousness, or any other concern.
Carer was advised to contact NHS 111 or the GP for non-urgent worsening.
Carer confirmed understanding of the advice given.
Abdominal pain is where “looks okay now” can turn into a problem later. Say that plainly.
We were called to you today because of abdominal pain. After assessment at the time of attendance you were considered safe to remain at home.
We explained that abdominal symptoms can sometimes change or worsen after the crew has left and that you should seek further help if your condition changes.
You were advised to call 999 immediately if the pain becomes severe, constant, spreads, or becomes significantly worse, or if you develop collapse, reduced consciousness, breathing difficulty, persistent vomiting, abdominal swelling, fever with deterioration, black stools, fresh bleeding, vomiting blood, heavy vaginal bleeding, or any sudden deterioration.
You were also advised to seek urgent reassessment if you become pale, clammy, weak, unable to tolerate fluids, unable to mobilise due to pain, or if pain is associated with fainting, chest symptoms, or increasing weakness.
You were advised to contact NHS 111 or your GP for ongoing abdominal pain, worsening symptoms that are not immediately severe, or if symptoms fail to improve as expected.
You confirmed that you understood the advice given.
Mental health notes should document the advice you actually gave, not fake certainty.
We were called to you today because of concerns regarding your mental wellbeing. After assessment at the time of attendance you remained at home.
We explained that emotional distress and mental health symptoms can change and that you should seek further help early if you begin to feel worse.
You were advised to call 999 immediately if you feel unable to keep yourself safe, develop thoughts of suicide or self-harm with intent, become significantly more distressed, confused, aggressive, unresponsive, or if there is any immediate concern for safety.
You were advised to seek urgent reassessment if you feel increasingly overwhelmed, lose control of your thoughts or behaviour, begin hearing or seeing things that increase risk, or if alcohol or drug use worsens the situation.
You were advised to contact NHS 111, your GP, or appropriate mental health services for ongoing support, worsening mood, anxiety, sleep disturbance, intrusive thoughts, or medication concerns.
You confirmed that you understood the advice given.
Post-seizure wording should cover recurrence, delayed recovery, injury, and failure to return to baseline.
We were called to you today following a seizure. After assessment at the time of attendance you were considered safe to remain at home.
We explained that further seizures or delayed symptoms can occur after the initial event and that you should seek further help if your condition changes.
You were advised to call 999 immediately if you have another seizure, repeated seizure activity, prolonged seizure activity, fail to return to your usual level of awareness, develop breathing difficulty, reduced consciousness, worsening confusion, significant headache, persistent vomiting, injury-related concerns, or any sudden deterioration.
You were also advised to seek urgent reassessment if you remain unusually drowsy, are not behaving as normal for you, are unable to mobilise safely, or if those around you become concerned that recovery is not progressing as expected.
You were advised to contact NHS 111 or your GP for non-urgent concerns, medication advice, or further support regarding seizure management.
You confirmed that you understood the advice given.
