Realistic Medicine

When a person in hospital has the potential for acute deterioration, the team providing care need ensure that any treatments of benefit are given while minimising interventions that may not provide ‘kind and careful care’.   

What can be done and what should be done are not necessarily the same thing. Indeed, protocol driven or "one size fits all" medicine can lead to more suffering and distress, not less. 

A treatment escalation plan (TEP) is a tool which records and communicates personalised and realistic goals of treatment. It should reflect what matters to the person receiving care if their condition should deteriorate. Like other types of future care plan, a TEP is not legally binding but can improve coordination of care and support shared decision making. 

Many NHS Boards have developed resources to support the use of TEPs and there is a national TEP in development.