Realistic Medicine

When a person with a serious illness has the potential for acute deterioration or may be coming towards the end of their life, the team providing care need to consider how to minimise medical intervention that that may cause more suffering and distress.

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 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.

Many NHS Boards have developed resources to support the use of TEPs, taking a Realistic Medicine approach. NHS Greater Glasgow and Clyde have developed this TEP guidance toolkit to support staff to feel prepared to use TEP.

Click here to view these resources.

This toolkit contains all the resources needed for experienced facilitators to run an interactive, online TEP conversation masterclass using the RED-MAP framework. It contains a detailed running order and script for the session, facilitator notes, and handouts for participants plus example clinical scenarios. Facilitators are encouraged to adapt the scenario to the learning needs of their participants. The toolkit can also be used for in-person training.

Tutor roles:

A minimum of 4 facilitators is required to run this masterclass.

1. Chair 
2. Lead Tutor (plus 1-2 additional tutors in training or for large groups) 
3. A senior tutor in role as a healthcare professional (should be a role they are familiar with) 
4. A simulated patient/relative or a professional in role as someone of the same gender and approximate age (trained volunteer, professional or tutor) 

Downloadable Toolkit Contains:

1. REDMAP image
2. REDMAP image slide
3. REDMAP Framework
4. Example REDMAP for TEP scenarios:
   Emergency admission with pneumonia (hospital setting)
   Emergency admission with cancer complications (hospital setting)
5. Scenario writing template - Anticipatory Care Planning
6. Webinar Masterclass Tutor Roles
7. Webinar Masterclass Structure
8. Having realistic conversations -TEP (REDMAP) handout for participants
9. Talking about ACP
10. Helpful language in ACP
11. Demonstration webinar of teaching method for facilitator training - NES conference 2022

This TEP (REDMAP) training resource was developed by senior clinicians and educators from NES, NHS Greater Glasgow and Clyde, The University of Edinburgh and EC4H.

Content updated September 2022