Your Treatment Escalation Plan (TEP)

What is a Treatment Escalation Plan (TEP)?

A Treatment Escalation Plan (TEP) is a tool the doctors and nurses in your team will use to plan your care. It is created with you and may be used when decisions need to be made quickly and you are not well enough to speak for yourself. We aim to create a TEP for all of our patients. Your TEP will be reviewed regularly. 

What does a TEP conversation involve?

The team looking after you will discuss treatments that may or may not be suitable for you in hospital. We will speak to your next of kin if we cannot speak to you. We may discuss treatments such as antibiotics (given through a vein), blood transfusions and feeding through a nasogastric tube.  

We may also discuss where you will be looked after in the hospital. Most patients will be looked after on our general wards, but in some situations patients may be looked after in the High Dependency or the Intensive Care Units. 

Do I need to discuss my TEP?

If you would rather not have this conversation, the team looking after you will always act in your best interests and plan your care with your next of kin. 

Will resuscitation be discussed?

Cardiopulmonary resuscitation (CPR) is a treatment that may be tried if your heart stops beating. It involves giving chest compressions, oxygen and sometimes electric shocks to try to restart the heart. CPR is often unsuccessful. Your team will discuss if this is a treatment that might be of benefit to you. A 'Do Not Attempt Cardiopulmonary Resuscitation' (DNACPR) decision may be made. This will allow a natural death when the time comes. 

What if I disagree with the decisions made by my team?

All decisions about your care will be based on your wishes and opinions. Some treatments may work if you are unwell, whilst some will not work. You have the right to refuse any treatment but treatments that will not work will not be offered. The ultimate decision to deliver treatment, including CPR, is with your team who will always act in your best interests. You can request a second opinion if you do not agree with any decisions made. 

How are TEP conversations recorded?

Following a TEP conversation, the team will complete a paper form which is kept with your other medical notes. If DNACPR has been agreed, the team will also complete this form and place it in your folder. With you or your next of kin’s agreement, your GP will be informed, and the form may go home with you. 

What if I have more questions?

Any of the doctors or nurses looking after you will be happy to discuss your TEP in further detail if required.