Resuscitation and Treatment Escalation Plan

Patient Information – February 2024

What is a TEP form? And why do I need to know about it?

TEP stands for ‘Treatment Escalation Plan’. Filling in the form provides an opportunity for you, the patient – as well as the doctors, nurses and health care professionals treating you – to discuss and come to an agreement on an outline of a plan for your future medical care.

Who fills in a TEP form? Am I involved? Can members of my family, or a friend be involved too?

Ideally, you and your clinical team should fill in the form together. You may wish to involve a member of your family, or a friend – but the choice is yours. If someone else holds a legal Power of Attorney for decisions about your health, ideally that person should also be involved.

What is in this form? And what do I need to think about?

A TEP conversation gives you the opportunity to discuss with your clinical team the kind of future treatments you would like to take place; or, that you may wish not to receive. During this discussion you should be helped to understand what these treatments involve and which treatments might be appropriate. You should feel free to voice any views or concerns you may have.

After the discussion, the TEP form will be placed in your medical notes so that any member of the team involved in your care can easily see this TEP at any time. If any changes are made, these should be discussed with you.

Do I have to complete a TEP form?

No, you do not have to complete a TEP form. A TEP gives a patient, their relatives and the medical team a chance to prepare and plan for your future care. It is therefore really helpful if a TEP form is in place.

However, if you have any anxiety or worries about completing a TEP – having an open discussion with your GP, your carer or, with your family – can be a great place to help you think through what really matters most to you.

Can I change my mind?

Yes, at any time. The TEP form is only used as guidance to treatment and can be altered according to changes in your health condition. Please let a member of your clinical team know if you wish to make / discuss any changes to your TEP. If you do wish to make changes or, your team wish to suggest new or additional/alternative treatments – the form is digital and thus can be more readily amended.

I have already made an Advance Care Plan – what is the difference between this and the TEP?

TEP forms are being used throughout the NHS. They are a readily recognised document for health professionals to use to guide treatment. Doctors and nurses are used to completing them.

There are also additional methods of providing those looking after you, with information about your preferences and priorities.

An Advance Care Plan is one document. This can be made at any time you wish. It is likely to involve a number of conversations over time and you can involve anyone you wish in those discussions.

What happens if my condition changes and I am no longer well enough to be able to discuss further changes to my TEP?

For example: if you were very ill and did not have the mental capacity to make these decisions, this TEP form can be used to guide your wishes for care.

Otherwise, unless you have previously stated that you do not want family, carers or advocates involved in your TEP, they will be involved in these discussions.

If nursing or medical staff think that you do not have the ability to make decisions about your care, they will carefully assess your capacity. This assessment is based on the requirements of the Mental Capacity Act 2005.

Is this document legal?

TEP is not a legal document and is for guidance only. This is clearly stated on the top of the form.

What kind of treatments are in a TEP?

Your views and wishes are essential when deciding on your treatment options. If you are unsure or need more information, please talk to your doctor or your nurse to get their advice.

It may be that there are treatments that will clearly not improve your condition. These should be sensitively explained to you. There might be treatments that may or may not improve your condition but could potentially impact your longer-term quality of life.

For more information please visit 13 Treatment escalation plans and resuscitation