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• General, Logistical, Red Flag and Risk (GLRR) approach to safety netting
  Tom Mallinson
  Published on: 24 April 2024

• Published on: 24 April 2024

  General, Logistical, Red Flag and Risk (GLRR) approach to safety netting

  • Tom Mallinson, Senior Lecturer / Rural GP College of Remote and Offshore Medicine, Malta / NHS Highland

  Smith et al (2022) present an excellent review of the current state of safety netting theory and practice in Primary Care. In relation to the education of paramedics working in primary care, the General, Logistical, Red Flag and Risk approach has been suggested as a means of implementing the theory of safety netting into a clinician’s practice (Mallinson, 2023). It reminds clinicians to always give a General worsening statement, meeting Smith et al’s Recommendation No. 1. The second point is to provide clear Logistical advice to patients on how to seek help; the specifics of what phone number to call to seek or summon help. This perhaps aligns to Recommendation 9; “including a specific safety-netting plan”. Red Flag safety netting reinforces the importance of patient education in relation to possible serious deterioration which aligns to Recommendation 4 in terms of “specific situations that should be cause for concern”. The final component of Risk based safety netting relates to shared decision making and specifically situations where there is disagreement and a patient is not following medical advice. The Risk component seeks to ensure that patients are fully aware of the potential risks inherent in their chosen course to action. This is vital in relation to ensuring patients are making informed decisions about their care. There is definitely more work to be done on improving education around Safety Netting, and Smith et al’s work provides us with clear recommendati...

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  Smith et al (2022) present an excellent review of the current state of safety netting theory and practice in Primary Care. In relation to the education of paramedics working in primary care, the General, Logistical, Red Flag and Risk approach has been suggested as a means of implementing the theory of safety netting into a clinician’s practice (Mallinson, 2023). It reminds clinicians to always give a General worsening statement, meeting Smith et al’s Recommendation No. 1. The second point is to provide clear Logistical advice to patients on how to seek help; the specifics of what phone number to call to seek or summon help. This perhaps aligns to Recommendation 9; “including a specific safety-netting plan”. Red Flag safety netting reinforces the importance of patient education in relation to possible serious deterioration which aligns to Recommendation 4 in terms of “specific situations that should be cause for concern”. The final component of Risk based safety netting relates to shared decision making and specifically situations where there is disagreement and a patient is not following medical advice. The Risk component seeks to ensure that patients are fully aware of the potential risks inherent in their chosen course to action. This is vital in relation to ensuring patients are making informed decisions about their care. There is definitely more work to be done on improving education around Safety Netting, and Smith et al’s work provides us with clear recommendations in this regard moving forwards.

  References
  Smith C.F., Lunn, H., Wong, G. and Nicholson, B.D.(2022). Optimising GPs’ communication of advice to facilitate patients’ self-care and prompt follow-up when the diagnosis is uncertain: a realist review of ‘safety-netting’ in primary care. BMJ Quality & Safety. 31:541-554.

  Mallinson, T. Consultation Skills and the Diagnostic Process. In. Eaton, G., Proctor, A. and St Leger-Francis, J. (2023). Primary Care for Paramedics. Class Professional Publishing. Bridgwater, UK.

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  Conflict of Interest:
  None declared.

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