Quality standard

Quality statement 1: Safety netting advice

Quality statement 1: Safety netting advice

Quality statement

People sent home after clinical assessment indicates that they are unlikely to have bacterial meningitis or meningococcal disease are given safety netting advice. [2012, updated 2024]

Rationale

Bacterial meningitis and meningococcal disease can be difficult to diagnose or distinguish from other conditions. People who are unlikely to have bacterial meningitis or meningococcal disease and have had clinical assessment, and, if appropriate, their family and carers, should be given advice on how to monitor their symptoms for any changes that could indicate bacterial meningitis or meningococcal disease. This will help to ensure they seek further medical advice if needed.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Process

Proportion of people sent home after clinical assessment shows that they are unlikely to have bacterial meningitis or meningococcal disease who are given safety netting advice.

Numerator – the number in the denominator who are given safety netting advice.

Denominator – the number of people sent home after clinical assessment shows that they are unlikely to have bacterial meningitis or meningococcal disease.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

What the quality statement means for different audiences

Service providers (such as primary care, out of hours and secondary care services) ensure that systems are in place to give safety netting advice to people (and their family and carers, if appropriate) who are being sent home because clinical assessment indicates they are unlikely to have bacterial meningitis or meningococcal disease. This advice should include information on symptoms that should prompt people to seek further medical advice. Service providers ensure that information can be given verbally and in writing, and that online resources are available.

Healthcare professionals (such as GPs and emergency department clinicians) provide safety netting advice to people (and their family and carers, if appropriate) who are being sent home because clinical assessment indicates they are unlikely to have bacterial meningitis or meningococcal disease. They provide people with information that includes the symptoms that should prompt them to seek further medical advice. They provide this information verbally and in writing, and they also refer people to the online resources that are available.

Commissioners ensure they commission services that give safety netting advice to people (and their family and carers, if appropriate) who are being sent home because clinical assessment indicates they are unlikely to have bacterial meningitis or meningococcal disease.

People who are being sent home after clinical assessment indicates that they are unlikely to have bacterial meningitis or meningococcal disease, and, if appropriate, their family and carers, are given advice about which symptoms and signs to look out for, and which changes should prompt them to seek further medical attention.

Definitions of terms used in this quality statement

Safety netting advice

Information given to people who are being sent home because clinical assessment indicates that they are unlikely to have bacterial meningitis or meningococcal disease. It should:

  • explain which symptoms and signs to look out for, and what changes should prompt them to seek further medical attention

  • direct to sources of online information.

[Adapted from NICE's guideline on meningitis (bacterial) and meningococcal disease: recognition, diagnosis and management, recommendation 1.3.2]

Equality and diversity considerations

One symptom of bacterial meningitis or meningococcal disease that should be included in the safety netting information is a non-blanching rash. It is important that the information clearly explains how this rash may present differently depending on skin colour, and how best to identify it on different skin tones, such as where on the body to look for it. It could also include links to any resources that can help people identify this symptom on different skin tones, such as Black & Brown Skin's Mind the Gap clinical handbook and web resource, and Bliss's symptom spotting on darker skin tones webpage. In addition, the Meningitis Research Foundation has produced a guide to meningitis and septicaemia symptoms and symptom checkers for babies, toddlers (children aged under 5) and teenagers and young adults (aged 13 to 24). These resources have not been produced by NICE and are not maintained by NICE. We have not made any judgement about the quality and usability of the resources. Other resources may also be available.

People should be provided with safety netting information that they can easily read and understand themselves, or with support, so they can communicate effectively with health care services. Information should be in a format that suits their needs and preferences. It should be accessible to people who do not speak or read English, and it should be culturally appropriate and age appropriate. People should have access to an interpreter or advocate if needed.

For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard or the equivalent standards for the devolved nations.