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How EMMA Handles Emergency and Urgent Calls

EMMA is designed to identify emergency and urgent situations immediately and respond appropriately. This article explains what EMMA does when a patient presents with an emergency, how safeguarding and mental health calls are handled, and what your team needs to know.

Purpose of This Article

Clinical safety is the most important aspect of EMMA's design. This article gives practice managers and staff a clear, complete picture of how EMMA handles emergency and urgent calls, so they can be confident in how the system operates and explain it to others.

Main Content

Clinical Safety First

Every EMMA release begins with clinical safety review. EMMA's emergency pathway intelligence, called Red Flag, is the single most scrutinised component of the system. It has been developed with clinical oversight from QuantumLoop AI's Chief Safety Officer and from Sir David Sloman, former Chief Operating Officer of the NHS.

Red Flag operates across every language EMMA supports. It detects emergency symptoms expressed in natural language, including variations in phrasing, spelling differences, and synonyms, so patients are not missed because of how they describe their situation.

How EMMA Detects Emergencies

EMMA monitors every call for emergency indicators throughout the entire conversation, not just at the start. If a patient mentions emergency symptoms or a critical situation at any point during the call, EMMA responds immediately.

Emergency detection covers:

  • Physical emergency symptoms such as chest pain, stroke signs, severe breathing difficulty, severe bleeding, and other life-threatening presentations
  • Suicidal ideation or expressions of intent to self-harm
  • Safeguarding concerns involving a child or vulnerable adult
  • Any other situation that indicates the patient requires immediate emergency assistance

What EMMA Does When an Emergency Is Detected

Physical emergency symptoms (Red Flag)

When EMMA detects a physical emergency:

  1. EMMA immediately advises the patient to call 999 or 111 depending on the severity
  2. The patient is given the choice to have their request captured in writing via SOFIA, or to be transferred to reception
  3. EMMA does not attempt to continue a standard consultation flow for patients presenting with emergency symptoms

Suicidal ideation and self-harm

When EMMA detects suicidal ideation or self-harm:

  1. EMMA transfers the call directly and immediately to your reception team
  2. This is handled differently from the standard Red Flag flow — there is no 999/111 advice step and no form capture option
  3. The transfer is immediate and unconditional

Safeguarding concerns

When EMMA identifies a safeguarding concern involving a child or vulnerable adult:

  1. EMMA transfers the call immediately to your reception team
  2. No attempt is made to capture a request or continue the call

The distinction between these scenarios is important. Suicidal ideation and safeguarding calls go directly to a human at your practice. Physical emergency calls receive 999/111 signposting with the option for onward transfer.

Other Calls That Always Transfer Immediately

In addition to emergency and safeguarding scenarios, the following call types always transfer to reception immediately, regardless of any other settings:

Vulnerable and protected patients

  • VIP or vulnerable patients on your configured list
  • Unwell baby under 12 months
  • Patients with digital exclusion
  • Death registration calls

Healthcare and professional callers

  • Hospitals, pharmacies, district nurses, community teams, health visitors, midwives, paramedics, social workers, mental health teams, the coroner's office, and other professional callers

Returning callers

  • Patients responding to a missed call from the surgery
  • Patients responding to an SMS from the surgery
  • Patients whose call was disconnected and are reconnecting

Specific requests

  • Requests for a named doctor or staff member

None of these transfer types are affected by your Transfer Sensitivity Level setting. They always bypass EMMA immediately.

Your Team's Role

Your reception team does not need to do anything differently for emergency or urgent calls. EMMA handles the identification and routing automatically.

When a call is transferred from EMMA to reception:

  • Your team answers as they would any inbound call
  • For emergency transfers, particularly suicidal ideation or safeguarding, the patient should be treated with appropriate care and urgency
  • There is no specific flag or label on the call to indicate why EMMA transferred it — your team will need to respond to the caller's needs directly

If you receive a concerning call from a patient that was transferred by EMMA, follow your practice's standard clinical and safeguarding protocols.

Sentinel: Always-On Monitoring

Sentinel is EMMA's always-on safety monitoring layer. It runs in the background on every call and flags any interaction that deviates from the expected flow. It operates independently of Red Flag and provides an additional layer of oversight across all call types.

Step-by-Step Instructions

No steps are required from your practice to activate emergency handling. EMMA's safety features are built in and operate automatically on every call.

If you want to review how a specific emergency call was handled, log in to the dashboard and access the relevant call recording. See: Understanding Call Recordings in the Dashboard (article 2.14).

If you have concerns about how a specific call was handled, contact support@quantumloopai.com with the date and approximate time of the call.

Troubleshooting

A patient called with emergency symptoms but was not transferred to reception. EMMA's Red Flag detects emergency symptoms and advises the patient to call 999 or 111 rather than always transferring to reception. This is intentional — directing patients to emergency services is clinically appropriate for life-threatening situations. If you believe a call was not handled correctly, locate the call recording in the dashboard and share it with your account manager immediately.

A patient with suicidal ideation was not transferred immediately. EMMA is configured to transfer suicidal ideation and self-harm calls directly to reception without delay. If this did not happen in a specific case, contact support@quantumloopai.com urgently with details of the call. This is treated as a high-priority clinical safety matter.

We are concerned that EMMA might miss an emergency expressed in an unusual way. Red Flag is designed to detect emergency symptoms across a wide range of natural language expressions, including varied phrasing, spelling differences, and synonyms. It is reviewed and refined with every major release. If you have a specific concern, contact your account manager to discuss it.

A healthcare professional said EMMA did not transfer them immediately. Healthcare and professional callers should always be transferred immediately. If this did not happen, locate the call recording and contact support@quantumloopai.com.

FAQs

Does EMMA always transfer emergency callers to reception? Not always. For physical emergency symptoms, EMMA advises the patient to call 999 or 111 and gives them the option to be transferred to reception or to have their request captured in writing. For suicidal ideation, self-harm, and safeguarding calls, EMMA transfers directly to reception with no other options offered.

How does EMMA detect emergencies in other languages? Red Flag operates across all 20+ languages EMMA supports. Emergency detection has been refined across each language to ensure consistent performance regardless of what language the patient is speaking.

Can we customise how EMMA handles emergency calls? The core emergency handling behaviour — Red Flag, the suicidal ideation transfer, and safeguarding transfers — cannot be changed by your practice. These are clinical safety features that apply to all surgeries. Speak to your account manager if you have specific requirements related to your practice's emergency workflows.

What happens if a patient ends the call before EMMA can transfer them? EMMA includes Lifeline, which means patients are informed at the start of every call that if the call drops they will receive a link to continue in writing. For emergency callers who disconnect, EMMA will have already provided 999 or 111 signposting. SOFIA does not send an SMS for calls where the patient has been advised to call emergency services.

Is EMMA clinically certified for emergency call handling? Yes. EMMA is registered as an MHRA Class I Medical Device and is compliant with DCB0129 and DCB0160. Emergency pathway intelligence is developed with direct clinical oversight and is the most scrutinised component of every EMMA release.

What should our reception team do when they receive a transfer from EMMA? Treat it as any other inbound call and respond according to the patient's needs. There is no indicator on the call to specify why EMMA transferred it. Your team should follow their usual clinical and safeguarding protocols for the situation presented.