We’re working to improve the management of deterioration during and post-COVID-19 (including through the roll-out of COVID Oximetry @home and COVID virtual wards), please click here to find out more about our COVID-19 related work.
Spotting and acting on the signs of deterioration in a patient or care home resident is vital to ensuring patient safety. The objective of the national Managing Deterioration Safety Improvement Programme (known as ManDetSIP) is to create and embed the conditions for staff across the healthcare system to improve the safety and outcomes of patients by managing deterioration, and provide a high quality healthcare experience across England. Read more about the national ManDetSIP here.
The National ManDetSIP aims to:
- Support the spread and adoption of the COVID-19 Oximetry @home remote monitoring model across England by March 2021.
- Support the spread and adoption of the acute Paediatric Early Warning Score (PEWS) and system-wide paediatric observations tracker for children across all appropriate care settings in England by March 2024.
- Support an increase the spread and adoption of deterioration management tools (e.g. NEWS2, RESTORE2, RESTORE2mini, SBARD etc.), reliable personalised care and support planning (PCSP), and approaches encompassing end of life care principles, to support Learning Disabilities, Mental Health and Dementia care management in relation to deterioration in at least 80% of all appropriate non-acute settings across health and social care by March 2024.
Current managing deterioration projects
Responding to COVID-19:
In the West of England, we rapidly converted our face-to-face RESTORE2 and RESTORE2mini training for care homes into a virtual offering, enabling us to continue to reach providers in the region at pace and scale. Read more about our training offer for care homes. We also held several virtual learning and sharing events to support the Learning Disabilities Collaborative and adoption and spread of NEWS2.
We have also supported the rapid local implementation of COVID Oximetry @home, and COVID-19 virtual wards, as well as responding to other local needs in partnership with AHSN colleagues in digital and innovation. Find out more about our response to COVID-19.
By mid-February 2021 over 1600 people with COVID have been enrolled in COVID Oximetry @home and COVID virtual ward services across the West of England. Read more about how we worked rapidly and collaboratively to roll out these services across our region, alongside reviewing a case study exploring the patient’s journey.
Safer Care through NEWS2 (National Early Warning Score)
We have developed a programme to encourage and support the use of a single early warning score – the National Early Warning Score (NEWS2) – across the region and at each of the interfaces of care across the healthcare system. Use of NEWS2 throughout acute and community settings enables deterioration to be recognised, tracked and appropriately responded to at all stages of a patient’s journey, including at points of handover of care. Find out more about NEWS2.
Watch our short film telling the story of a patient in North Somerset, who made a quick and full recovery from sepsis as a result of NEWS being communicated at every handover of care.
ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment. ReSPECT is about creating a personalised recommendation for someone’s clinical care in emergency situations where they are not able to make decisions or express their wishes. Our focus on ReSPECT evolved from our work on Structured Mortality Reviews and the national Learning from Deaths programme which highlighted the need for appropriate care planning as patients approach the end of their life. Read more about ReSPECT.
The West of England Learning Disabilities Collaborative
Responding to the findings of the Learning Disabilities Mortality Review is a priority for the West of England. The disparity between the age of death for people with learning disabilities (age 4 years and over) and the general population (all ages) in 2019 was 22 years for males and 27 years for females. Many of these deaths continue to be from avoidable causes, such as pneumonia and sepsis. The West of England Learning Disabilities Collaborative was established in early 2019 to address this, by focusing on three priority areas. Find out more about the West of England Learning Disabilities Collaborative.
Get in touch
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Please find a brief listing of some of our key completed projects focusing on managing deterioration and patient safety:
Emergency Department (ED) Checklist
Our Emergency Department Collaborative was set up in August 2016 to encourage greater collaboration between each of the six acute trust emergency departments (EDs) across the West of England, as well as the South Western Ambulance Service. The Emergency Department Safety Checklist aimed to standardise and improve the delivery of basic care in EDs, to improve resilience in EDs during periods of crowding, to improve the safety and clinical outcomes for patients accessing the emergency care system. Find out more about the ED Checklist.
Structured Mortality Reviews
A precursor to ReSPECT, the West of England AHSN (in collaboration with eight acute trusts) was one of the early implementers of the structured review and developed a best practice framework as a template to support the trusts in this project. Find out more about Structured Mortality Reviews.
Our Human Factors programme developed the non-technical skills of support staff to enhance safer ways of working – these include teamwork, communication, leadership and an awareness of human factors when designing systems and processes. Find out more about our Human Factors project.
We hosted two learning events on the topic of falls. Find out more about our 2017 event “Reducing harm from falls” and our 2016 falls event.
Primary Care Collaborative
We worked with our member Clinical Commissioning Groups and practices across the region as part of our primary care collaborative. Read more about the Primary Care Collaborative.
Our Frailty Community of Practice launched in summer 2017. Find out more about our work on frailty.