Creating an acute care team

In 2016, East Lancashire Hospitals NHS Trust consulted on how to create its new Acute Care Team (ACT).

ACT needed a clear vision to develop advanced clinical assessment and nurse prescribing skills as the baseline need for staff responding to the deteriorating patient.

This service specification has since extended. It now includes suitably experienced AHPs offering a further enhanced skill set. The AHPs make sure patients are afforded the appropriate escalation in response to clinical deterioration.

The also trust decided to include advanced clinical practitioners (ACPs) in the extended clinical team. ACPs are highly experienced with the skills needed to provide timely interventions to stabilise patients whose clinical condition deteriorates unexpectedly. This level of advanced clinical decision making and problem solving enables a more comprehensive and encompassing package of care and increases support for the workload of the medical teams, particularly in the out of hours period, contributing to the trust workforce transformation strategy.

Achievements

This has resulted in achieving significant improvements in response times to deteriorating patients:

• in 2016/17, 89% of patients with National Early Warning Scores (NEWS) higher than 6 were seen within an hour
• by 2018, 96% of patients with NEWS of 6 or higher were seen within an hour

In October 2017, the trust introduced a target to measure the ACT response to high NEWS (7 or higher) in 15 minutes. Initially, the response was 70%. By 2018, this had improved to an average of 88%

The trust also reduced the target time for follow up post critical care from 36 hours to 24 hours. ACT now consistently achieves this for 95% of patients.