At City Hospitals Sunderland the safety of our patients is our paramount concern, especially with regards to patients whose condition deteriorates unexpectedly.

Our Critical Care Outreach team (CCOT) are available 24 hours a day 7 days a week to help support ward teams in the care of acutely ill patients within the ward environment and are usually contacted by ward teams when a deterioration in a patient’s condition is observed.

The Call 4 Concern initiative (C4C) is a service which enables patients and families the ability to contact the Critical Care Outreach Team directly for their help and advice if they feel there is a clinical concern that has not been recognised or addressed despite them having informed the ward nurses or doctors.

As we recognise that sometimes patients and family members can identify that something is wrong when others do not, as they know the patient better than anyone.

This leads to patients and relatives being provided with more choice about which they can consult concerning their care, and facilitate the early recognition of the deteriorating ward patient, casting the net of safety further. It may also lead to the patients and families feeling empowered about their care and have a greater understanding of the processes that are going on around them.

We feel that this service provides a patient centred approach to our referral process, improving patient experience, the flow of service and engagement of patients in allowing them to be involved in the management of their care but more importantly highlight those patients that on rare occasions are deteriorating but have not been referred by medical and/or nursing staff for numerous reasons.

We piloted this approach during an 8 month period with patients transferred from the ICCU to other parts of the hospital. As part of the fab change week we expanded the service to include all patients that have been in contact with the critical care outreach service at any point during their hospital episode.

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