In 2009, the United Kingdom’s National Health Service (NHS) released a framework of core competencies for responding to acutely ill patients in hospital. These identify the key skills and knowledge required by different care providers to respond to various clinical scenarios according to their role and responsibilities. In this framework basic life support training is recommended as a mandatory requirement for all employees, including non-clinical staff. The competency framework has now been archived and there is no available information regarding evaluation of the implementation or impact of these competencies in practice. The NHS competency framework is available for download from: The intention of Standard 9 is to ensure that systems are in place to support the clinical workforce to recognise clinical deterioration and provide an appropriate and timely response. Action 9.6.1 stipulates that basic life support training is one of the mechanisms to ensure that the clinical workforce have the essential skills and training to achieve this. This is consistent with the traditional approach of annual resuscitation training for nurses and allied health staff, and with recommendations made by organisations such as the National Institute of Clinical Excellence in the . However, there is evidence that delayed or inadequate recognition of deterioration and/or escalation of care (commonly described as afferent limb failure) are the most commonly reported points of failure in recognition and response systems. While some professional groups, such as anaesthetists or intensive care physicians, will need training that far exceeds any minimum requirement, it seems reasonable that patients should be assured that any clinician providing patient care in an acute health service has achieved a minimum standard of competency in the skills required to recognise clinical deterioration, escalate care, and provide a timely and appropriate response while awaiting help from responders with advanced clinical skills. Currently there are varied approaches to providing training and education related to recognising and responding to clinical deterioration. There is a lack of clear and specific agreement, guidance or evidence about what knowledge is required as a minimum standard for all clinicians providing patient care, how it should be taught, and how competency should be assessed. To provide clarity in the requirements of the NSQHS Standards, and to ensure that patients are protected from harm, the Commission is seeking further information about the minimum standard that should be required for competence in the skills and knowledge required to provide safe care to patients who deteriorate in acute care settings.
In 2009, the United Kingdom’s National Health Service (NHS) released a framework of core competencies for responding to acutely ill patients in hospital. These identify the key skills and knowledge required by different care providers to respond to various clinical scenarios according to their role and responsibilities. In this framework basic life support training is recommended as a mandatory requirement for all employees, including non-clinical staff. The competency framework has now been archived and there is no available information regarding evaluation of the implementation or impact of these competencies in practice. The NHS competency framework is available for download from: The intention of Standard 9 is to ensure that systems are in place to support the clinical workforce to recognise clinical deterioration and provide an appropriate and timely response. Action 9.6.1 stipulates that basic life support training is one of the mechanisms to ensure that the clinical workforce have the essential skills and training to achieve this. This is consistent with the traditional approach of annual resuscitation training for nurses and allied health staff, and with recommendations made by organisations such as the National Institute of Clinical Excellence in the . However, there is evidence that delayed or inadequate recognition of deterioration and/or escalation of care (commonly described as afferent limb failure) are the most commonly reported points of failure in recognition and response systems. While some professional groups, such as anaesthetists or intensive care physicians, will need training that far exceeds any minimum requirement, it seems reasonable that patients should be assured that any clinician providing patient care in an acute health service has achieved a minimum standard of competency in the skills required to recognise clinical deterioration, escalate care, and provide a timely and appropriate response while awaiting help from responders with advanced clinical skills. Currently there are varied approaches to providing training and education related to recognising and responding to clinical deterioration. There is a lack of clear and specific agreement, guidance or evidence about what knowledge is required as a minimum standard for all clinicians providing patient care, how it should be taught, and how competency should be assessed. To provide clarity in the requirements of the NSQHS Standards, and to ensure that patients are protected from harm, the Commission is seeking further information about the minimum standard that should be required for competence in the skills and knowledge required to provide safe care to patients who deteriorate in acute care settings.
Training-and-competencies-for-recognising-and-responding-to-clinical-deterioration-in-acute-care-consultation-paper-Apr-2014.docx