Whittington Health NHS Trust

“The Ward manager has given feedback to the nurse who did not escalate melaena. The nurse has booked to attend a course in January 2023 which includes how to recognise and manage the deteriorating patient. This course will re- enforce knowledge, improve competence, encourage better communication, and enhance team working. This course is run by the Critical Care Outreach Team.”

“The mental health liaison team is responsible for informing the nurse in charge of Whittington Hospital's ED and the named nurse looking after the patient in the ED what the recommended level of observation is”

“The nurse in charge of ED and the mental health liaison team are jointly responsible for ensuring that security staff and any other relevant Whittington ED staff are fully aware of the required observation level”

“Visiting AHMPs and section 12 doctors must introduce themselves to the nurse in charge of ED and the named nurse responsible for the patient and request a clinical handover (Including the current observation level) and to view the mental health care plan”

“Whittington Hospital's ED staff are responsible for ensuring that the patient is observed in line with the observation level as documented in the mental health care plan”

“As part of improving communication between organisations signage has been introduced in Whittington ED, which is prominently placed around the nurses' station, to ensure that visiting doctors and AHMPs are aware of this process and that the name of the patient's allocated nurse and any 1:1 or 'special' staff member is visible outside the patient's cubicle”

“To ensure that the level of observations is being complied with and that the clinical decision making regarding Mental Health patients is robust Senior Whittington ED staff members (nurse in charge, site team, ED registrar or consultant) conduct a situation report 5 times per day in which the status of the department including 2 length of stay of mental health patients and risk assessment is discussed, this is followed by a review in which plans for patients are confirmed and quality of care is”