Abstract

The evidence base concerning the vulnerability
of the deteriorating patient has been built over
a period of two decades or more (Schein et al,
1990; Franklin and Mathew, 1994; McQullian et al,
1998; Department of Health (DH), 2000). In addition,
the Audit Commission (1999) reported on the need
for a system of early detection of a patient at risk of
deteriorating and in likely need of specialist critical
care services. For many acute NHS trusts within the
UK, a move towards a system of early detection and
a focused support system for ward-based clinical staff
has been commonplace with the evolution of early
warning scoring (EWS) systems and the critical care
outreach team