PLEASE READ: the Recognising and Managing Deterioration programme is being reviewed to align with updated NICE Guidance on sepsis published on 31st January 2024.
Please ensure you read the guidance and take note of the updates as you complete the training. The guidance is here and the programme is being updated as a priority.
Updated sessions with more info and links further down:
Changes to vital signs, behaviour and mental state often occur before a serious event, such as cardiac arrest. Being able to recognise and act on these changes are essential skills for improving patient safety and outcomes.
The Recognising and Managing Deterioration programme has been developed to support the workforce and organisations in ensuring staff have the necessary knowledge and skills to recognise and manage deterioration in adult patients.
The programme is divided into 3 main sections which focus on patient assessment, early warning scores, and sepsis. Each section includes sessions relevant to practise in various settings and specialities. We recommend that you review each section for all the sessions relevant to your role and workplace to ensure you get the most out of the learning. Some sessions are universally accessible and marked separately.
Use the sections and links below to navigate the resources.
The patient assessment sessions are aimed at healthcare professionals, frontline staff, and all carers who are the first contact for the deteriorating patient.
The resources within this programme discuss the ABCDE approach as a system for assessment for clinicians and nurses, as well as guidance for carers, reception staff ambulance services and mental health professionals.
The old sessions called recognising and managing deterioration on elfh will remain until the 30th of November for any learner to be able to still utilise them. The new sessions replacing these are called the ABCDE approach and are launched on the Learning Hub as below.
Failure to recognise patient deterioration and act promptly poses a significant patient safety risk and can lead to adverse outcomes, including preventable death.
This programme focuses on the ABCDE approach which is used to systematically assess an acutely unwell patient. It involves working through the following steps:
The resources are designed for individuals in clinical roles working with adults. It is offered at 2 levels to match the learner’s experience and clinical setting:
Universal: targeted at a broad audience, including healthcare assistants, support workers, and junior nurses. These sessions are accessible to anyone.
Advanced: aimed at experienced healthcare professionals, such as nurses, allied health professionals, and junior medical professionals. These sessions are intended for the NHS workforce and medical students.
For more details about the ABCDE approach and to access the elearning please click here https://www.e-lfh.org.uk/programmes/abcde-approach/
People with learning disabilities are often at increased risk of a number of health issues. This elearning has been developed to provide carers with information to reduce the risk of health deterioration in the people they support.
As people with learning disabilities can often be reliant on family and paid carers to help them manage their needs and support them to access health services, this programme aims to provide those paid and unpaid carers with health-related information that can help reduce some of the many health inequalities that people with learning disabilities face. Developed by the West Yorkshire Health and Care Partnership, we hope this programme will help reduce preventable causes of ill health and reduce health inequalities.
The sessions are:
These sessions can be accessed here: https://www.e-lfh.org.uk/programmes/caring-for-people-with-a-learning-disability/
For additional material please review a video tutorial on recognising deterioration in a person with a learning disability.
Deterioration, NEWS2 and sepsis in care homes
These learning resources on Deterioration, NEWS2 and sepsis have been designed in particular for care home staff to ensure care home residents receive appropriate, timely medical care. They provide a comprehensive training for non-clinical carers in the community. The training may also be suitable for health care assistants working in other settings and nursing students.
This is a mainly film-based course that covers:
NHS has created several videos on soft signs aimed at anyone with care responsibilities. These will provide guidance in measuring the patient’s blood pressure, temperature and other vital signs correctly. You can access all the videos by clicking on the links below.
This is a newly built session to cover all the old content for reception staff.
Receptionists often serve as the first point of contact for individuals with urgent health needs. NHS England, in collaboration with Hartlepool and Stockton Health, has developed a new learning resource for reception staff.
This resource serves as an introduction to identifying and addressing deteriorating patients, in line with the latest NICE guidelines and NHS standards. The session is designed to help those working in community-based care settings recognise signs of potentially life-threatening conditions and escalate cases appropriately.
The training focuses on identifying specific symptoms that may indicate a deteriorating patient, such as chest pain, stroke, sudden breathlessness, and sepsis, and guides receptionists on how to escalate these cases to a clinician within their service or practice.
You can access the elearning here (https://learninghub.nhs.uk/catalogue/deteriorating-patients-an-introduction-for-reception-staff )
The old materials are available on elfh until the 15th of December for any learner to be able to still utilise them. You can access the session here: https://portal.e-lfh.org.uk/Component/Details/592885
NEWS training for frontline staff
This elearning module and case studies have been developed for all frontline clinical staff by the London Ambulance Service NHS Trust.
By the end of the session, learners will be able to:
NEWS training for paramedics
The resource covers:
The NEWS in mental health settings elearning session offers learners an overview of the National Early Warning Score (NEWS) and specific case studies relevant to staff involved in the care of patients with mental health conditions.
This resource covers:
the need for a National Early Warning Score (NEWS2) and the evidence to support its use
raising awareness and increase understanding of how the National Early Warning Score (NEWS2) is used in the recognition and response to deterioration
understanding the purpose of SBARD as a structured communication tool
case studies that offer learners the opportunity to consider how they might manage patients in similar situations
This training package contains all sections of the NEWS2 in mental health settings elearning in a PowerPoint format and can be used in a facilitated learning session.
The Early Warning Scores section of the programme includes resources on the National Early Warning Score (NEWS2), which is endorsed by NHS England and NHS Improvement for use in acute and ambulance settings. This section also includes maternity early warning scores, paediatrics early warning scores and neonatal track and trigger elearning sessions.
NEWS2 in Primary Care elearning
The NEWS2 in Primary Care session introduces the National Early Warning Score (NEWS) and its use in a primary care setting. It also includes:
The Case studies of NEWS in Primary Care session contains practical examples of when NEWS could be used and offers the primary care clinician the opportunity to consider how they might manage patients in similar situations.
The secondary care training package has been developed for healthcare staff in secondary care settings. This resource covers:
The NEWS in mental health settings elearning session offers learners an overview of the National Early Warning Score (NEWS) and specific case studies relevant to staff involved in the care of patients with mental health conditions.
This resource covers:
This training package contains all sections of the NEWS2 in Mental Health settings elearning in a PowerPoint format and can be used in a facilitated learning session.
Deterioration, NEWS2 and sepsis in care homes
These learning resources on Deterioration, NEWS2 and sepsis have been designed in particular for care home staff to ensure care home residents receive appropriate, timely medical care. They provide a comprehensive training for non-clinical carers in the community. The training may also be suitable for health care assistants working in other settings and nursing students.
This is a mainly film-based course that covers:
The new national Maternity Early Warning Score (MEWS) tool sits within NHS England’s PIER framework and has been developed with key stakeholders to replace the range of different MEWS tools that are currently available. MEWS has been designed to ensure that identification of deterioration is based on pure physiology using a total score, which is combined with subjective assessments (additional concerns) that support the escalation process.
The elearning session, Introduction to the Maternity Early Warning Score, introduces the new national MEWS tool and describes why and how the tool was developed. The session:
Access the MEWS elearning session.
The new Newborn Early Warning Track and Trigger (NEWTT2) tool sits within NHS England’s PIER framework and replaces the NEWTT framework designed by the British Association of Perinatal Medicine (BAPM) in 2015. BAPM have updated the tool to reflect quality improvement methodology and feedback from healthcare professionals.
The elearning session, Deterioration of the newborn NEWTT2, introduces the NEWTT2 tool. The session:
Access the NEWTT2 elearning session
The new national Paediatric Early Warning System (PEWS) chart monitors deterioration in children in inpatient settings, and is supported by other aspects of the PEWS.
This elearning module is for all clinicians who will complete, interpret or use the updated PEWS chart in an inpatient setting. It does not require pre-existing knowledge or understanding of the updated PEWS chart.
The elearning session comprises the following sections, which reflect the organisation of the PEWS chart:
Access the PEWS elearning session
Sepsis contributes to over 26,000 deaths annually. Asking the question ‘Could this be sepsis?’ is a critical when assessing a deteriorating patient.
Recognising its importance and the need for specialised training, NHS England has developed an e-learning programme to offer guidance on the recognition and management of sepsis across various settings.
This programme includes sessions aimed at community-based healthcare professions which provide information on the latest NICE guidance on recognising and responding to suspected sepsis in adults, children and young people, and people with a learning disability.
The full sepsis programme can be accessed here.
COVID-19 support: Working with partners we have developed an animation for patients on COVID-19, how to measure oxygen levels (using a pulse oximeter), what the danger signs to look out for are and when to seek urgent help.
This is accompanied with a standard operating procedure and patient information leaflet.
Dr Claire Nadaf DProf MSc BSc(Hons) RN SFHEA
Head of Academic Enterprise and Engagement
Health Sciences University
Sue Maddex RGN, MSc AHCP, PGDipE, SFHEA
Senior Lecturer
Adult Nursing /Institute of Health and Social care
London South Bank University
Dr Simon N. Stockley MB ChB, FRCGP, FIMC (RCSEd), DUMC
GP, Eaglescliffe Medical Practice, North-east of England
Medical Director, National COVID-19 Vaccination Programme
Dr Alison Tavaré
NHSE SW Learning Disability Collaborative Clinical Lead
Health Innovation West of England Clinical Lead
NCEPOD Clinical Co-ordinator
Dr Chris Carey
Consultant Anaesthetist UH Sussex NHS Trust
Clinical Director for Spinal and Neurosurgery, Plastics and Major Trauma Service
Vice President, Royal College of Anaesthetists
Danielle Fullwood
Head of Strategic Education and Skills
NHS Coventry and Warwickshire Integrated Care Board
Tony Kelly
National Specialty Advisor, National Maternity and Neonatal Programme
NHS England
Hannah Rutter
Quality Improvement Lead for Perinatal Deterioration
NHS England
Sarah Gray, Programme Manager
Essi Niittymaki, Senior Project Manager
Claire Beattie, Lead Learning Designer
Rachel Grant, Learning Designer
Abigail Lingford, Graphic Designer
The News and Deterioration programme is freely available to access here.
Please note your progress and completion of sessions will not be recorded and you will not be able to generate a record of completion. If you require evidence of learning, please register and then log in to access this programme on the elfh Hub.
If you already have an account with elfh, then you can enrol on to the News and Deterioration programme by logging in to the elfh Hub, selecting My Account > Enrolment and selecting the programme. You can then access the programme immediately in the My elearning section.
To view the News and Deterioration programme, select the View button below. If you already have an account with elfh, you will also be able to login and enrol on the programme from the View button.
If you are a HR, IT or Practice Manager and would like to register and enrol large numbers of staff within your organisation for access onto the News and Deterioration programme, please contact elfh directly.
For HR departments wanting to know more about gaining access to courses using an existing Learning Management System please contact elfh directly to express interest.
Please select the following link for more information on how to use the elfh Hub.