The identification of the critically ill or deteriorating patient is the key to preventing admission or readmission to the critical care facility. ‘Comprehensive Critical Care’ (DoH 2000), recommended the use of guidelines, standards and protocols developed by multi-professional collaboration. NHS trusts are encouraged to develop appropriate Critical Care Services including the identification of all patients requiring level 1, 2 or 3 care throughout the hospital. These current guidelines are the first issued by the Intensive Care Society on the subject of Outreach Services (2002).

 Guidelines for the Introduction of Outreach (2003)

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The Intensive Care Society (ICS) document that details a more comprehensive classification for critically ill patients than was previously available (revised 2008).

 Levels of Critical Care for Adult Patients (revised) 2008

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Independent Healthcare Association. September 2002.

Produced by an Independent Healthcare Association Working Group. This document is intended to provide guidance to drive good practice and to provide a basis for local policy development within critical care networks, the objective being for providers and commissioners to work together to meet the needs of all critically ill patients and their families in their geographical area. IHA member organizations that are offering critical care services must assess their policies for the delivery of care against this guidance.

 Guidance on Comprehensive Critical Care for Adults in Independent Sector Acute Hospitals

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This report sets out a programme of action to help to secure the nursing contribution to the national critical care programme- Comprehensive Critical Care (2000). It was developed in response to a call from critical care practitioners and managers for a framework that draws together national and local action needed or underway, that will improve the quality of care for patients.

 The nursing contribution to the provision of comprehensive critical care for adults

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This HSC summarises the modernisation programme for critical care services following the publication of Comprehensive Critical Care, the Report of the Expert Group on Critical Care Services and allocated additional resources for critical care services during 2000/01; set out the requirements for increased critical care capacity for winter 2000; and gave advance notice of additional investment in neonatal intensive care in 2000/01.

 HSC 2000/017: Modernising critical care services

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In April 1999, the Department of Health established a review of adult critical care services, and appointed an expert group to develop a framework for the future organisation and delivery of critical care. This Report sets out the key findings and recommendations of the Expert Group. It makes proposals for the development of a consistent and comprehensive critical care service throughout the NHS in England.

 Comprehensive critical care: a review of adult critical care services

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NICE Clinical Guideline July 2007. This guideline describes how patients in acute hospitals should be monitored to help identify those whose health becomes worse and how they should be cared for of this happens.

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