The Ashford and St Peters NHS Foundation Trust Critical Care Outreach Team (CCOT) was established in 2001, the service has since evolved and currently provides 24 hour Outreach Service with dedicated Outreach Specialist Nurse cover 08.00-2015, seven days per week, 364 days per year.

This guideline sets out evidence based standards for the provision of care for adult patients who either at risk of or who are acutely ill in ward environments at Ashford and St. Peter’s Hospitals NHS Foundation Trust.

This guideline provides details on identifying patients, determining safe location of patient in ward areas, provision of equipment, care required and effective lines of communication.

Registered health care professionals are accountable for optimising the care of those patients at risk of or who are acutely ill in their care.


Definition of Acutely Ill Patients

Patients who are either at risk of or who are acutely ill in ward environments have been classified by the Department of Health as requiring level 1, 2 or 3 care. The definitions were originally developed after the publication of Comprehensive Critical Care in 2000, and latterly revised to reflect the Critical Care Minimum Dataset (CCMDS) which has been mandated since April 2006. It follows the approach of allocating levels of care to patients according to their clinical needs therefore clinical judgement should be used to determine which level of care would be most appropriate based on the criteria below.

  • Level 0 Criteria refers to patients whose needs can be met through normal ward care in an acute hospital with observations required less frequently than 4 hourly.
  • Level 1 Criteria refers to patients at risk of their condition deteriorating, or those recently relocated from higher levels of care, whose needs can be met on an acute ward with additional advice and support from the critical care outreach team.
  • Level 2 Criteria refers to patients requiring more detailed observation or intervention including support for a single failing organ system or post – operative care and those ‘stepping down’ from higher levels of care.


Policy Details

Download: PDF version
Compiled by: Ingrid Johnson
Ratified by: SNMLC
Date Ratified: October 2014
Date Issued: November 2014
Review Date: April 2015
Target Audience: All clinical staff
Contact name: Ingrid Johnson