Critical Care Outreach Team

Patient Information Leaflet

What is the critical care outreach team (CCOT)?

• The Critical care outreach team (CCOT) is a team of highly skilled and professional Nurses.
• The team has a background in intensive care nursing or emergency care.
• The CCOT supports and advises ward Nurses and Doctors about your specialist care needs.
• Whittington Hospital has one of the lowest mortality rates of all hospitals in England and Wales.
• This means fewer patients die after receiving care at the hospital compared with many other hospitals.

When do we get involved?

• The CCOT team will be involved in your care if your vital signs are abnormal or if there are concerns that your condition may get worse.
• Any member of the ward team may contact us if they have any concerns.
• We will then come to see you and do a full physical assessment as well as a drug review, blood test review, and review any imaging you may have.
• We may start specialist treatment, do extra blood tests, or do a quick ultrasound scan.
• Most of our team can prescribe medicines. They may include nurses, pharmacists, physiotherapists, or other specialist healthcare professionals.
• They can prescribe treatments within their area of expertise, just like a doctor, to help manage your care.
• If you need a higher level of care, we will arrange a safe transfer to the High Dependency Unit (HDU) or Critical Care Unit (CCU).
• We will check on you before and after you leave the High Dependency Unit (HDU) or Critical Care Unit (CCU).
• This helps make your transfer of care smoother. We will monitor your progress and advise on any further critical care needs.
• We will also provide guidance and support to you and your family.
• The Outreach Team lead on tracheostomy care (a hole at the front of the neck with a tube to help you breathe) within the Trust.
• We will continue to visit all patients with tracheostomy tubes on the ward as specialist care is required.

Martha’s Rule

• The CCOT team is the first point of contact for Martha’s Rule.
• Martha’s Rule allows patients and families to ask for an alternative review if they feel someone’s condition is getting worse.
• It is named after Martha Mills, a young girl whose death highlighted the need for families to be heard when they raise concerns.
• The rule empowers patients, relatives and carers to speak up if a condition seems to be getting worse.

How do I ask for a Martha’s Rule review?

• Speak to the team looking after you or the person you care for.
• If you are still worried and feel that the care team is not dealing with your concerns, please ring the Martha’s Rule phone line on 020 7288 3976.
• This number is available 24 hours a day, 7 days a week.

Working hours of the CCOT

• The CCOT service is 24/7 (24 hours a day 7 days a week).
• At night the Nurse Specialist will hand over your care to the intensive care Doctor on duty and may ask them to review you overnight.
• We work very closely with all members of the multidisciplinary team including your medical Consultant, Physiotherapists and Dieticians.
• We work closely with critical care Doctors. We may discuss any concerns about your condition with them.
• We may also ask them to come and review you.

Critical Care Follow up clinic

• Some patients have physical or emotional problems after being critically ill.
• This can happen because being very unwell, spending time in intensive care, and being on a mechanical ventilator (breathing machine) can affect the body and mind. These problems can continue after leaving hospital.
• Most people improve over time, but recovery can take weeks or months.
• The Whittington critical care unit offers a follow-up clinic for patients who have been on a mechanical ventilator while on the unit.
• If you would like a follow up appointment, please speak to the critical care outreach Nurse or email whh-tr.itufollowup@nhs.net

Our commitment to you

• Critical Care Outreach staff work as a team, committed to providing excellent care.
• To help us do this, please feel free to comment on what we have done well or less well, and to suggest ideas to improve our service.
• You can do this by visiting: https://qrco.de/bglGYA or by scanning the QR code below.

Contact our service

• Please speak to a member of staff on the ward.
• If you are still worried and feel that the care team is not dealing with your concerns, please ring the Martha’s Rule phone line on 020 7288 3976.
• This number is available 24 hours a day, 7 days a week.