Implementation guides

Many of the resources within the deterioration in children web pages –the focus for the Re-ACT project (Respond to Ailing Children Tool) – may aid the implementation of improvements for the recognition and treatment of deteriorating children: the TED-type presentations, case studies and parent stories may provide information, practical advice or encouragement to guide change in your service or organisation.

The list of resources here are not exhaustive. Please let us know of any others you have used and value or have developed in your organisation (and had approved for implementation and sharing). Email us at:

MODRIC Guidelines

Manipulation of Drugs Required in Children (MODRIC): A Guide for Health Professionals is now published and freely available for health professionals and is intended for use by healthcare professionals working in UK hospitals in neonatal and paediatric (birth to 18 years) in-patient settings.

Designing the right medicine for children News update

Case Studies

Gloucester Hospitals NHS Foundation Trust

By introducing a sepsis six pathway Dr Charles Candish and his service improvement team at Gloucestershire Hospitals NHS Foundation Trust, have been able to make significant improvements to the use of the sepsis six care bundle from 16% in April 2012 to 91% September 2013 for unscheduled care, and from 5% in September 2011 to 70% in November 2012 for inpatients.

Royal Manchester Children’s Hospital as part of Central Manchester University Hospitals NHS Foundation Trust.

The aim of the project was to ensure a safer experience for children with complex needs whilst they are inpatients at Royal Manchester Children’s Hospital (RMCH). It was initiated following several high level incidents involving children with complex needs; these incidents particularly related to delayed recognition of deterioration.

This safety case provides an over view of the safer clinical systems, Health Foundation Project within the Royal Manchester Children’s Hospital that aimed to reduce risk and remove hazards from the pathway of the child with medical complexity.

Nottingham University Hospitals NHS Trust

At Nottingham University Hospitals NHS Trust ‘failure to rescue’ had been identified as a high clinical risk, but improvement work was being performed ‘in silos’ without consistently benefiting from shared learning or goals. In March 2012, a new programme called ‘Recognise and Rescue’ was formed which brought relevant pre-existing clinical focus groups together to collaborate alongside key stakeholder departments.

The aim was to improve care of the deteriorating patient by improving recognition and reducing delays to treatment or escalation through a data driven, multidisciplinary and trust-wide strategy.