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Patients deteriorate in hospital for many reasons. Failures to recognise, escalate and respond appropriately can cause preventable harm. To address this, hospitals have been improving their systems for managing the care of patients who deteriorate.

This guide is intended to help project leads and teams prepare for and implement improvements to their shared goals of care approaches. It sets out why this is important, components to be implemented, available support, and recommended activities during the preparation, implementation and sustain periods.

If you have any queries about these resources, please email

Last updated: 1st December, 2021