Critical Futures: Current Workstreams

End of Life and Escalation of Treatment

Enhanced Care

 

END OF LIFE AND ESCALATION OF TREATMENT
The Faculty Board agreed to lead a working party on End of Life Care and escalation of treatment, which met for the first time in November 2017.  The group is chaired by Dr Joe Cosgrove.  See Critical Eye for further updates on progress to date.

Working Party aims

  • To define recommendations for practice, policy, education and research in the area of end of life care in critically ill adult patients in contact with the critical care service.
  • Overtime, to develop enduring networks that will allow better coordination of national policy, standards and guidelines in relation to end of life care in critically ill adult patients.

  • To define the role of the FICM and other stakeholders in the communication of issues around end of life care in critically ill adult patients and the wider healthcare community in general.

  • To define knowledge gaps in the area of end of life care in adult critical illness in order to inform research prioritisation.

Core membership

  • Faculty of Intensive Care Medicine (Chairing organisation)

  • National Outreach Forum

  • NHS England

  • Royal College of Anaesthetists

  • Royal College of Emergency Medicine

  • Royal College of Physicians

  • Royal College of Surgeons

  • UK Critical Care Nursing Alliance

  • ICU Steps

 

ENHANCED CARE
The Faculty Board agreed to lead a working party on Enhanced Care which will meet for the first time in May 2018.  The group is chaired by Dr Alison Pittard, our Vice Dean.  See Critical Eye for further updates on progress to date.

What is Enhanced Care?
The first stage of the project is to consider the perioperative care of patients who do not require admission to a High Dependency Unit (Level 2) but need a higher level of care than can be provided on a general ward. Where facilities have already been developed to meet this need they are variously known as Post-Operative, Post-Anaesthetic or Enhanced Care Units, or ‘Level 1+’ care. FICM wishes to ensure that delivery of care in these areas is both safe for patients and of the highest quality with an evidence based strategy for their development.

Longer-term, the working party will be extended beyond this work stream into enhanced care in other areas (i.e. medicine) with a revisited core membership.

Working Party aims

  • A consensus statement on the need for enhanced care units/services, including potential benefits in reducing the risk of cancelled operations and improving the patient experience and journey in the postoperative period.
     
  • A broad definition of

    • Agreed terminology,

    • provision requirements, and

    • workforce.

  • Recommendations to relevant professional bodies for additions to existing standards documents, guidelines and training curricula.

  • A summary of current evidence in the area.

  • A summary of examples of current enhanced care in practice.

Core membership

  • Faculty of Intensive Care Medicine (Chairing organisation)

  • Royal College of Anaesthetists

  • Royal College of Surgeons

  • UK Critical Care Nursing Alliance

  • British Anaesthetic and Recovery Nurses Association

  • NHS England Clinical Reference Group for Adult Critical Care

  • Intensive Care Society

  • Lay input via the Board

  • A wider stakeholder and consultation group are under discussion but will reflect the diverse range of sites that would need to manage these services.