Executive summary
- CRITCON translates the real-time observation & assessment of strain by clinical leaders in both routine circumstances and rapidly evolving situations, into a succinct communication score. This enables local, regional & national understanding, escalation, operational decision-making and loadbalancing.
- Strain is the subjective consequence of the demand placed on a critical care unit or network given the capacity it has available.
- CRITCON & co-ordinated mutual aid are tools specifically designed to distribute resource, ensure equity of access, and avert the possibility of ANY unit or site being forced into a state of resource triage while there remains accessible capacity in the system.
- CRITCON describes the strain status of individual units, networks of units and the country as a whole, accepting that strain will be shared and distributed across the system.
- Individual units can report CRITCON from 0-3.
- Where strain is shared across a system, network or region, the declaration of CRITCON 4 or 5 will be made automatically through the NCDR report, based on the number of units within a region at CRITCON 3, and then the number of regions at CRITCON 4.
- Where CRITCON 4 or 5 is declared, System or Regional EPRR leads will communicate the CRITCON status to Networks and individual units for their broader awareness and their twice daily reporting in the Directory of Services (DoS).
Expectations
- Every effort should be made by a Trust to discharge ward ready patients from critical care to optimise bed capacity and staffing standards in a primary attempt to reduce CRTICON score.
- CRITCON scoring is specific for critical care units. It does not replace the OPEL score used by organisations. OPEL score and CRITCON score should be seen as complimentary in helping to describe an overall picture of strain for a critical care unit within an organisation.
- CRITCON has been written for use by adult critical care units.
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A critical care unit should upload its CRITCON score into the DoS twice a day, as part of usual reporting of critical care activity.
References
- The Guidelines for the Provision of Intensive Care Services (GPICS). Intensive Care Society and Faculty of Intensive Care Medicine https://ics.ac.uk/guidance/gpics.html [accessed 14th April 2023]
- NHS England Adult Critical Care Surge Planning guidance: NHS commissioning » Adult critical care surge plan guidance (england.nhs.uk) (to be updated September 2023)
Supported by
- Adult Critical Care Operational Delivery Networks
- NHS England, Adult Critical Care Programme
Endorsed by
- Faculty of Intensive Care Medicine (FICM)
- Northern Ireland Intensive Care Society (NIICS)
- UK Critical Care Nursing Alliance (UKCCNA)
- Welsh Intensive Care Society (WICS)
