Recognising and managing deterioration - elearning for healthcare
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This programme is in partnership with...
  • Health Education England
  • London Southbank University
  • Bournemouth University_Partnership Logo
  • Hampshire Hospitals nhs foundation trust
  • wessex accademy health science network
  • Academic Health Science Networks

About the recognising and managing deterioration programme

Changes to vital signs, behaviour and mental state often occur before a serious event, such as cardiac arrest. Being able to recognise and act on these changes are essential skills to improving patient safety and outcomes.

Deterioration in patients.pdf >

The Recognising and Managing Deterioration programme has been developed to support the workforce and organisations in ensuring staff have the necessary knowledge and skills to recognise and manage deterioration in adult patients. The programme includes resources on the National Early Warning Score (NEWS2), which is endorsed by NHS England and NHS Improvement for use in acute and ambulance settings.

Signs of Life - Educational Game


Signs of life is a simulated training resource, where healthcare professionals can practice the care of the deteriorating patient. The game is played out in a hospital ward or nursing home setting. In real time scenarios, players record a patient’s vital signs in a simulated work situation, decide what interventions are required and are given critical feedback on the best clinical decisions to take.

Ufi VocTech Trust funded the development of the game which has been produced by Desq, staff from Dudley Group NHS Foundation Trust and a former care sector nurse.

Recognising and managing deterioration elearning

The recognising and managing deterioration elearning module has been developed for a wide variety of health and social care professionals working in clinical environments where adults could physically deteriorate.

This resource is structured around the ABCDE assessment tool and allows participants to revise their anatomy and physiology, develop their skills and knowledge in the assessment process to recognise deterioration and manage the findings within the scope of their clinical role.

The resource is offered at 2 levels (Universal and Advanced) to reflect the participant’s experience and clinical setting.

Receptionist training package

A learning resource for reception staff, composed of training resources and a workbook, has been developed by HEE in collaboration with Hartlepool and Stockton Health, as an introduction for reception staff to address the deteriorating patient.

Receptionists are commonly the first point of contact for people with acute health needs. This training helps receptionists recognise specific symptoms that may indicate a deteriorating patient, and how they would consider escalating this to a clinician within their service or practice. It particularly focuses on to the symptoms of chest pain, stroke, sudden breathlessness and sepsis.

Resources by settings

Use the links below to find resources relevant to your setting.
Selecting the links will open a new tab in your browser and take you directly to the relevant area of the programme.

  • Primary Care
    1. NEWS in Primary Care elearning

    The NEWS in Primary Care session introduces the National Early Warning Score (NEWS) and its use in a primary care setting. It also includes:

    • Evidence of NEWS and its use in the community.
    • Its effective use between primary and secondary care.
    • Links to other useful resources and references for further research.

    The Case studies of NEWS in Primary Care  session contains practical examples of when NEWS could be used and offers the primary care clinician the opportunity to consider how they might manage patients in similar situations.

    1. Sepsis and NEWS webinar

    The Sepsis and NEWS (National Early Warning Score) webinar took place on 17 March 2020, hosted by Alison Tavaré, Primary Care Clinical Lead, West of England Academic Health Science Network.

    This webinar addresses NEWS:

    • How it supports the identification and early management of the deteriorating patient.
    • Its use in primary care.
    • Emerging evidence for community settings.
    • How to support the identification of the patients with possible COVID-19, referring to sources of information and data that will offer real time updates on its future treatment.
    1. Train the Trainer package

    This training package contains all sections of the NEWS in Primary Care elearning in a PowerPoint format and can be used in a facilitated learning session.


  • Secondary Care

    The Secondary Care training package has been developed for healthcare staff in secondary care settings and comprises two learning resources:

    1. Using NEWS in the recognition of deterioration

    This resource covers:

    • The need for a National Early Warning Score (NEWS) and the evidence to support its use.
    • Raising awareness and increase understanding of how the National Early Warning Score (NEWS) is used in the recognition and response to deterioration in secondary care settings.
    • Understanding the purpose of SBARD as a structured communication tool.
    1. NEWS in Secondary Care – case studies

    This resource supports the effective diagnosis and management of NEWS in relation to deterioration, and includes case studies on:

  • Social Care

    Deterioration, NEWS and sepsis in care homes

    These learning resources on Deterioration, NEWS and sepsis have been designed in particular for care home staff to ensure care home residents receive appropriate, timely medical care. They provide a comprehensive training for non-clinical carers in the community. The training may also be suitable for health care assistants working in other settings and nursing students.

    This is a mainly film-based course that covers:

    • An introduction to NEWS in care home settings and its benefits
    • An introduction to sepsis and serious illness
    • The importance and significance of soft signs
    • An overview of each component part of NEWS and how to measure:
    • Respiratory rate
    • Oxygen saturations
    • Blood pressure
    • Pulse rate
    • Level of alertness
    • Temperature

Coming soon

NEWS in Mental Health

A NEWS in Mental Health training resource is currently being written. The training will offer learners an overview of NEWS, as well as specific case studies relevant to staff working in a mental health setting.

NEWS in Ambulance services

A NEWS in Paramedics training resource is currently being written. The training will offer learners an overview of NEWS, as well as specific case studies relevant to staff working in an ambulance service.

Further resources

Further NEWS resources have been referenced within the sepsis learning materials:

COVID support: Working with partners we have developed an animation for patients on COVID, how to measure oxygen levels (using a pulse oximeter), what the danger signs to look out for are and when to seek urgent help. This is accompanied with a standard operating procedure and patient information leaflet.

Meet the team

  • Antonio-De-Gregorio

    Antonio De Gregorio

    Programme Coordinator – Antimicrobial Resistance and Sepsis, Health Education England, Population Health and Prevention Team
  • Mohamed Sadak

    Mohamed Sadak

    Clinical Lead and Programme Manager, Antimicrobial Resistance and Sepsis, Health Education England, Population Health and Prevention Team
  • Janet Flint

    Janet Flint

    Programme Lead, Health Education England, Population Health and Prevention Team
  • Dr Chris Carey

    Associate Postgraduate Dean, Health Education England Kent, Surrey, Sussex
  • Dr Sanjiv Ahluwalia

    Dr Sanjiv Ahluwalia

    Postgraduate Dean, Health Education England, North Central and East London
  • Dr Simon Stockley

    Content author Receptionist training package
  • Alison Tavaré

    Dr Alison Tavaré

    Content author, NEWS in Primary Care training & Deterioration, NEWS and Sepsis in Care Homes
  • Dr Matt Inada-Kim

    Dr Matt Inada-Kim

    Content author, Consultant Acute Physician, & Sepsis Lead, Hampshire Hospitals NHS Foundation Trust National Clinical Director Infection, Antimicrobial resistance and Deterioration (NHS England & NHS Improvement)
  • Sue Maddex

    Sue Maddex

    Senior Lecturer, London South Bank University, Content Author of Recognising and Managing Deterioration
  • Claire Nadaf

    Claire Nadaf

    Senior Lecturer, Bournemouth University, Content Author of Recognising and Managing Deterioration
  • Danielle Fullwood

    Danielle Fullwood

    Senior Nurse; Professional Development, Health Education England, Content author of Secondary Care training package
  • Alan Ryan

    National Programmes Director, Health Education England
  • Emma Nye

    Emma Nye

    Programme Manager, HEE elearning for healthcare
  • Jon Collins

    Jon Collins

    Project Manager, HEE elearning for healthcare
  • Victoria Ward

    Victoria Ward

    Lead Learning Designer, HEE elearning for healthcare
  • Tracy Watkins

    Tracy Watkins

    Learning Designer, HEE elearning for healthcare
  • Jenny Berrisford

    Jenny Berrisford

    Learning Designer, HEE elearning for healthcare
  • Rashmi Chavda

    Rashmi Chavda

    Graphic Designer, HEE elearning for healthcare
  • Leanne Hargreaves

    Leanne Hargreaves

    Stakeholder Officer, HEE elearning for healthcare

How to access

Available to all

The News and Deterioration programme is freely available to access here.
Please note your progress and completion of sessions will not be recorded and you will not be able to generate a record of completion. If you require evidence of learning, please register and then log in to access this programme on the elfh Hub.

If you already have an account with elfh, then you can enrol on to the News and Deterioration programme by logging in to the elfh Hub, selecting My Account > Enrolment and selecting the programme. You can then access the programme immediately in the My elearning section.

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To view the News and Deterioration programme, select the View button below. If you already have an account with elfh, you will also be able to login and enrol on the programme from the View button.

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Registering large numbers of users

If you are a HR, IT or Practice Manager and would like to register and enrol large numbers of staff within your organisation for access onto the News and Deterioration programme, please contact elfh directly.

Organisations wishing to use their own LMS

For HR departments wanting to know more about gaining access to courses using an existing Learning Management System please contact elfh directly to express interest.

More information

Please select the following link for more information on how to use the elfh Hub.

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