East Cheshire, Greater Manchester

Patient Safety Collaborative - Managing Deterioration

The National Patient Safety Improvement Programme (NatPatSIPs) three programmes of work collectively form the largest safety initiative in the history of the NHS. They support a culture of safety, continuous learning and sustainable improvement across the healthcare system.

The Care Home element of the national programme is led and co-delivered by the NHS England & Improvement patient safety team, who work with the 15 regionally based Patient Safety Collaboratives (PSCs). The national teams are closely aligned and supportive of the national enhancing health in care homes team.

Reduce deterioration associated with harm by improving the prevention, escalation and response to physical deterioration through better system co-ordination and as part of safe and reliable pathways across health and social care by March 2023

  • Adoption of deterioration management tools in at least 60% of care homes (including those caring for people with Learning Disability, Autism and Mental Health) by the end of March 2023

In Greater Manchester, Health Innovation Manchester Care Home Programme Team, collaborate with local health and care providers from across Greater Manchester (GM) to co-develop and deploy initiatives that aim to reduce resident deterioration and the associated harm.

Due to the commissioning and quality assurance structures for care homes our colleagues at Innovation Agency are supporting Eastern Cheshire deploy the care homes aspects of the Care Home programme.

As part of this programme, we have previously supported the Covid-19 response through the Covid Oximetry @home initiative and the testing.

This overall goal of the current programme of work is to reduce care home resident deterioration and our ambition is to improve the prevention, identification, escalation, and response to physical deterioration, through better system co-ordination and as part of safe and reliable pathways of care. (PIER see Fig 1).  To facilitate this, we are supporting the increased adoption and spread of the RESTORE2 Mini deterioration management tool in care homes across Greater Manchester, including those homes caring for people with a Learning Disability, Autism and Mental Health.



RESTORE2 Mini is a physical deterioration and escalation tool for use in care homes that incorporates structured communications through SBARD (Situation-Background-Action-Recommendation-Decision). This ensures common language is used across healthcare settings.

HInM is offering free training to care home staff and is also promoting a Train the Trainer model so training can be cascaded internally.  We have also taken a qualitative approach as well as quantitative, to continue to support care homes, and assist with RESTORE2 mini and SBARD becoming part of their systems and processes.

The work in Greater Manchester is led by Verity Morton (Senior Programme Development Lead), Stuart Kaill (Programme Development Lead) and Lorraine Burey (Project Manager).

For more information regarding the Managing Deterioration Safety Improvement Programme please contact Verity Morton – verity.morton@healthinnovationmanchester.com


More information and free resources to support the use of RESTORE2 Mini can be downloaded HERE

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