A new implementation network hosted by the NHS Wales Executive will support NHS Wales organisations to effectively recognise, escalate and respond to acute physical deterioration. 

Chris Hancock and Clare Dieppe have been appointed as Network Manager and Clinical Lead of the Acute Physical Deterioration Implementation (APDI) Network respectively. 

The Acute Physical Deterioration Implementation (APDI) Network will help health boards and trusts in Wales to implement Early Warning Score systems and Call 4 Concern models across all ages, as directed in Welsh Health Circulars published in September 2024, October 2024 and February 2025. 

Hosted by the National Strategic Clinical Network for Critical Care, Trauma and Emergency Medicine, the implementation network will work with organisations until January 2027 to reduce variation in the tools, protocols and procedures surrounding deterioration, to achieve reliable rapid response systems to improve patient safety. 

After supporting the implementation of standardised early warning scores across all age ranges and in all relevant settings, the network will develop a common dataset for reporting the effectiveness of rapid response safety systems, and engage with patients and the public in codesigning an all-Wales approach to implementation of Call 4 Concern. 

As part of the Safe Care Partnership, the network will also work with clinical teams across Wales to test and embed system-wide improvements in escalation and response, examining all steps of escalation from routine observations through to critical care referral and considering appropriate ceilings of therapy.

The Clinical Reference Group for the APDI Network has been formed and its inaugural meeting is taking place in April 2025.