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Critical Care Strategy


The Network provides specialist clinical input into the critical care implications of acute service reconfiguration in North West London.

NWLCCN Adult Critical Care Strategic Development Framework
The Network Adult Critical Care Strategic Development Framework is authored on behalf of the North West London Critical Care Network Steering Group, with wide discussion and input from Network clinical groups, together with Commissioner and acute Trust executive representation.


  • Critical care reconfiguration poses challenges, as critically ill patients are intrinsically clinically unstable. Patient needs and clinical condition can alter rapidly and unpredictably, requiring a degree of contingency planning to underpin each acute care model. A key intention of this document is to ensure that the critical care impact of any acute service change is constructively and comprehensively considered.
  • Any detailed implementation of acute service changes will rely on decision-making at multiple levels, including internal service reconfigurations within acute Trusts, collaborative commissioning between acute Trusts and PCTs; and strategic support from London-wide agencies.
  • This document is intended to inform this decision-making process at all levels. The document does not set out to say which acute service changes should or should not occur, but instead to provide informed insight into the patterns of critical care provision which would be required to support each change.
    The document also considers issues which are not specifically raised in “A Framework for Action” but where reconfiguration provides a further opportunity to improve patient outcome through improved access to local and tertiary critical care, seamless referral pathways for specialist care such as emergency neurosurgery, and safe inter-hospital transfers where necessary.
  • The success of this guidance, and of the Critical Care Network’s input, relies on its readership being prepared to actively project its key points and recommendations into all relevant acute service discussions and fora.
  • The document is not intended to survey or designate services per site, nor to state the critical care capacity required to support a particular service change, since this needs more detailed consideration of each proposal. The Network would expect this guidance to be considered in detail as part of the overall case and service model for specific service change proposals.