Transforming Care: Stop and Watch

Local Nurse encourages people who care for vulnerable patients to use free Early Warning resource

An Early Warning Tool that was developed in north Cumbria and supports families, relatives, and carers to reduce a patient’s risk of serious illness is continuing to be used across the country.

The project has been led by NHS North Cumbria CCG’s Director of Nursing and Quality, Anna Stabler, who is encouraging more people to make use of the free resource. Anna said, “Stop and Watch was developed as a response to local learning reviews that highlighted circumstances where patients could have been helped to seek medical assistance sooner. 

“The need for it was particularly noted in patients with a learning disability, as the characteristics and symptoms associated with the learning disability potentially masked symptoms of other underlying health problems, meaning they might go undiagnosed and lead to more serious health issues. 

“It was clear that there was a need to raise awareness of symptoms so that appropriate medical treatment could be provided as soon as possible.”

The tool takes the form of a pocket sized Z-card and uses widely recognised emojis to help illustrate twelve key signs of deterioration, presenting them as a simple abbreviation. It is hoped that by using this approach the campaign will appeal to all age groups and will be both engaging and easy to understand. 

Anna Stabler added, “Presenting the 12 signs of deterioration as a simple abbreviation helps people to remember them, and as the Early Warning Tool comes in a printed leaflet format, carers and family members are able to keep this with them as an aid memoire. It can be used as a reference point to check any concerns a person has, and also has space for notes to be made to aid communication of concerns to health professionals.

The development included input from other CCG’s at a LeDeR conference in October 2018, and the concept was shared with patient user groups when in its draft format for their feedback. 

Stop and Watch has been rolled out across nursing and residential homes in Cumbria and the North East, and is included in care certificate training in hospital settings for North Cumbria Integrated Care NHS Foundation Trust. It has also been shared across England through the Learning Disabilities Mortality Review (LeDeR) programme, and presentations were given at national conferences in Manchester and in the North East. 

Anna added, “Feedback following conferences has been very positive, and requests for the training materials have been received from lots of other areas including Manchester, London, Coventry and Leeds.”

Dedicated training sessions are available where people can learn the background of the tool and how to use it. The sessions are open to both staff and members of the public, or other organisations who are in contact with or provide care for vulnerable people. You can find information about booking onto training sessions by searching for Stop and Watch on the Cumbria Learning and Improvement Collaborative website, here: 

You can request the resource for free by contacting Anna via the Communications Team at NHS North Cumbria CCG. The team’s contact details are: telephone: 01768 245437, or email: 

There are a number of other materials available to raise awareness of the tool, which can be can be found as follows:

Short animation

Stop and Watch webpage

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