• Based at Central Manchester University Hospitals NHS Foundation Trust with a focus on Royal Manchester Children’s Hospital.
  • Ran from October 2011 for two years.
  • Focused on improving safety and quality of care for children with complex illnesses.
  • Aimed to provide a better experience of care for children, their families and carers by improving handover processes across primary, secondary and tertiary care.

Within a paediatric hospital, many patients have complex health problems, involving more than one speciality and a multidisciplinary team. Good communication between teams – and the identification of which team is in overall charge – is essential to ensure safe patient care.

Families of a child with a long-term condition can face considerable difficulty negotiating barriers, both within hospitals and between hospital and community. There can be frequent admissions, duplicated and unnecessary care, prolonged hospital stays, and failure to recognise and respond to serious illness in the acute care setting. They need support to understand the processes that are required to care for their child.

The necessary involvement of different specialties creates additional potential for miscommunication, both with families and clinicians. It is important to develop a process of communication that clarifies roles and responsibilities and gives the child and their family a cohesive system of care.

Since 2001, mortality reviews have been undertaken for all deaths within Royal Manchester Children’s Hospital. The trust identified communication and handover as an area where improvements could have a significant impact on patient safety.

A team at Central Manchester University Hospitals Trust set out to test the Safer Clinical Systems approach within a project that focused on improving safety and the quality of care for children with complex illnesses, by improving handover processes across primary, secondary and tertiary care. The project aimed to provide a better experience of care for children with complex needs, and their families and carers. 

Further reading

Research report

Safer Clinical Systems: Evaluation findings

December 2014
Research report

Lessons from the second phase of the Safer Clinical Systems programme.

About this programme


Safer Clinical Systems


A programme that ran in two phases from 2008 to 2013. It helped health care teams to proactively...

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