Dear Ms Voisin, Re: Peter Dorney Inquest 14 November 2014, Regulation 28 Report Further to your narrative conclusion and concerns raised to North Bristol NHS Trust in the form of a Regulation 28 Report, am responding to confirm the Trust's actions: At the inquest, understand the Ward Sister gave evidence that Early Warning Score (EWS) training is not mandatory at the Trust for nurses and she was of the opinion that it should be This Is not completely accurate. All new nurses (both NBT Extra and NBT) receive mandatory EWS training on induction at the Trust; The clinical induction programme takes place over 3 days and includes 30 minute training session on EWSISBAR (Situation, Background, Assessment and Recommendation). This induction programme has been in place since 2011_ those nurses who been at the Trust to when this induction programme commenced, EWS training is not mandatory, but is carried out as appropriate. This training is included in nurse's Blue Passport (a training record used by every nurse) and carried out as appropriate i.e. when member of staff is deemed to require it: Training requirements are discussed at an individuals annual appraisal and during the course of the year; if necessary; have set out below the system at the Trust In relation to EWS training: North Bristol Trust implemented the Bristol Observation Chart in 2007 a8 part of joint safety prior have For

collaborative work with University Hospitals Bristol: The Bristol chart makes it very clear when patient triggers an EWS, and our policy covers the process of escalation to medical staff that must be responded to within timed period depending on the severity of the score As mentioned above; all new nurses are trained on induction in the EWS score; and the vast majority of nurses have had this training: Since receiving the Regulation 28 directorate has reviewed which individuals have not received the Report; each for those individuals to receive this training and measures are being in place This has been limited to a few staff that have been employed at North Bristol NHS Trust for more than a few years. As of 13 January 2015,our records show that 93% of all nurses (both NBT extra and NBT) have received EWS training: This is well abave ur target range for compliancy within any given subject; which is assessed at 85%. confident that we have the right EWS training in place for all nurses, and that am few individual nurses (7% as of 13 January 2015) that have been Identified as those the training following a review by each directorate, will have received not receiving the training within the next 3 months.