Information for patients
This leaflet can be made available in other formats including large print, CD and Braille and in languages other than English, upon request.
Are you concerned about a patient’s condition and they are getting worse?
C4C provides 24-hour access to a Critical Care Outreach Nurse.
We believe that patients and family members know when their condition or that of a loved one is changing for the worse.
The role of the Critical Care Outreach Nurse is firstly to ensure that critically ill patients, or those at risk of becoming so, receive the right treatment as quickly as possible in the most suitable location within the hospital.
The Critical Care Outreach Nurse responds to critically ill and life threatening situation by recognising and responding to early signs of deterioration (progressively worsening).
Patient safety and deterioration is a high priority at North Tees and Hartlepool Hospital.
When can I make a C4C call?
- If you are worried that you, your relative or young person/friend admitted to hospital are deteriorating (becoming more unwell despite treatment).
- If you feel your concerns are not being recognised by the nurse or ward doctor and acted upon and the patient is deteriorating, then you can directly call our team.
- If you have been a patient in critical care on this admission and you are experiencing difficulties and your concerns are not being appropriately acknowledged (listened to).
The team are contactable 24 hours a day, 7 days a week.
Remember this is a confidential service and all the Critical Care Outreach Team will work closely with you and all the healthcare staff to act on your concerns.
Using this service will not have a negative impact on your care or the care of your loved one in any way.
How to make a Referral
Discuss your concerns with the patient’s ward nurse or doctor.
- Have you noticed changes and are still worried?
- Do you feel your concerns are not being recognised as important or acted upon?
- Are you concerned about an immediate danger?
When the Critical Care Outreach Team receive your call, they will need to know;
- The patient’s name.
- The ward on which they are being treated.
- A brief description of the problem and what has already been done about it.
- Your contact details and your relationship to the patient.
We aim to answer your call promptly, however, on some occasions we may be dealing with an emergency that may delay our response. In this instance, we advise that you speak to the ward team again.
Responding to your call
When the Critical Care Outreach Nurse receives your call, you will need to provide the patient’s name and which war they are being nursed on, including a brief description of your concern.
After prioritising (assessing) the urgency of the issue. The team will listen to your concerns. They can see all of the medical notes and be able to view all bedside observations and test results.
They will use this information to assess the situation and ensure that you get the help you require.
the Critical Care Outreach Nurse will liaise with the patient’s primary team on the ward and any other healthcare professionals, if needed, to optimise your relative’s care.
We will discuss further treatment options and escalation plans suitable for your loved one by working with you and your family to ensure the best health outcomes for your specific health concerns. This will not have a negative impact on patient care.
How to refer to C4C
You can refer to the Critical Care Outreach Team by contacting the hospital directly at 01642 617 617 and ask the operator to put you through to the Critical Care Outreach Nurse.
alternatively, you can phone on the site on 01642 (6)46 383.
We are continuously aiming to improve the service we provide to ensure patient safety and early escalation of care.
Again, be aware that sometimes we are unable to respond to your call immediately if already engaged in a medical emergency, which may delay our response. In this case, we advise you to speak to the Ward team again.
The response will depend on the urgency of the case and also prioritisation of the Outreach Team.
When not to refer to C4C
When NOT to make a C4C call. C4C is a patient safety initiative.
This service is not to report general issues or problems which can be resolved or de-escalated at ward level by the primary team.
This may include issues with:
- Visiting Times.
- Hospital Food.
- Hospital cleanliness.
- Any other general issues.
Any complaints, please liaise with the Patient Experience Team (PET), who can offer confidential advice, support and information on health related matters for patients, families and carers.
To contact PET, please phone 01642 624 719 or send an email at [email protected].
Comments, concerns, compliments or complaints
Patient Experience Team (PET)
We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:
Telephone: 01642 624719
Freephone: 0800 092 0084
Opening hours: Monday to Friday, 9:30am to 4:00pm
Email: [email protected]
Out of hours
Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.
Telephone: 01642 617617
Data protection and use of patient information
The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.
Telephone: 01642 383551
Email: [email protected]Privacy Notices
This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:
Email: [email protected]
Leaflet reference: PIL1473
Date for Review: January 2026