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As a result of the action every hospital in England has been asked by the Medical Director of the NHS to ensure they have plans in place to monitor "exceptional and sustained" deterioration in performance and contingency arrangements to ensure patient safety is not compromised.
Under a section about potential "challenges" that could lead to a downgrade, Moody's cited "significant and sustained deterioration of student market position".
Keogh advised medical directors – the most senior doctor in NHS trusts – that they should be ready to make such a request if they experienced an "exceptional and sustained deterioration in performance as indicated by Ambulance Handover Delays and 4-hour A&E".
Administrator FRP Advisory said a "sustained deterioration" since the EU vote had exacerbated Rivington Biscuits in Wigan's financial difficulties.
Russell Cash, partner at FRP Advisory, said the business was left "facing unsustainable cash-flow pressure" after "a sustained deterioration in trading conditions and significant additional pricing costs since the summer".
Sustained deterioration in health status led subjects to re-evaluate the uncertainty of their future (Additional file 6: Box 5).
Similar(53)
This patient had a similar cervical spinal cord injury about 15 years ago, when he developed transient numbness and paresis of the lower limbs following a fall. 1) Persons with Klippel-Feil syndrome should be made aware of the increased risk of sustaining transient neurologic deterioration after minor trauma if there is associated radiographic evidence of spinal stenosis.
But denial can't be sustained in the face of deterioration, and soon enough they both took practical steps to deal with their ailments — in Rebecca Alexander's case, Type 3 Usher syndrome, which robs the patient of eyesight and hearing; in Nicole C. Kear's, retinitis pigmentosa, which inexorably leads to blindness.
A small change in GFR of 5 mL/min in an individual patient may well be due to variability in measurement of plasma creatinine, and is unlikely to lead to any action, unless it was sustained or there was further deterioration, which is another reason for regular monitoring.
As expected, increases of fatigue in the course of sustained performance were associated with a deterioration of perceptual-motor performance and an increase of safety margins.
Several observations suggest differently: a protracted chronic phase, lack of response to several other treatments, relatively high response rate, sustained long-term improvement, and the rapid deterioration of the headache after the device was switched off or had technical failures.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com