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Working internationally to improve care of critically ill patients

A team of Cambridge University Hospitals Trust critical care staff are visiting Kampala, Uganda this month, as part of the SCALE Critical Care partnership. Over the course of a week, they will be based at Mulago National Referral Hospital, co-training with Ugandan faculty around 100 ICU staff from across Kampala and other cities in Uganda. CUH Critical Care Nurse Gayle Brunskill will stay on for another three weeks to embed the training into the ICUs and support a team of trainers in the delivery of clinical practice training through simulation.

Critical Care Nursing Lead Lisa Enoch delivering bedside teaching in Kampala, Uganda.

The vital role of critical care staff

Access to critical care is a crucial component of healthcare systems. Low- and middle-income countries like Uganda face a rising burden of critical illness and premature death yet the capacity to provide care for critically ill patients in intensive care units (ICUs) is extremely low.

The SCALE Critical Care partnership is a health workforce development initiative between Uganda’s Ministry of Health and the NHS. With support from Ugandan and UK-based organisations including Cambridge Global Health Partnerships (CGHP), the aim is to grow the skills and knowledge of Ugandan and UK critical care health providers through peer-to-peer learning and exchange.

How it works

The partnership is building staff capacity and capability to deliver intensive care, as well as driving reciprocal health system improvement in the UK and Uganda more broadly through a combination of remote and in-person training and learning. It enables Ugandan health workers to benefit from the Medical Training Initiative (MTI) scheme and scholarship pathways in the UK for critical care, and it provides opportunities for UK professionals to learn from the clinically rich environment in Uganda through virtual grand rounds and simulation training, technical monthly meetings, and bi-lateral visits.

Intensive teaching

The upcoming visit by the UK-based team will build on the in-person training already delivered – including managing a deteriorating patient in critical care – and continue the implementation of jointly-run virtual simulation training. The nursing team will deliver the simulation training while the doctors run the internationally accredited BASIC course for providing immediate and emergency care.

So what can the team expect? “I am excited to learn and teach different ways of working to benefit patients both in Uganda and the UK,” says Gayle. “While I am there, I will also be developing my teaching skills in an unfamiliar environment and with nurses of differing knowledge and skill sets than I am used to. This development in my educational experience will help my teaching of critical care nurses back in the UK.”

Joining Gayle from the Critical Care nursing team will be CUH staff members Lisa Enoch, Lead Critical Care Education Nurse, and Critical Care Nurses Celeste Formenton and Anna Kiernan. Consultant Anaesthetist James Varley and Consultant Intensivist and Acute Medicine Physician Kobus Preller are joining from the doctors’ team.

CGHP’s role

The visit is arranged with CGHP and is one of four ongoing strands of health partnership work that we’ve facilitated between Cambridge and Uganda since 2015: maternal and neonatal health, antimicrobial stewardship, cancer and critical care.


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