Dr Duncan Smith
About
Overview
Duncan joined the Division of Nursing at City, University of London in 2014 from full time practice in the NHS. Duncan has a clinical background in acute and critical care nursing, most recently working in critical care outreach roles. Alongside his Senior Lecturer post, Duncan is an honorary Consultant Nurse with the Patient Emergency Response and Resuscitation Team (PERRT) at University College London Hospitals NHS Foundation Trust. He is also a Generic Instructor Course Educator for the Resuscitation Council (UK) and Advanced Life Support Group.
Alongside his interests in cardiac care, critical care, and resuscitation practice, Duncan is interested in nursing within low and middle income settings and in caring for patients with tropical illnesses. Duncan spent two years living and working in Uganda under the auspices of Voluntary Services Overseas (VSO). During this time, he worked alongside Ugandan colleagues teaching pre-registration nursing students and also supporting the development of nursing staff working within an Intensive Care Unit (ICU). Throughout his VSO assignment, Duncan worked clinically alongside students in a variety of hospitals (Government, mission, and private), clinics, and in the ICU.
In 2018, Duncan was awarded a NIHR/HEE Clinical Doctoral Research Fellowship to complete his PhD. For his doctoral work, Duncan developed a theory-based behaviour change intervention (targeting registered nurses and healthcare assistants) to improve responses to deteriorating patients. From a research perspective, Duncan is interested in implementation science, behaviour change, and the use of theory to design interventions targeting healthcare practitioners. He is also interested in clinical-academic careers and building research capacity amongst nurses and AHPs. Duncan is currently acting as academic supervisor for three critical care nurses undertaking NIHR-funded pre-doctoral fellowships, and is the clinical-academic mentor for a further pre-doctoral fellow.
Duncan is the module leader for the APM052 (advanced clinical assessment) module, which is a core clinical module on the MSc in Advanced Clinical Practice. He also enjoys teaching on the post-graduate critical care modules.
Qualifications
- Doctor of Philosophy (PhD - nursing), City, University of London, United Kingdom, July 2018 - November 2022
- Postgraduate Certificate (academic practice/education), City, University of London, United Kingdom, 2014 - September 2015
- Master of Science (cardio-respiratory), Imperial College London, UK, 2011 - September 2013
- Diploma in Tropical Nursing, London School of Hygiene & Tropical Medicine, United Kingdom, February - September 2006
- Master of Nursing, University of Nottingham, UK, September 1999 - July 2003
Employment
- Honorary Consultant Nurse, University College London Hospitals NHS Foundation Trust, April 2015 - present
- Honorary Charge Nurse, University College London Hospitals NHS Foundation Trust, United Kingdom, January 2015 - June 2022
- Lecturer in Adult Nursing, City, University of London, United Kingdom, August 2014 - August 2020
Fellowships
- Clinical Doctoral Research Fellowship, Health Education England/National Institute for Health Research, April 2018 - July 2022
Memberships of professional organisations
- Fellow, Higher Education Academy, October 2015 - present
- Nursing & Midwifery Council
Teaching
Module leader
APM052 - Advanced Clinical Assessment, Critical Thinking and Diagnostic Reasoning Across the Lifespan
Contributor
CAM001/CA3001 - Core Concepts in Critical Care
Contributor
CAM002/CA3002 - Dimensions in Critical Care
Publications
Publications by category
Book
- DeVita, M.A., Hillman, K. and Bellomo, R. (Eds.), (2011). Textbook of Rapid Response Systems. Springer New York. ISBN 9780387928524.
Chapter
- Sprogis, S.K. and Smith, D. (2024). Tiered Rapid Response Systems. Textbook of Rapid Response Systems (pp. 161-173). Springer Nature Switzerland. ISBN 9783031679506.
Journal articles (20)
- Virtudazo, M.D., Ede, J., Smith, D. and Pattison, N. (2026). The determinants of nursing staff escalating clinical deterioration out-of-hours: A mixed methods systematic review. International Journal of Nursing Studies, 178, pp. 105406-105406. doi:10.1016/j.ijnurstu.2026.105406
- Smith, D., McIntyre, S. and Sekhon, M. (2026). Acceptability of a behaviour change intervention to improve care of clinically deteriorating patients on acute hospital wards: A theory-based mixed-methods study. Australian Critical Care, 39(1), pp. 101512-101512. doi:10.1016/j.aucc.2025.101512
- Kavanagh-Brown, W., Smith, D. and Bowden, T. (2025). The assessment and management of acute dyspnoea: a case study. British Journal of Nursing, 34(7), pp. 386-391. doi:10.12968/bjon.2024.0455
- Woolfe Loftus, N., Smith, D. and Aitken, L.M. (2025). The Scope of Nurses' Assessment of Deteriorating Patients in Coronary Care Units: A Mixed Methods Study. Journal of Clinical Nursing, 34(4), pp. 1250-1263. doi:10.1111/jocn.17500
- Smith, D., Cartwright, M., Dyson, J. and Aitken, L.M. (2024). Use of nominal group technique methods in the virtual setting: A reflective account and recommendations for practice. Australian Critical Care, 37(1), pp. 158-165. doi:10.1016/j.aucc.2023.09.004
- Smith, D. and Aitken, L.M. (2023). Rethinking the problem of clinically deteriorating patients: Time for theory-informed solutions. Australian Critical Care, 36(6), pp. 925-927. doi:10.1016/j.aucc.2023.09.001
- Hong, J.Q.Y., Chua, W.L., Smith, D., Huang, C.M., Goh, Q.L.P. and Liaw, S.Y. (2023). Collaborative practice among general ward staff on escalating care in clinical deterioration: A systematic review. Journal of Clinical Nursing, 32(17-18), pp. 6165-6178. doi:10.1111/jocn.16743
- Chua, W.L., Smith, D., Wee, L.C., Ting, K.C., Yeo, M.L.K., Mordiffi, S.Z.... Liaw, S.Y. (2023). Development and psychometric evaluation of the Attitudes Towards Recognising Early and Noticeable Deterioration (ATREND) scale. Journal of Clinical Nursing, 32(11-12), pp. 2684-2699. doi:10.1111/jocn.16350
- Williams, G., Pirret, A., Credland, N., Odell, M., Raftery, C., Smith, D.... Massey, D. (2023). A practical approach to establishing a critical care outreach service: An expert panel research design. Australian Critical Care, 36(1), pp. 151-158. doi:10.1016/j.aucc.2022.01.008
- Smith, D., Cartwright, M., Dyson, J., Hartin, J. and Aitken, L.M. (2022). Selecting intervention content to target barriers and enablers of recognition and response to deteriorating patients: an online nominal group study. BMC Health Services Research, 22(1). doi:10.1186/s12913-022-08128-6
- Smith, D., Cartwright, M., Dyson, J., Hartin, J. and Aitken, L.M. (2021). Barriers and enablers of recognition and response to deteriorating patients in the acute hospital setting: A theory‐driven interview study using the Theoretical Domains Framework. Journal of Advanced Nursing, 77(6), pp. 2831-2844. doi:10.1111/jan.14830
- Smith, D., Cartwright, M., Dyson, J., Hartin, J. and Aitken, L.M. (2020). Patterns of behaviour in nursing staff actioning the afferent limb of the rapid response system (RRS): A focused ethnography. Journal of Advanced Nursing, 76(12), pp. 3548-3562. doi:10.1111/jan.14551
- Smith, D., Sekhon, M., Francis, J.J. and Aitken, L.M. (2019). How actionable are staff behaviours specified in policy documents? A document analysis of protocols for managing deteriorating patients. Journal of Clinical Nursing, 28(21-22), pp. 4139-4149. doi:10.1111/jocn.15005
- Smith, D., Francis, J.J. and Aitken, L.M. (2019). DEveloping a Complex Intervention for DEteriorating patients using theoretical modelling (DECIDE study): Study protocol. Journal of Advanced Nursing, 75(9), pp. 2024-2035. doi:10.1111/jan.14076
- Loftus, N.W. and Smith, D. (2019). Investigating ward nurses’ responses to deteriorating patients. Nursing Standard, 34(3), pp. 76-82. doi:10.7748/ns.2019.e11020
- Loftus, N.W. and Smith, D. (2018). Investigating ward nurses’ responses to deteriorating patients. Nursing Standard. doi:10.7748/ns.2018.e11020
- Smith, D. and Bowden, T. (2017). Using the ABCDE approach to assess the deteriorating patient. Nursing Standard, 32(14), pp. 51-63. doi:10.7748/ns.2017.e11030
- Bowden, T. and Smith, D. (2017). An overview of adult cardiopulmonary resuscitation equipment. Nursing Standard, 31(23), pp. 54-63. doi:10.7748/ns.2017.e10461
- Smith, D.J. and Aitken, L.M. (2016). Use of a single parameter track and trigger chart and the perceived barriers and facilitators to escalation of a deteriorating ward patient: a mixed methods study. Journal of Clinical Nursing, 25(1-2), pp. 175-185. doi:10.1111/jocn.13104
- Smith, D. (2012). Counterpulsation in cardiogenic shock: the belief is there but where is the evidence? British Journal of Cardiac Nursing, 7(8), pp. 387-394. doi:10.12968/bjca.2012.7.8.387
Practitioner article
- (2012). Counterpulsation in cardiogenic shock: the belief is there but where is the evidence? British Journal of Cardiac Nursing, pp. 387-395
Professional activities
Clinical activity
- Consultant Nurse - Patient Emergency Response and Resuscitation Team (Critical Care Outreach), University College London Hospitals NHS Foundation Trust, June 2022 - present