SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

should be provided with appropriate advice and information on where to access follow-on ED
care, and discharged from the UCC. The receiving ED should be informed that the patient
will be attending and the patient should be provided with a case-number to ensure that they
do not have to repeat registration and assessment on arrival at the ED.
The E&UC CIG recognises that some stable, non-emergency patients will be unable to make
their way to an alternative service safely (for example, some paediatric patients). In this
instance, the UCC will be expected to confer with the patient in order to come to a decision
on whether safe transport is required. Where safe transfer is needed, the UCC provider will
be responsible for arranging the transport of the patient.
In line with Department of Health guidance 11 a non co-located UCC patient requiring transfer
to an ED will be regarded as eligible for safe transport if they comply with any of the
following minimum criteria:
• Where the medical condition of the patient is such that they require the skills or
support of Patient Transport Service (PTS) staff on/after the journey and/or where it
would be detrimental to the patient‟s condition or recovery if they were to travel by
other means
• Where the patient‟s medical condition impacts on their mobility to such an extent that
they would be unable to access healthcare and/or it would be detrimental to the
patient‟s condition or recovery to travel by other means
• Recognised as a parent or guardian where children are being conveyed
• PTS will also be provided to a patient‟s escort or carer where their particular skills
and/or support are needed e.g. this might be appropriate for those accompanying a
person with a physical or mental incapacity, vulnerable adults or to act as a
translator.
Please note that the Shaping a healthier future Travel Advisory Group is currently reviewing
the whole issue of patient transfer, with the aim of increasing patient convenience. The
outcome of this work may result in a revision of these recommendations.
Emergency (‘999’) transfers
A small number of patients will require urgent, „blue light‟ transfer to an ED or specialist
acute unit (e.g. suspected cardiac). Where this occurs, the E&UC CIG recommends that
transport is provided by the London Ambulance Service (LAS). To ensure patient safety, the
E&UC CIG recommends that any Service Level Agreement with the LAS should include the
following requirements:
LAS response time should be the same as when responding to a „999‟ emergency
in an out of hospital setting (i.e. a maximum of 8 minutes). The necessity for this
response standard will be kept under review
LAS ambulances should be appropriately crewed, such that UCC staff will not be
required to accompany the patient during transfer
Responsibility for deciding where a patient should be transported to should lie with
the LAS. This decision should be made according to their knowledge of the
diagnosis and in line with their internal protocols 12
In line with CEM guidance, the LAS should not consider the UCC to be a „place of
safety‟ for prioritisation purposes 13 .
11 „Eligibility criteria for Patient Transport Services (PTS)‟; Department of Health; September 2007
12 „Building the evidence base in pre-hospital urgent and emergency care. A review of the research evidence and
priorities for future research‟ – Janette Turner; University of Sheffield, 2011
13 „Unscheduled Care Facilities - Minimum requirements for units which see the less seriously ill or injured‟ –
College of Emergency Medicine, July 2009
7b. Work of the Emergency and Urgent Care CIG 171