1. Introduction and Scope
Coast Medic aims to provide high quality, clinically effective patient care using our resources efficiently. The key objectives of this policy are:
- To ensure all patients receive high quality care by a suitably qualified clinician where appropriate
- To ensure that no patients are abandoned or left without care or access to care
- To ensure compliance to the care quality commission (CQC)
2. Competence
All staff involved in the care and or transportation of patients with Coast Medic must ensure that they can work to the standards as set out by JRCALC, the scope of practice of their professional body and within the scope of Coast Medic policies.
All clinicians employed by the Trust must ensure that they are up to date with current clinical practice.
Coast Medic staff are reminded that registered health care professionals have a responsibility to maintain their knowledge and skills in accordance with their registered body’s Policy:
- Nurses – Nursing and Midwifery Council
- Paramedics – Health Professions Council
- Doctors – General Medical Council
Clinicians who feel that their knowledge and skills fall below the competencies of the Institute of Healthcare and Development (IHCD) should in the first instance contact their line manager.
Coast Medic will assess the training needs which identifies statutory and mandatory training. This training may be in a variety of formats (e.g., in-house, external, work based, briefing, e-learning etc.).
Coast Medic Mandatory Training is required to be completed on an annual basis
3. Transportation of Patients
The destination of the patient must be determined using criteria based upon clinical needs. Attending staff must make a full assessment of the patient before determining where the patient will be taken. Guidance on
The decision of destination will be from the latest version of JRCALC UK ambulance clinical practice guidelines. Staff should consider the clinical needs of the patient, the facilities available at local hospitals and the local pathway agreements. Where a designated destination has been provided, the patient must be conveyed to the precise destination stated upon receipt of the call details. Should subsequent assessment reveal a change in treatment priorities, the initial destination may be revised in the best interests of the patient.
Palliative care patients may have a designated destination such as a hospice-this should be taken into account and contact made with the hospice or palliative care team about appropriate destination if the Patient’s condition is not time critical.
Patients attended as the result of emergency calls where conveyance is deemed necessary, should be conveyed to the nearest appropriate health care facility. There are certain exceptions to this:
- Where the nearest/local Emergency Department does not receive a certain category of patient these patients must be conveyed to the next appropriate Emergency Department.
- When the condition of the patient suggests that rapid access to specialist care will require that they be directly conveyed to a hospital providing that speciality.
- A doctor or other health care professional (HCP) with responsibility for the patient may make a request for the patient to be taken to a designated destination other than the nearest Emergency Department. Staff should comply with the request, if the facility has accepted the patient.
- Should the patient refuse to travel, or it is deemed appropriate to not transport you should refer the patient to another health care professional via your Line Manager.
4. Removal from Scene
Staff should refer to Coast Medic Manual Handling Policy for guidance on how to remove the patient from scene to a conveying vehicle.
Staff must ensure that all efforts are made to protect the privacy, confidentiality and dignity of their patients.
Non-emergency patients who are required on clinical grounds to stay in their wheelchairs during conveyance will only be conveyed in an appropriate vehicle with floor clamps and a safety harness used to secure the patient.
5. En-Route
If a patient is in the care of the service and is deemed critically ill it is expected that the member of staff who is most appropriately trained to deliver extended skills will travel with the patient on the journey to hospital. If several health care professionals are escorting the patient, the attendant may travel in the front of the ambulance but must be prepared to assist the escorting team if required.
6. Upon Arrival/Handover
A verbal handover should be given to the receiving member of staff followed by written patient report form including all relevant clinical and assessment information.
If a discharged patient has been conveyed home, but there is, in the professional opinion of the crew, an inadequate level of support to maintain the patient’s welfare, the crew should inform control.
Before potentially returning the patient to the hospital. The department the patient was collected from should be contacted for appropriate arrangements to be made for the patient, with the responsibility for the
Patient resting with the facility that the patient came from.
7. Patient Groups
Patients are categorised by age into the following definitions by the United Kingdom Resuscitation Council (UKRC)
Adults are defined as patients from 16 years + of age
Children are defined as patients from 1 year to 16 years of age
Infants are defined as patients aged Birth to 1 year
Patients are also categorised by their presenting medical condition into:
Trauma patients are defined as those with injury or shock to the body from violence or accident.
Medical patients are defined as those with a disease or illness.
Mental health patients are defined as those with psychological or behavioural pattern associated with distress or disability that occurs in an individual that is not part of their normal development or culture.
Patients with a disability – Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations. Thus, disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives. (World Health Organisation 2010(WHO)). 10 High Risk Patient Groups.
Patients suffering from any disease that affects cognitive function including patients with Learning Difficulties, Dementia or any disease which may affect a person’s capacity to consent, should be considered a ‘high risk’ patient group.
All callers/patients should be deemed to have the capacity to consent unless assessed otherwise. Some of these patients may lack capacity to consent and a referral to the safeguarding team as per the Safeguarding Policy may be appropriate. Guidance may be sought from a senior Paramedic/Line Manager.
8. Documentation
Appropriate notes MUST be added to the electronic patient reporting system. In the event of software failure, complete a paper PRF and notify the on call manager by phoning the crewline.