Jet Rescue – Medical Escort Policy

This policy sets out practical guidance for Jet Rescue Air Ambulance managers and staff who organize and undertake patient transfers to and from hospitals. The policy is designed to ensure safety for the patient, and the welfare of any member of staff involved in escort duties.

Necessity..

Escorts may be necessary when a patient requires investigation or treatment at a hospital located far away from their current location. The escort may involve accompanying the patient to and / or from the receiving hospital. This may include a short term or long term stay for the patient.

Whatever the circumstances, escorting staff and managers need to be clear about what is expected of them, and their accountability to the patient and their employer. This policy is designed to offer advice and guidance, but cannot cover all eventualities.

General Principles

Assessment and communication of care needs before transfer

Preparation and communication are important. Whether the transfer be planned or unplanned, there should be contact between Jet Rescue Air Ambulance and the receiving hospital before the transfer, to ensure that the patient is expected, and the patient’s care needs have been explained to the receiving hospital.

It is recommended that a referral to the hospital is made in writing, preferably in advance of the journey. In an emergency a phone call may be sufficient, however in all cases a copy of a referral letter should accompany the patient. Medical and nursing notes can be brought with the patient by the escort staff, but should not be left at the receiving hospital as they are the property of Jet Rescue Air Ambulance. If necessary, photocopies of relevant medical and nursing notes should be arranged before the transfer. A transfer form, containing relevant medical and nursing information should also be completed, and can be left with the patient, as long as a copy remains in the Jet Rescue Air Ambulance medical / nursing notes.

An assessment should be made of whether the patient requires an escort, and if so, what level of staff is required. Some patients may be fit enough to travel on their own, using their own transport, or be escorted by a relative or volunteer. At the other extreme, a critical ill patient in ITU may require a full medical team. This decision should be made by the Director of Operations, seeking advice from the medical staff where necessary, and taking into account risk factors.

Duty of care

Jet Rescue Air Ambulance has a duty of care to ensure that its patients are safe. This duty of care continues while the patient is under the care of Jet Rescue Air Ambulance, which would include transit to or from a hospital.

The patient remains in the care of Jet Rescue Air Ambulance, up until the point that handover takes place between Jet Rescue Air Ambulance staff, and the receiving hospital’s staff. At the conclusion of handover, the receiving hospital should assume full responsibility for all care needs of the patient. On completion of the treatment, it should be the responsibility of the receiving hospital to ensure that the patient is reassessed and re-stabilized before handover to Jet Rescue Air Ambulance.

Should the handover be delayed beyond what it reasonably expected, the member of staff escorting the patient should draw the matter to the receiving hospital’s attention, seeking management support where necessary. Should this not resolve the issue, the escort should contact the Jet Rescue Operations Director (or out of hours, the site manager) at Jet Rescue Air Ambulance to seek their advice.

Employment issues

The role of the escorting staff is to:

1) Ensure the patient arrives at the receiving hospital safely

2) Hand over care to the receiving hospital’s staff

3) Accept hand over from the receiving hospital’s staff and to return the patient safely.

As a general rule, an employee of Jet Rescue Air Ambulance would require an employment contract in order to practice on hospital’s premises. In the case of staff visiting a hospital for practice experience or teaching, for example, an honorary contract may suffice, however this is unusual in the case of escorted patients.

As part of their duty of care, Jet Rescue Air Ambulance staff must provide care up and to the point of handover of the patient to the receiving hospital, but once handover has been effected, the receiving hospital can not provide vicarious liability to an escort nurse, unless an honorary contract is in place. Neither can Jet Rescue Air Ambulance be held liable for care given by its own staff on a hospital’s premises, once the receiving hospital has accepted a duty of care for that patient following handover. Staff is therefore strongly advised not to carry out clinical duties once the care of the patient has been handed over, even for a short period of time. They must however ensure the patient is safe before and during the period of handover.

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