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Patient Transport Policy and Procedures

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									                PATIENT TRANSPORT POLICY AND PROCEDURES

                                          Documentation Control

Reference                                     HS/EI/005

Approving Body                                Directors‟ Group

Date Approved                                 3 August 2010

Implementation Date                           3 August 2010

Version                                       4
                                               NUH version 3 (July 2008)
Supersedes

Consultation                                  Primary Care Trust, Finance, Transport
                                              Booking Team, PTS Handover Group,
                                              EMAS

Date of Completion of                         22 June 2010
Equality Impact Assessment

Target Audience                               All staff and public

Supporting Documents and                      Travel Cost Scheme, Traffic
References                                    Management Policy, National Guidance
                                              for Eligibility for Non Emergency Patient
                                              Transport

Review Date                                   April 2013

Lead Executive                                Director of Operations

Author/Lead Manager                           Alan Farrar Deputy Director of
                                              Operations
                                              Jo Tomlinson Asst Head of Property
                                              Services (Land and Property)
                                              Antonia Kingaby, EIA Officer

Further Guidance/Information                  Patient Transport Booking Office
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                                          Contents

Paragraph          Title                                                         Page

1                  Procedure Statement                                           4

2                  Introduction                                                  4

3                  Responsibilities                                              5

4                  Eligibility Criteria                                          6

5                  Patients in Receipt of Mobility Allowance                     7

6                  Financial Assistance                                          8

7                  Escorts/Attendants                                            8

8                  Booking procedure (Monday – Friday)                           9

9                  Bariatric Patients                                            10

10                 Fast Track / Patient with a rapidly deteriorating condition   10

11                 Discharge ( Includes inter hospital transfers/home visits)    10

12                 Special Discharge Situations (On the day requests including   12
                   weekends)

13                 Emergency Inter-Hospital Transfers                            12

14                 How to Book Discharge Transport                               12

15                 Equality and Diversity Statement                              13

16                 Equality Impact Assessment Statement                          14

17                 Environmental Impact Assessment Statement                     14

18                 We Are Here For You Standards Mission Statement               14

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                                          Contents


Paragraph          Title                                                 Page

Appendix 1 Eligibility flow chart                                        16

Appendix 2 Mobility Codes                                                17

Appendix 3 Equality & Environmental Impact Report                        18

Appendix 4 Discharge Flow Chart for Patient with Rapidly Deteriorating   22
           Condition

Appendix 5 Employee Record of Having Read the Policy                     25

                   We Are Here For You Standards Compliance Assessment   26




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1.0     Policy Statement

1.1     Nottingham University Hospital NHS Trust is committed to ensuring that
        the Patient Transport Service provided to the Trusts patients is a high
        quality, punctual and professional Service that will support and
        complement the provision of health care at Nottingham University
        Hospitals NHS Trust and meets the needs of the patients we serve.

1.2     We will do this with our partners who commission and or provide patient
        transport.

1.3     Whatever the role we play, NUH will ensure that‟s its staff are always
        respectful of people‟s individuality, privacy and dignity, that we take the
        time to listen and hear what people say, we take ownership of
        delivering the help that is required, we look and behave
        professionally. We involve patients/carers as partners, helping them to
        be clear about their condition, choices, care plans and how they might
        feel. We understand the important role that patients‟ and family‟s
        feelings play in helping them feel better and aim to offer a responsive
        service, simplify processes and work to solve patients/carers
        frustrations.

2.0     Introduction

2.1     This document provides information for all members of staff and the
        public: information needed to provide a quality, punctual and
        professional Patient Transport Service that will support and
        complement the provision of health care at Nottingham University
        Hospitals NHS Trust.

2.2     Non-Emergency Patient Transport will only be approved and arranged
        where it has been identified by the patients GP or Consultant that
        the patient‟s health would suffer through the use of public or private
        transport and there is a clear medical need. As per the national policy
        for eligibility for non emergency patient transport


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2.3     Each patient should be able to get to and from the hospital in a
        reasonable time and in reasonable comfort without detriment to their
        medical condition.

2.4     Non –emergency patient transport should be the exception not the rule,
        therefore there must be strict adherence to the procedure

2.5     This service is only provided to patients receiving treatment from/or at
        Nottingham University Hospitals NHS Trust.

3.0     Responsibilities

        * Trust Board - is responsible for ensuring a professional transport
        service which meets the needs of the patients.

        * Primary Care Trust (PCT) - are the commissioners for the service and
        will ensure the service is fit for purpose.

        * Delete as appropriate

3.1     Chief Executive - is ultimately accountable for ensuring the patients
        experience when visiting the hospital is a positive one.

3.1.1 Although the Patient Transport Service is provided by the Primary Care
      Trust. The Chief Executive delegates to the Operations Director the
      responsibility of ensuring that the service provided does not impact
      on the patient experience or service delivery.

3.2     The Primary Care Trust - shall have management responsibility for
        PTS.

3.3     Transport Booking Officers – shall be responsible for accurate
        booking of transport, helping to minimize abortive journeys and
        ensuring appropriate application of the eligibility criteria.
        All reasons for granting and refusing transport must be clearly
        documented on the booking system.
        They will take into account details contained within the notes section of
        the booking to ensure that all relevant details are taken into account
        when reviewing transport needs and or modes of transport.
        Access to book on line will only be granted once training has been
        passed. Training will be facilitated by the provider.

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3.4     Individual NUH Members of Staff - shall be accountable for ensuring
        they abide by the Patient Transport Procedures. This is applicable to
        all forms of Transport used for moving patients into or from the Trust.
        Staff should ensure that all requests are assessed against the eligibility
        criteria and abortive journeys minimised.




3.4.1 Access to book on line will only be granted once training has been
      passed. Training will be facilitated by the provider. All reasons for
      granting and refusing transport must be clearly documented on the
      booking system.

3.5     Transport Providers – all staff engaged with transporting patients in to
        and out from the Trust shall ensure that they minimize abortive
        journeys and ensuring that the eligibility criteria has been appropriately
        applied. The Transport Providers will be monitored against key
        performance indicators established by the PCT to ensure that the
        service commissioned is provided.

3.6     Contract review group - This PCT lead group meets to discuss those
        contracts that the trust holds and participates in at PCT review
        meetings with the patient transport providers

3.7     East Midlands Ambulance Service (EMAS) is the sole provider of
        Patient Transport Services (PTS) and responsible for ensuring that
        services are available at all times, this includes procuring additional 3rd
        party transport providers when required.

3.8     They will be responsible for the management of their vehicles and will
        comply with the NUH policy on Traffic Management.

4.0     Eligibility Criteria

4.1     Patients attending hospital appointments do not have an automatic right
        to non – emergency patient transport

4.2     It is the patients‟ responsibility to make their way to and from hospital.

4.3     However, transport will be provided, but only if a clear medical need
        has been identified either by the patients GP or Consultant Further
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        clarification may be sought from the GP or Consultant by the booking
        team when reviewing travel options and or criteria.

4.4     For non – emergency patient transport, the patient‟s identified medical
        needs should be identified as one of the following criteria:

        The patient requires skilled assistance when transferring to and from a
        vehicle, (for example, being on a stretcher, due to dementia, physical
        disabilities or mental capacity issues).

        The patient has a disability or condition that makes it difficult,
        impossible or undesirable for them to be conveyed by alternative
        transport, (for example dementia, physical disabilities or mental
        capacity issues)

        The patient has a condition whereby skilled assistance during the
        journey may be required, (for example severe epilepsy, dementia)

        Stretcher Patients.

        The patient has a disability or condition that may result in risk or
        embarrassment to the patient or others during transport, (for example
        severe epilepsy, dementia and mental capacity issues).

4.5     For those who do not meet the eligibility criteria, other transport options
        must explained, for example the Medilink service or public transport
        Options. These can be found on the Trust intranet
        http://www.nuh.nhs.uk/patients-and-visitors/transport/default.aspx

4.6     The WRVS also supplies a Volunteers car driver‟s transport scheme,
        providing transport services for patients and visitors in need. To
        Contact the WRVS Voluntary Drivers Scheme Tel: 0115 924 9924
        extension 63393

5.0     Patients in receipt of Mobility Allowance

5.1     What is Mobility Allowance?

5.1.2 Mobility Allowance is the second component of the Disability Living
      Allowance (DLA) and is used to pay for the cost of your travel either by
      taxi or public transport, or with the Motability Scheme you exchange
      your mobility allowance for a car.
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5.1.3 Patients in receipt of Mobility Allowance should make their own way to
      hospital and are not automatically entitled to none emergency patient
      transport unless a clear medical need has been identified. (Please refer
      to point 4.0 regarding eligibility criteria)

5.2     Phone number and web site details of DLA

        Disability Living Allowance Unit
        Warbreck House
        Warbreck Hill
        Blackpool
        Lancashire
        FY2 0YE

        Phone number (Helpline) 08457 123 456
        Text phone 08457 224 433

        Opening Hours: Monday to Friday 7.30 am to 6.30 pm

6.0     Financial Assistance

6.1     Patients who do not fit the eligibility criteria for non emergency patient
        transport may obtain a cash refund for travel to the hospital when
        travelling by public transport or private car, if they are in receipt of
        one of the following:

        Income support

        Working families tax credit

        Income-based job-seekers allowance

6.2     Patients arriving by public transport must bring the receipt/ticket and
        their proof of benefit with them. They must go to hospital administration
        offices at either campus to make their claim.

6.3     Patients arriving by private car may be able to apply for petrol costs
        current rate per mile up to the cost of public transport fare. Proof of
        benefits must also be provided at the time of the claim.

6.4     Further details of the hospital travel cost scheme can be found at
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        http://www.nuh.nhs.uk/patients-and visitors/transport/

7.0     Escorts/Attendants

7.1     Escorts/attendants are allowed to accompany patients in non –
        emergency patient transport as long as the escort/attendant fits into
        one of the following criteria and the patient has a clear identified
        medical need as outlined in point 4.4

        Professional from a nursing home or school

        Accompanying a minor (under 16 years of age). The escort/attendant
        for a minor must be a responsible adult.

7.2     Accompanying a patient with special needs e.g. the patient is aphasic,
        blind, confused, has learning disabilities or needs skilled assistance for
        the journey

8.0     Booking Procedure – Monday - Friday
        Outpatients, Admissions, Day Cases,

8.1     A minimum of 24 hours and maximum of 4 weeks notice is required to
        register a request for none – emergency patient transport

8.2     ANY CANCELLATION NOT NOTIFIED WITHIN 24 HOURS MAY
        RESULT IN ADDITIONAL CHARGES BEING RAISED AND OR A
        DISRUPTION TO OPERATIONAL SERVICES.

8.3     This can have a far reaching effect on the level of patient care such as:
        Increased cost
        Delay in treatment
        Missed appointments
        Increased waiting times

8.4     If your Consultant or GP have advised that you have a medical
        condition that may entitle you to none emergency patient transport,
        the patient or their representative should contact the Transport
        Booking Office on 0115 840 5898 between the hours of 9.00am –
        4.00pm, Monday to Friday.

8.5     It is vital that the patient or their representative states if the patient will
        require an escort/attendant to be with them and on which part of the
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        journey. (Please refer to section 7 for eligibility criteria for
        escorts/attendants)

8.6     If specialist equipment is required for use by the patient during the
        journey, the patient or their representative must state this when making
        the booking for none emergency patient transport.

8.7     Patients may travel in specially adapted wheelchairs if they have them.

8.8     Patients, who are able to transfer from a wheelchair to a seat, will not
        be able to bring their own wheelchair. Wheelchairs are available on
        arrival at hospital.

8.9     If the patient‟s mobility will differ on the homeward journey please make
        this clear when making the booking.

8.10 If a patient needs to be admitted to the main hospital from the Day
     Surgery Unit, contact ambulance control x 40424.

8.11 Day Hospitals should make bookings directly with the transport
     provider. (Please do not forget to cancel a „regular‟ booking if one
     day‟s journey is not required for any reason)

8.14 The Trusts named taxi provider must not be used for the transportation
     of patients. All PTS journeys should be provide by EMAS

9.0     Bariatric Patients. Bariatric Patients are those greater than 21 stone
        in weight, although weight must not be the only consideration the
        patients build must also be assessed. Therefore, EMAS will need to
        undertake a risk assessment prior to transportation. 24 hours notice
        within the East Midlands and 48 Outside is required.

10.0 Fast track/ Patient with a Rapidly Deteriorating Condition
     EMAS are committed to providing a quick service for these patients.
     The procedure for Fast Track booking is:
       Telephone PTS Control Room on 0115 9296481 rather than book
       online
       Ask to speak to a team leader
       Provide with relevant information:
       DNAR status –
       Consider if family wish to travel with patient
       Consider the need for direct transfer
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             Consider if Oxygen is needed
             Consider mobility is a stretcher needed.
             Contact Hospital Palliative Care Team (City campus ext 54977 /
             QMC campus ext 68402) if you require any further guidance
             The information sheet at Appendix Four must be completed and
             followed in all cases.

11.0 Discharge (includes inter hospital transfers and home visits)

11.1 A patient‟s journey home should be discussed with the patient upon
     admission. It is expected that all patients will make their own
     arrangements unless there is a medical need for non – emergency
     patient transport.

11.2 Where medical need has been identified, transport should be booked in
     advance of the discharge date where possible. If the discharge address
     is „out of the East Midlands‟ if possible 48 hours notice should be given
     and it may be that the patient can only be discharged at the weekend.

11.3 A patient with a date for elective surgery and where it is known they will
     be in hospital for less than 48 hours and they live „out of the East
     Midlands‟ should have their discharge transport arranged prior to their
     admission. The eligibility for transport must be established at pre–op
     assessment, and duly cancelled if appropriate, by the member of staff
     receiving the information.

11.4 Discharge transport after an emergency admission must be ordered as
     soon as possible after discharge date is known.

11.5 It is the responsibility of ward staff to notify the transport provider that
     the patient is ready to leave the ward.

11.6 The patient is not ready to go until all of the following are in place: -
        Medication
        Doctor‟s letter
        Home care package
        Therapy aids
        DNAR (“Do not attempt resuscitation”) paperwork

11.7 The patient must be „made ready‟ with the transport provider. The ward
     should ensure that the patient is ready to leave at the time they are
     booked. Any delays caused or arrivals outside of the agree times must
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        be reviewed either internally or with the provider to ensure re –
        occurrence is minimised.

11.8 If the patient is not ready to leave the ward when the ambulance crew
     arrives, the crew is not required to wait.

11.9 The patient‟s discharge could be delayed for at least 24 hours with the
     obvious implications for the ward and the waiting list.

11.10 NO PHONE CALL BOOKINGS WILL BE ACCEPTED. The only
      accepted method of booking is PTS Online or when the system is down
      fax. Any fault with the system must be reported to EMAS immediately
      on 0115 9193477 (office hours).


11.11 DNAR paperwork must be completed at ward level and travel with the
      patient. The transport provider will also need to know who is aware of
      the order i.e. the patient / relatives etc.

11.12 The transport provider must be notified of any communicable illness
      such as MRSA and Clostridium Difficile.

12.0 Special Discharge Situations
     On the day requests, including weekends

12.1 It will be necessary to contact the EMAS control room ext (77)40424. It
     must be stressed that the patient MUST be ready for discharge, as
     described above, before this request is made.

12.2 Inter hospital transfers/home visits are dealt with in the same way as a
     discharge. If the receiving hospital is a long distance away, extra time
     must be given to the ambulance service. At least 48 hours notice must
     be given.

12.3 Long Distance discharges/transfers must be discussed with EMAS
     liaison staff prior to making a booking. At least 48 hours notice must be
     given.

12.4 Weekend discharge/transfers must be booked on the day by calling the
     EMAS control room

13.0 Emergency Inter Hospitals Transfers
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13.1 A patient who requires specialist treatment on the journey from the
     hospital e.g. a patient with intravenous drips in situ, a patient with
     uncontrolled epilepsy or unconfirmed fractures, will be transported by
     the accident and emergency department of EMAS by contacting 0115
     9297517

14.0 How to Book Discharge Transport

14.1 Only the staff designated by the Ward Manager or their deputy may
     make transport bookings.

14.2 Refer to Appendix 3 to establish patient‟s mobility needs (never use the
     wheelchair option UNLESS the patient has his/her personal wheelchair
     with them on the ward).

14.3 Please use the PTSonline system wherever possible. You may use
     printed form SN789 in person to EMAS

14.4 Each time the patient requests transport they must be asked if anything
     has changed since their last visit regarding their mobility or condition.
     These changes must be recorded on the booking system.

14.5 Highlight any special instructions. E.g. Any infectious disease, DNAR,
     MRSA (identify site, is it covered?), C Diff. Oxygen (how much).

14.6 It is important that the any access difficulties (like steps) at the home
      address are identified. Does the patient need to be carried upstairs?

14.7 Book any equipment to travel with the patient e.g. walking frame.

14.8 Note that only one small bag will be carried in the transport. Relatives
     must remove all other luggage. In special circumstances and after
     negotiation with EMAS extra luggage may travel with the patient.

15.     Equality and Diversity Statement

15.1 All patients, employees and members of the public should be treated
     fairly and with respect, regardless of age, disability, gender, marital
     status, membership or non-membership of a trade union, race, religion,
     domestic circumstances, sexual orientation, ethnic or national origin,
     social & employment status, HIV status, or gender re-assignment.
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15.2 All trust polices and trust wide procedures must comply with the
     relevant legislation (non exhaustive list) where applicable:

        Equal Pay Act (1970 and amended 1983)
        Sex Discrimination Act (1975 amended 1986)
        Race Relations (Amendment) Act 2000
        Disability Discrimination Act (1995)
        Employment Relations Act (1999)
        Rehabilitation of Offenders Act (1974)
        Human Rights Act (1998)
        Trade Union and Labour Relations (Consolidation) Act 1999
        Code of Practice on Age Diversity in Employment (1999)
        Part Time Workers - Prevention of Less Favourable Treatment
        Regulations (2000)
        Civil Partnership Act 2004
        Fixed Term Employees - Prevention of Less Favourable Treatment
        Regulations (2001)
        Employment Equality (Sexual Orientation) Regulations 2003
        Employment Equality (Religion or Belief) Regulations 2003
        Employment Equality (Age) Regulations 2006
        Equality Act (Sexual Orientation) Regulations 2007

16.     Equality Impact Assessment Statement

16.1 NUH is committed to ensuring that none of its policies, procedures,
     services, projects or functions discriminate unlawfully. In order to
     ensure this commitment all policies, procedures, services, projects or
     functions will undergo an Equality Impact Assessment.

16.2 Reviews of Equality Impact Assessments will be conducted inline
     with the review of the policy, procedure, service, project or function

17.     Environmental Impact Assessments

17.1 The purpose of an Environmental Impact Assessment is to make
     sure that when carrying out its public functions (or implementing
     policies and practices related to those functions) the trust
     considers the likely impact of the policy or procedure in causing change
     to the environment, and whether this change is harmful or helpful.

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17.2 This may involve direct effects such as changes in the use of
     resources, waste levels, or energy, (as some examples). Further
     guidance on environmental impacts may be found in: Sustainable
     Development - Environmental Strategy for the National Health
     Service (www.dh.gov.uk) and Sustainable Operations on the
     Government Estate (www.defra.gov.uk ).

17.3 Policies will not be accepted for ratification without a completed
     Environmental Impact Assessment.

18.     We Are Here For You Standards mission statement:

18.1 This Trust is committed to providing the highest quality of care to our
     patients, so we can pledge to them that „we are here for you‟. This Trust
     supports a patient centred culture of continuous improvement delivered
     by our staff. The Trust established the Values and Behaviours
     programme to enable Nottingham University Hospitals to continue to
     improve patient safety, outcomes and experiences. The set of twelve
     agreed values and behaviours explicitly describe to employees the
     required way of working and behaving, both to patients and each other,
     which would enable patients to have clear expectations as to their
     experience of our services




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                                           Assessing Patient/Escort eligibility for patient transport.
 Appendix 1                                                                 Start
                                                                    Does the patient believe
                                                                                                             Does the patient claim mobility
                    Does the patient require skilled         YES   there is a medical reason       NO                                                   YES
        YES                                                                                                           allowance?
                  assistance to and from the vehicle?                 for booking Hospital
                                                                           transport?                                        NO
                                      NO
                                                                                                        Does the patient have their own transport       YES
              Does the patient have a disability or           CLAIMING TRAVEL EXPENSE                    or a friend/relative that could help out?
              condition that makes it impossible or
        YES
            undesirable to be conveyed by alternative         The patient may obtain a cash
                                                                                                                             NO
                            transport?                        refund for travel to the hospital
                                                              when travelling by public transport
                                      NO
                                                              OR private car IF they are in receipt     Is own/friend/relative transport available if   YES
                                                              of one of the following:                      we change the appointment time?
                Does the patient have a condition such
               that there is a reasonable possibility that
        YES                                                       Income Support                                            NO
              an event could occur during transport that
                                                                  Working Families tax credit
                   would require skilled assistance?
                                                                  Income based Job Seekers                 Has the patient considered public           YES
                                      NO                           Allowance                                           transport?
                Does the patient have a disability that       If they arrive by public transport                             NO
               may result in their condition or behavior           the ticket must be produced
        YES
                 during the transport being a risk or              along with proof of benefit
              embarrassment to themselves or others?               received. The claim may then           Why not - expense or inconvenience? INCONVENIENCE
                                                                   be made at Hospital
                                      NO
                                                                   Administration.                                        Expense
               Could the patients confused state or lack
        YES    of motivation result in non attendance if      If they arrive by private car they        Get travel expenses reimbursed
                               unaided?                            may apply for expenses.                      - see notes (left)
                                      NO                     Where patients have „yes‟ or
               Patient does NOT qualify for Hospital         „inconvenient‟ to these questions             Patient must make arrangements
                                                             they should make their own way or             using own vehicle, lifts or public
                             transport
                                                             using their own or public transport.       transport, and must be reminded that
                                                             They must be reminded that hospital          hospital transport is for those with
                            Book Transport                   transport is for those with medical                  medical need ONLY
                                                             needs only.




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Appendix Two


New or                    Patient Mobility code               Use of Mobility code explained
Replacement               explained
Code
                                                              Journeys by Voluntary Car Service/Out of
C                         Fully Mobile - Car transport        area Journeys/Journeys transported by
                                                              Private Hire
C1                        Fully Mobile - Car transport        Ambulance Car (PTD)

A1                        Fully mobile - unable to get into a Single Crew Ambulance - no attendant
                          car - single crew

                          Hand seat patient - able to
                                                              Double Crew Ambulance - Driver and
A2                        transfer/travel in a normal
                                                              attendant
                          ambulance seat but requires the
                          assistance of a double crew

                          Own wheelchair (wheelchair
                          bound) patient unable to transfer
                                                              Single Crew Ambulance with ability to
WC1                       or travel in a normal seat within
                                                              transport patient in own wheelchair
                          ambulance - Access to and from
                          property manageable by one
                          person ONLY
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                          Own wheelchair (wheelchair
                                                               Double Crew Ambulance with ability to
                          bound) patient unable to transfer
WC2                                                            transport patient in own wheelchair - Driver
                          and travel in a normal seat within
                                                               and Attendant
                          ambulance - due to
                          access/egress - medical need
                                                             Double Crew Ambulance with stretcher
ST                        Stretcher required - Patient
                                                             facility
                          needs to lay during transportation

                          A&E Ambulance
AE                                                             A&E Ambulance Technician/Paramedic
                          Technician/Paramedic trained
                                                               trained staff required due to medical need
                          staff
NP                        Non Patient Transport




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Section One: Equality and Environmental Impact Assessment                                             Appendix 3


What is being assessed?                                          Is the policy/function/service/project

Policy           Guideline              Procedure    Plan    Existing             Proposed 

Service                                                         Changing/Reviewed 

Name of Policy or Service                                        Is the policy/guideline/procedure/plan/service being
Non – Emergency Patient Transport                                assessed relevant to:

Name of Responsible Manager                                      Staff          Patients        Stakeholders 
Alan Farrar
                                                                 Environment 

Give a brief description, aims and objectives of the             Will there be a requirement to consult on the
Policy/Guideline/Procedure/Plan/Service                          proposed Policy, Guideline, Procedure, Plan or
This policy provides information for all members of staff        Service?
and the public on the use of Non-Emergency Patient
Transport. Transport will only be approved and arranged          Yes            No 
where it has been identified by the patients GP or
Consultant that the patient‟s health would suffer through        If Yes who will be consulted?
the use of public or private transport and there is a clear
medical need. As per the national policy for eligibility for     Staff          Patients        Stakeholders 
non emergency patient transport

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Section Two: Screening Checklist


Does your Policy, Guideline, Procedure,                 YES                             NO
Plan or Service contain any statements or If “Yes” please complete the   If “No” please give reasons on
actions which may potentially impact      Full Impact Assessment in      the summary sheet in section 3
upon any of the following Areas?          section 4
                                                EQUALITY
Age
Gender (Male, Female and Transsexual)                                                  No
Race                                                                                   No
Sexual Orientation                                                                     No
Religion or Belief                                                                     No
Disability                                                                             No
Dignity & Human Rights                                                                 No
Working Patterns                                                                       No
Social Deprivation                                                                     No
                                             ENVIRONMENTAL
Air                                                     Yes
Land                                                                                   No
Water                                                                                  No
Resource Depletion                                     Yes

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Section Three: Summary of Screening

COMPLETE THIS SECTION IF YOU HAVE ANSWERED “NO” IN THE SCREENING SECTION


Please state your reasons below giving as much information as possible including any relevant data to
support your findings

Equality                           The Patient Transport Procedure does not discriminate against any of the equality strands as
                                   the criteria states that eligibility is on identified medical grounds.

Environment                        There is no identified impact on land or water


Date EIA Completed                 Please state the monitoring and review           State the names of those involved in the
                                   arrangements:                                    EEIA assessment:

21 June 2010                       Once ratified this procedure should follow       Name                 Position
                                   NUH guidelines for review.                       A Kingaby            EEIA Officer
                                                                                    P Peck               Travel and Security
                                                                                                         Co-ordinator


Once completed this section will be added to the policy with section 1 (if you identified both “yes” and “no”
include sections 1, 3 and 4) as the penultimate appendix to the policy.


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  Section Four: Full Impact Assessment Plan
  COMPLETE THIS SECTION IF YOU HAVE ANSWERED “YES” IN THE SCREENING SECTION

     Equality/                        Potential/Possible    Action Required          Target   Responsible      Expected
Environmental Area                    Impact identified                               Date     Person/s        Outcome

Air                                Emissions from vehicles Ensure that all       ongoing      EMAS          Better fuel
                                                           vehicles are                                     usage
                                                           serviced on a
                                                           regular basis in-
                                                           line with SLA

Resource Depletion                 Natural depletion of     No action required                EMAS
                                   vehicles used for        as the
                                   transport                depletion/renewal
                                                            of vehicles is a
                                                            natural process
Once completed this section will be added to the policy with section 1 (if you identified both “yes” and “no”
include sections 1, 3 and 4) as the penultimate appendix to the policy.
Date EIA Completed State the names of those involved in the EEIA assessment:
                       Name                                              Position
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                                   A Kingaby   EEIA Officer
21 June 2010                       P Peck      Travel and Security Co-ordinator




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                                                                                    Appendix Four
Name:
ID Number:
    Insert Patient Sticker



                                   Discharge Flow Chart
                              Patient with a Rapidly Deteriorating Condition
          Name (Print)                  Full Signature    Initials         Profession                 Date




                    Please tick relevant boxes as appropriate                            Date / initial

   Fast Track
   Fast Track eligible - Complete & fax Fast Track referral form with
   information on prognosis & care needs required
   City Fast track Co-ordinator          0115 8834740
                                        Fax 0115 8834725
   County Fast Track Co-ordinator        01623 673643 / 673639
                                        Fax 01623 672568
   Other - State:                       
                                        Fax

   Place of Discharge
   Home □            Nursing Home □          Residential Home □       Relatives Home □

   Patient & Family / Carer Understanding
   Patient aware of diagnosis
   Carer aware of diagnosis
   Patient aware of prognosis
   Carer aware of prognosis
   Confirm understanding of plan of care (fast track) / future care

   Environment - If any of the following apply discuss with community team
   Does the patient live alone- can the nurse gain access □
   Smoking patient/carer                                    □
   Alcohol misuse patient/carer                             □
   Aggression patient/carer                                 □
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Equipment – OT referral                            Requested               Supplied
Bed & mattress                                          □
Commode/urinal/catheter & stoma bags/pads               □
Hoist & training                                        □
Mouth Sponges/gloves/aprons/sheets                      □
Syringe driver & key for locked box / Syringes          □
Other:                                                  □
Care Needs- Social Work referral
Assess care needs over a 24 hour period & discuss with family / carer
Clarify package of care & document on patient / carer discharge information
sheet

Community Referrals
District Nurse –  DN referrals 0115 8833111 / 0115 8462377 (Out of Hours)
with verbal update (medication requirements / need for sitter service / syringe
driver use)
Fax written referral to District Nurse
GP –  Provide verbal update & discuss NEMS - Out of hours registration via
Special Patient Note / GSF status / Registration of End of Life Care Decision
Form / Anticipatory prescribing
Fax written referral to GP
Nurse Specialist – referral & verbal update if required
For Nottingham City PCT Care Home discharges  EOLC Implementer 0115
8834786 ext 34787

Transport                                                                         Date/initial
Confirmed date / time of discharge: ___ / ___ / ___ @ _____ hours
Fax End of Life Care Decision Form to EMAS prior to discharge as relevant
EMAS  0115 9296481 & speak to team leader relating to the following as
appropriate
Rapidly deteriorating & wish for care at home           □
Single patient travel direct to destination             □
Family requesting travel with the patient               □
Place of care (upstairs/downstairs)                     □
Additional equipment i.e. oxygen/syringe driver         □
Medication – pre-emptive prescribing for symptoms
Dosette                                                 □
Subcutaneous prn medication (last days of life)         □
Syringe driver                                          □
Water for injection for s/c meds                        □
Oxygen - Complete HOOF                                  □
Fax HOOF 0800 214709
 0800373580 - to confirm installation
Wound dressings/catheters/sheaths                       □
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Patient & / or carer understanding of medication             □
Fax TTO form to District Nurse & GP

If plan coordinated by discharge coordinator, arrangements /
plan confirmed by registered nurse prior to discharge

Date/Time                                 Additional information   Initial




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                                                             Appendix Five

           EMPLOYEE RECORD OF HAVING READ THE PROCEDURE
              PATIENT TRANSPORT POLICY AND PROCEDURES

I have read and understood the principles contained in the named procedure.


Print Full Name:                      Signature:   Date:




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                                                     We Are Here For You
                                                    Compliance Assessment


To what extent is your Policy or Trust-wide Procedure affected by the following We
Are Here For You values?

Please rate each value from 1 – 3 (1 being not at all, 2 being affected and 3 being very
affected)

1.    Polite and Respectful                                  3
Whatever our role we are polite, welcoming and positive
in the face of adversity, and are always respectful of
people‟s individuality, privacy and dignity.

2.   Communicate and Listen                                  3
We take the time to listen, asking open questions, to hear
what people say; and keep people informed of what‟s
happening; providing smooth handovers.

3.     Helpful and Kind                                      2
All of us keep our „eyes open‟ for (and don‟t „avoid‟)
people who need help; we take ownership of delivering
the help and can be relied on.

4.   Vigilant (patients are safe)                            3
Every one of us is vigilant across all aspects of safety,
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practices hand hygiene and demonstrates attention to
detail for a clean and tidy environment everywhere.

5.    On Stage (patients feel safe)                          2
We imagine anywhere that patients could see or hear us
as a „stage‟. Whenever we are „on stage‟ we look and
behave professionally, acting as an ambassador for the
Trust, so patients, families and carers feel safe, and are
never unduly worried.

6.    Speak Up (patients stay safe)                          2
We are confident to speak up if colleagues don‟t meet
these standards, we are appreciative when they do, and
are open to „positive challenge‟ by colleagues.

7.     Informative                                          1
We involve people as partners in their own care, helping
them to be clear about their condition, choices, care plans
and how they might feel. We answer their questions
without jargon. We do the same when delivering services
to colleagues.

8.     Timely                                                3
We appreciate that other people‟s time is valuable, and
offer a responsive service, to keep waiting to a minimum,
with convenient appointments, helping patients get better
quicker and spend only appropriate time in hospital.
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9.    Compassionate
We understand the important role that patients‟ and          2
family‟s feelings play in helping them feel better. We are
considerate of patients‟ pain, and compassionate, gentle
and reassuring with patients and colleagues.

10. Accountable                                              3
Take responsibility for our own actions and results

11. Best Use of Time and Resources                           2
Simplify processes and eliminate waste, while improving
quality

12. Improve                                               2
Our best gets better. Working in teams to innovate and to
solve patient frustrations

Total Score                                                  28




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