ambulance volunteer car service policy and procedures

Ambulance Volunteer Car Service Policy and Procedures

Document Profile Box Document Reference: QSSD 615 Version: 0001 Ratified by: Date ratified: Name of originator/author: Les Mullen Name of responsible committee/individual:

Date issued: Review date: Target audience: Volunteers in Ambulance Car Service Document owner: Authorised signatory:

North East Ambulance Service NHS Trust Ambulance Car Service Policy And Procedures

Ref: QSSD 615 Version: 0001 Status: Draft Issue Date: August 08

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Contents

Section Page 1 Introduction 3

2 Context 3

3 Selection of Volunteer 3

4 Local induction 4

4.1 Content 4

4.2 Utilisation 5

4.3 Induction Attendance 5

4.4 Induction Training Compliance 5

5 Volunteer Agreement 5

5.1 Payment of Expenses 5

5.2 Driving Licence 6

5.3 Insurance 6

5.4 Availability 7

5.5 Physical / Mental Fitness 7

5.6 Vehicles 7

5.7 Driving Skills 8

5.8 Training 8

5.9 Service Specification and Code of Conduct 8

6 Equality and Diversity Statement 12

7 Documentation Requirements 12

8 Management of the Service 13

9 Monitoring compliance with the effectiveness of procedural documents 13

10 Consultation approval and ratification process 14

11 Dissemination and implementation 14

Appendices

Appendix A Volunteer Code of Conduct 15

Appendix B List of Trust Designated Officers 19

Appendix C ACS Travel and Subsistence Rates and Allowances 20

Appendix D Explanation of the Law relating to the Use of Handheld Mobile Devices whilst Driving 22



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Section Page Appendix E Risk Management – General Policy Statement 24

Appendix F Confidentiality 26

Appendix G Infection Prevention and Control 27

1. INTRODUCTION

This policy sets out the arrangements within the North East Ambulance Service NHS Trust (the Trust) for the operation of the Ambulance Car Service (ACS) and addresses the following:

• Selection of volunteers. • Terms and conditions of Volunteering. • Role of volunteers, operating instructions and code of conduct. • Operational management. • Monitoring arrangements. • Operational audit.

Note :

The Ambulance Car Service is a Voluntary Role, and as such does not constitute any Contractual arrangement or any Contract of employment, stated or implied, with The North East Ambulance Service NHS Trust.

All Volunteers are required to declare a clear understanding of the Volunteer Status, by signing and returning a copy of this policy.

All Volunteers will also be acknowledging that they may cease to be available as a Volunteer at any time, and the Trust may also cease to use, without being required to give any formal notice.

2 CONTEXT

2.1 The Trusts’ Patient Transport Service (PTS), provides a range of transportation for non-emergency patients travelling between their homes, hospitals, clinics and community units. The purpose of the journeys covers a variety of activities such as outpatient visits, treatment, admission, discharge and transfer, with all activity being co-ordinated through Patient Transport Controls at Ambulance Headquarters.

2.2 The criteria for patients’ use of PTS is based on clinical, social and demographic needs under guidance issued by the NHSME (HSG (91)29). Clinical need must be determined by a doctor, dentist or midwife on the principle that each patient should be able to reach hospital in a reasonable time and in reasonable comfort without detriment to their medical condition.

2.3 The Trusts’ PTS service is, in the majority of cases, delivered by the Trusts’ own staff with the Trusts’ own vehicle fleet. This service is supplemented by the ACS operated by volunteers using their own vehicles. These volunteers are unpaid and not employed by the Trust but do receive reimbursement of expenses. The ACS is an integrated and valued part of the PTS.

3 SELECTION OF VOLUNTEERS



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3.1 The Trust will select ACS volunteers in accordance with the principles of this Policy.

3.2 The Trust criteria for candidates wishing to be considered for ACS Volunteer activities is that volunteers must / must be:

• Under 70 years of age due to DVLA licence standards. • Physically and mentally fit. • Be of good character and provide at least one character reference. • Contactable by telephone and must possess a mobile phone. • Ideally possess a full clean driving licence. • Possess a suitable Vehicle.

3.3 Selection for Volunteers will be made by completion of an application form, driving assessment, interview, Criminal Records Check, acknowledgement of vehicle suitability, and character reference.

3.4 Volunteers will be required to complete a medical questionnaire and if necessary undergo a medical and eyesight examination arranged by the Occupational Health Department of the Trust, prior to commencing Voluntary activities.

3.5 A suitably qualified officer of the Trust will assess the driving skills of each volunteer. If, in the Trusts opinion, the Volunteers driving skills and the volunteers’ proposed vehicle do not meet the Trusts’ requirements, the application will not be progressed any further.

3.6 Successful volunteers will be required to attend the appropriate training courses as organised by the Trust. Training will be related to ACS journeys outlined in the training pack, and include induction training prior to commencement, followed by compulsory refresher training as required by the Trust.

3.7 Owing to the nature of the Trusts’ business, volunteers will be subject to an Enhanced Criminal Disclosure check. Volunteers will only be accepted into the ACS subject to verification of details provided through the criminal record bureau check. Prospective volunteers will be required to consent to this check when all other assessments have been successfully completed.

3.8 Any mileage costs incurred during the interview, assessment and training process will be reimbursed by the Trust.

4 LOCAL INDUCTION

4.1 Content

The induction course is compulsory and will cover the following;

• Utilisation of Volunteers

• ACS policies and Procedures

• How journeys are allocated.

• Instruction on Completion of Claim Forms and Log Sheets

• Incident Reporting



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• Contact with PTS Control

• Basic CPR and Patient Handling and Care

• Confidentiality

• Infection prevention and Control

4.2 Utilisation of Volunteers

Ambulance Car Service Volunteers are utilised to provide an alternative to ambulance transport for walking patients travelling to and from treatment centres, primarily in the North East, but also to other parts of the country as required. Volunteers determine their own availability.

4.3 Induction Attendance

All Volunteers are required to attend the Induction Training and any future training deemed by the Trust as a requirement for the Ambulance Car Service Volunteer. The Induction training must be attended prior to commencement of allocation of any journeys.

4.4 Induction Training Compliance

All Volunteers will be required to sign the Induction Training Schedule on completion of the Induction Day.

5 VOLUNTEER AGREEMENT

5.1 Reimbursement of Expenses

5.1.1 Volunteers undertake ACS journeys on an unpaid basis. They will however, receive reimbursement of expenses by way of a mileage allowance of 39 pence per mile. The expense rates are periodically reviewed using the AA website information for base discussion with the ACS Focus Group.

5.1.2 Additional out of pocket expenses will be payable for any journey involving an overnight stay to cover the cost of meals (see appendix C). All claims for meals will require receipts. Accommodation will be booked and paid for by the Trust directly.

5.1.3 An allowance of £1O per month will be paid to cover the cost of mobile telephone calls.

5.1.4 .An allowance of up to £1.25 per month will be paid to cover postal costs for expense claims and log sheets.

5.1.5 Claims for mileage and expenses shall be made on the claim form supplied by the Trust. When completed they should be forwarded to the Ambulance Car Service Administrator at Ambulance Headquarters.

5.1.6 Volunteers are required to provide the Trust with their Bank details in writing, by completion of form AHQ 48 on their Induction Course.

5.1.7 Reimbursement of expenses are made by BACS (electronic bank transfer) in arrears, with claims being accepted by the Trust as follows;



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Calendar Monthly

1st of the month to the 15th

16th to last day of the month

Claims which fall outside these criteria will be returned for correction.

5.1.8 All claims will be checked and any discrepancies investigated. Any potential fraudulent claims will be withheld until an investigation has been completed. Any proven fraudulent claims may lead to criminal prosecution.

5.1.9 Volunteers should note that in certain circumstances expenses payments carry a tax liability. It is the responsibility of the volunteer to deal with matters of taxation associated with the ACS. Details can be obtained through HM Inspector of Taxes.

5.2 Driving licence

5.2.1 All volunteers should possess a full and preferably clean current driving licence. The driving licence will be inspected annually, by the ACS Administrator.

5.2.2 Any driving related endorsements or convictions must be reported to the ACS Administrator immediately. The Trusts’ officer will then decide on the course of action to be taken.

Examples Outcomes

• Speeding May cease to use

• Dangerous driving Cease to use

• Driving without care and attention May cease to use

• Driving under the influence Cease to use

5.2.3 The Trust reserves the right to view any volunteer’s driving licence on request

5.3 Insurance

5.3.1 The Trust requires all ACS volunteers to have fully comprehensive insurance covering transportation of patients to and from treatment centres and at all times whilst carrying out journeys as a Volunteer. A copy of the renewal certificate must be provided on an annual basis, to the ACS Administrator.

5.3.2 Volunteers are required to ensure that their insurance fully covers patients and carers travelling to and from treatment centres, against any risk whilst travelling in their vehicle and Volunteers are required to provide proof from their Insurance Company that this activity is covered. Volunteers should also make their Insurance Company aware, that they receive expenses for this activity.

5.3.3 The Trust does not accept any responsibility or liability for damage or injuries to either volunteers, patients or any other third party, incurred in the course of journeys made as a Volunteer. It is therefore essential that volunteers assure themselves



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that they obtain a letter of authority from their insurance company confirming that they are covered to undertake journeys on behalf of North East Ambulance Service, with full passenger liability. A copy of this letter must be forwarded to the Trust before commencement of any voluntary activities. All claims for damage or injury shall be pursued by the volunteer through their insurance company.

5.3.4 The volunteers must inform their own motor insurer if the annual mileage covered whilst undertaking voluntary activities exceeds 10,000 miles per annum. A copy of this letter and the response must be forwarded to the Trust

5.3.5 Volunteers must cooperate with the Trust in the event of any claims received

5.4 Availability

5.4.1 ACS volunteers are asked to nominate days and times when they will be available for allocation of journeys and to notify the ACS Administrator or the Planning Department. Volunteers are of course at liberty to change their availability, but are asked whenever possible to give the ACS Administrator or Planning Department at least 48 hours notice of these changes.

5.4.2 Notification of availability is not a guarantee that journeys will be allocated as all ACS activity is at the exigencies of the service.

5.4.3 Journeys will normally be allocated and notified to volunteers on the day before travel, by fax (which will be supplied by the Trust if required), or by telephone in respect of short notice changes.

5.4.4 No assistance is given by the Trust in respect of reimbursement of telephone installation or rental costs.

5.4.5 No assistance will be given by the Trust in respect of reimbursement of telephone call costs as this is included in the patient journey mileage rate. However, a fixed monthly payment of £10.00 will be made towards the cost of running a mobile telephone which is used for ACS purposes. This payment will be reviewed annually.

5.5 Physical/mental fitness

5.5.1 Volunteers are required to assist patients to/from and into/out of the vehicle. Patients’ personal belongings will also need to be transported. It is essential therefore, that volunteers have sound general health to enable them to facilitate this activity.

5.5.2 Any medical condition affecting the volunteers’ driving ability, and subjecting patients to risk whilst in that driver’s care, must be reported immediately to the ACS Administrator. The Occupational Health Department can provide specialist advice in these circumstances.

5.5.3 Attention is also drawn to the 1972 Road Traffic Act which requires that all drivers must advise the Licensing Centre, without delay, of the onset or worsening of any medical condition which is likely to affect their driving, putting Patients and the general public at risk. The Trust must be advised of any change in the volunteers’ health which may affect their ability to carry out journeys on behalf of the Trust.

5.5.4 Volunteers will be asked to complete a health questionnaire prior to commencement and periodically thereafter. They may also be required to attend a medical examination as deemed necessary.



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5.6 Vehicles

5.6.1 Vehicles used by Volunteers must be a 4-door family saloon size as a minimum to allow easy access and egress for patients who may not be fully mobile. The vehicle must be fitted with both front and rear seatbelts and be in a clean sound condition.

5.6.2 Vehicles in excess of 7 years of age are not normally considered suitable for ACS, but this may be waived for exceptional vehicles at the discretion of the Trust and the appropriate Trust officer.

5.6.3 The vehicle must be covered by fully comprehensive insurance (see section 5.3.1) and possess a valid Ministry of Transport (MOT) test certificate where applicable. MOT and insurance certificates must be submitted annually.

5.6.4 The vehicle must be maintained in a clean condition both internally and externally.

5.6.5 The vehicle should be covered for breakdown through membership of a recognised motoring organisation.

5.6.6 Any change in vehicle should be reported immediately to the ACS Administrator. This includes use of a loan or courtesy car.

5.6.7 The vehicle may be re-assessed for fitness of purpose at any time by the Trust. Checks on speedometer may be requested at any time by a representative of the Trust for audit purposes.

5.7 Driving Skills

All volunteers are required to pass an initial driving assessment before commencement as a Volunteer. The Trust also reserves the right to reassess volunteers on an annual basis.

5.8Training

5.8.1 Volunteers are required to attend an initial induction course and to achieve an acceptable standard of competence. The Trust will also require ACS volunteers to attend a half day refresher course as determined by the Trust. The Trust reserves the right to refer a volunteer for additional training as and when it is deemed necessary, in order to ensure that the required level of competence is maintained. All volunteers must meet the necessary level of competence for an ACS volunteer; failure to do so will result in the cessation of use as a Volunteer.

5.8.2 ACS volunteers will receive training in the correct procedures for supporting walking patients. Patients who are immobile or require other than the most limited assistance will be transported by PTS crews.

5.9 Service specification and code of conduct

5.9.1 Other than as previously dealt with ACS volunteers are required to transport patients in accordance with agreements between the Trust and the hospital units served. Volunteers should be aware that once the patient leaves home they become the responsibility of the Trust until they are handed over to a responsible health care professional and similarly on the return journey until they are back in their own home, and as such must adhere to the following;



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5.9.2 Volunteers must carry and display identification at all times.

5.9.3 On arrival at patients address

• Park in a safe position as near as possible to the patients address. • Knock on door or ring doorbell. • Introduce yourself and offer identification. • As far as reasonably practical ensure electrical appliances have been switched

off. • As far as reasonably practical ensure home is secure and patient has keys,

appointment card and medication etc. • Escort patient from the door of the house to the vehicle with any luggage or

belongings.

• If patient does not answer door contact PTS Control immediately for advice, wait a few minutes then leave a no reply slip.

5.9.4 At the vehicle

• Decide if patient will sit in the front or rear of the vehicle (this may be determined by medical condition, e.g. will need to sit in the front if knees cannot be bent)

• Open the vehicle door. • Help the patient safely into seat. • Ensure the seat belt is fastened. • Safely close the door.

5.9.5 Driving

• ACS volunteers must at all times, drive smoothly, safely and within the law. • The patients benefiting from travelling with Volunteers are non-emergency

patients therefore high speeds are inappropriate. • Volunteers must not smoke or eat whilst conveying patients. • No alcohol must be consumed before or during transportation of patients. • Volunteers must always follow the shortest available route. Volunteers must

abide by the law regarding the use of mobile phones – see Appendix D

5.9.6 At the hospital/clinic

• ACS volunteers may use designated ambulance parking areas for delivering or collecting patients.

• Patients must be escorted to their destination department and if necessary helped to book in.

• Whilst waiting for patients volunteers must not obstruct ambulance waiting areas or other designated no waiting zones.

• Patients should be collected from the department or designated collection point and escorted to the vehicle.

5.9.7 On return

• On arrival at the patient’s home or return destination volunteers must escort the patient from the vehicle and safely settle them in their home.

5.9.8 All incidents including road traffic accidents (service policy refers)



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• Volunteers involved in road traffic accidents must abide by guidance contained within the Highway Code.

• Volunteers must inform PTS Control of any incident, as soon as is reasonably practicable, providing details of the incident and any patients involved.

• A written report of the accident must be submitted to the Planning Manager at Ambulance Headquarters within 3 days of the accident, using the Trust Incident Report Form NEAS 07, provided by the ACS Administrator. The following information should be provided:

1. Date of accident. 2. Location of accident. 3. Registration numbers of vehicles involved. 4. Name of driver. 5. Name and address of everyone in the vehicle. 6. Details of any injuries sustained. 7. Insurance details of other party. 8. Police reference number (CAD) if reported. 9. Witness statements if applicable.

10. For any road traffic accident or incident entering or exiting the vehicle confirmation that this has been reported to volunteers motor insurance

5.9.9 Injury or Incidents involving volunteer, patients or third party.

• Any injury sustained in the course of transporting patients, must be reported to the appropriate Trust officer as soon as reasonably practicable.

• Volunteers will then be required to complete an Incident Report Form NEAS 07 obtained from the ACS Administrator. This must be completed and returned within 5 days of the accident.

5.9.10 General

• Volunteers must be polite and considerate to patients and hospital staff at all times.

• Seat belts must be worn by both volunteers and patients in their care. • Escorts may only be carried where authorised in the booking. • Volunteers are asked to remember that spare seating may be required for

additional patients on the return journey. • Patients may request to take their own folding wheelchair/mobility aid to the

hospital when it has not been booked. This will be at the discretion of the Volunteer, as to whether there is available space to transport the folding wheelchair/mobility aid.

• Volunteers are reminded that whilst the patient may require a degree of assistance there should be no need to physically lift patients. If this proves necessary or if the driver has any cause for concern he/she should contact PTS Control for advice.

• With the exception of guide dogs, animals must not be carried whilst conveying patients. Guide dogs will only be allocated after consulting the Volunteer.

• Volunteers are reminded that hospital schedules depend on arrival as close as possible to appointment times. It is undesirable for patients to arrive very early or very late.

• Patients must only be dropped off at the destination on the booking. This is to help prevent accidents and to avoid the possibility of patients “going missing.”



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• If for any reason the patient does not travel it is the responsibility of the volunteer to inform PTS Control at the earliest opportunity.

• Should there be any doubt concerning the well-being of any patient the volunteer must contact PTS Control without delay.

• If a volunteer cannot collect or return a patient home, PTS Control must be informed so that alternative arrangements can be made.

• Under no circumstances should volunteers accept money or gifts from patients, escorts or relatives.

• Volunteers must not advertise goods/ services in the vehicle whilst transporting patients.

• Volunteers must direct Patients to the complaints procedure when necessary. A booklet is enclosed for your information and gives details of contact numbers. These booklets are also available from most hospitals.

5.9.11 Identification

• Volunteers will be provided with an appropriate identification badge and car signs, which must be displayed at all times during the course of ACS journeys only.

• Volunteers will also be provided with white Polo shirts and a Black Fleece bearing the NEAS logo which must only be worn when undertaking ACS journeys. A High visibility waistcoat and first aid kit will also be provided.

• Identification must only be displayed when transporting patients on journeys allocated by the Trust.

5.9.12 Code of conduct

• All ACS volunteers must adhere to the Trust’s Code of Conduct – see appendix A.

5.9.13 Confidentiality

• All ACS volunteers must not breach confidentiality at anytime – see appendix F.

5.9.14 Cessation of Volunteer Role

• Since the ACS is an entirely voluntary activity the arrangement may be ceased by either party without notice. The Trust may cease the arrangement for the following reasons –

• Lack of patient care No door to door service given

• Breach of confidentiality See Appendix F

• Failing to comply to ACS Policies and procedures

• Breach of Code of Conduct See code of Conduct

• Bringing Trust into Disrepute Inappropriate activities



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• Criminal or driving convictions Alcohol or drugs etc

• Inappropriate patient contact Sale of products to patients

• Over claiming mileage/ expenses

This list is not exhaustive and can be determined by the general principle of the ACS Policy and Code of Conduct and includes any action deemed by the Trust to have a detrimental impact on its reputation.

• Utilisation of volunteers will automatically cease when the volunteer attains the age of 70 years due to DVLA licence standards.

6 Equality and Diversity Statement

The Trust is committed to providing equality of opportunity, not only in its employment practices but also in the services for which it is responsible. As such, this document has been screened, and if necessary an Equality Impact Assessment has been carried out on this document, to identify any potential discriminatory impact. If relevant, recommendations from the assessment have been incorporated into the document and have been considered by the approving committee. The Trust also values and respects the diversity of its employees and the communities it serves. In applying this policy, the Trust will have due regard for the need to:

• Eliminate unlawful discrimination • Promote equality of opportunity • Provide for good relations between people of diverse groups

For further information on this, please contact the Equality and Diversity Department.

7 DOCUMENTATION REQUIREMENTS

Whilst the Trust is responsible for the implementation and overseeing of procedures it is ultimately the responsibility of the volunteer to provide copies of document changes within 7 days of the change. If these copies are not forthcoming then volunteers may find that they will not be allocated any journeys until such time as the documentation is received. Copy documentation required:

• Insurance certificate. • MOT certificate. • Vehicle registration document. • Any relevant police check documentation. • Letter of authority from insurance company.

Driving licenses, insurance and MOT certificates will be checked annually, with copies being required for any changes as previously detailed.

8 MANAGEMENT OF THE SERVICE

8.1 The ACS Service is managed through the PTS Planning and Control Department which falls within the Strategy and Clinical Standards Directorate..



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Day to day management and monitoring of the service is the responsibility of the PTS Planning and Control Mangers. The monitoring process may include random speedometer checks of Volunteers vehicles for Audit purposes.

• The ACS is intended to operate as a supplement to the directly

managed service. The responsibility for establishing the criteria for deciding to use ACS lies with the Planning Managers but in general the ACS will be an option where:

• The patients appointment lies outside the normal PTS operating hours. • ACS is demonstrably the most cost effective option for transporting

the patient. • The patients’ condition dictates that a car is the most appropriate

vehicle. • The journey cannot be allocated to the directly managed service.

8.2 Designated officers are responsible for ensuring that systems for monitoring the service are robust. In particular:

• Driving licences, vehicle insurance and MOT test certificates are checked annually.

• Volunteers complete health questionnaires as required, and attend medical checks as appropriate.

• Refresher training is carried out as appropriate. • Volunteers’ age is monitored and written notification will be sent to

confirm cessation of use at the age of 70 years due to DVLA licence standards.

• Files containing volunteers’ personal details are held in confidence at Ambulance Headquarters.

9 MONITORING COMPLIANCE WITH AND THE EFFECTIVENESS OF PROCEDURAL DOCUMENTS.

This policy will be reviewed twelve monthly or earlier if required by:

The Trust Board The Assurance Committee

The effectiveness of the policy will be monitored on regular basis via the trusts Executive Team.

10 CONSULTATION, APPROVAL AND RATIFICATION PROCESS

10.1 Consultation Process

This policy has been discussed with the Equality and Diversity Group which includes representatives from staff side and all directorates.

Formatted: Indent: Left: 2.54cm



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10.2 Policy Approval Process

This policy has been submitted to the Policy Review Group for approval.

10.3 Ratification Process

This policy has been approved by the Policy Review group and submitted to the JCC for ratification.

11 DISSEMINATION AND IMPLEMENTATION

11.1 Dissemination

Once ratified this policy will be added to the Document Quality Control System and added to the Intranet site to which all NEAS staff have access. Earlier versions of the document will be archived in the quality system. Two copies of this policy will be sent each volunteer driver, one to be kept for personal reference and one to be signed and returned to HQ where it will be kept with in the individual’s personal file as record that they have read and understood the policy.

11.2 Implementation of Procedural Documents

Information about this policy will be sent to each volunteer driver and it will be delivered as part of the induction and refresher courses.



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Appendix A

NORTH EAST AMBULANCE SERVICE NHS TRUST AMBULANCE CAR SERVICE

VOLUNTEER CODE OF CONDUCT Thank you for volunteering to become an Ambulance Car Service Volunteer (ACS) for the North East Ambulance Service NHS Trust (the Trust). Please take time to read the following information. This code of practice applies whilst you are providing your voluntary services to the Trust so that you are aware of your requirements and limitations as an ACS Volunteer. Aims and objectives of the ACS Volunteer Scheme:

• The overriding intention of the programme is to assist in the transportation of walking patients to and from treatment centres, and provide an alternative to ambulance transport where appropriate. The principle of the scheme is to provide a responsive volunteer service for walking patients with defined transport needs.

• As the scheme is a voluntary programme the participants will receive out of pocket expenses only.

The Trust will support the ACS Volunteer in the following way:

• Provide access to training in basic life support and customer care skills. • Make available personal support and counselling services which can be utilised on request. • Communicate allocated journeys by fax or telephone. • Communicate with you on a regular basis to ensure all claims for expenses are appropriate

and up to date. • Provide managerial support to assist in the resolution of any operational problems.

ACS Volunteers must:

• Comply with the ACS policy document which describes the volunteers’ role. • Attend the initial training course prior to being accepted as an ACS Volunteer, and

attending compulsory refresher training as requested by the Trust If you are unable to attend any training session, then it is important that you notify the training officer as soon as possible. Failure to re-qualify will mean inability to participate as an ACS volunteer until successful completion of the re-qualification.

• Maintain patient confidentiality at all times i.e. treating any information as private and confidential and not disclosing or permitting any disclosure to any person or otherwise; not making use of or permitting the use of (other than in the carrying out your allocated journeys) any confidential information relating to any patient. You must ensure that all log sheets, working papers or other material (in whatever format it is stored) and any copies are submitted with your monthly claim form. Failure to comply with the confidentiality obligations will result in cessation of use as a Volunteer.

• Ensure that you have the required standard of health and fitness, required by Occupational Health, to carry out journeys on behalf of the Trust.

• Contact the Planning Department regularly to notify them of your availability. If you wish to alter or are no longer available it would be extremely helpful to give the Planning Department as much notice as is possible.

Further Obligations:

• You are authorised to transport only those patients and carers allocated to you by the Trust.



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• You are not exempt from the provisions of the Road Traffic Act and if you receive any convictions under the Act whilst carrying out journeys for the Trust, then they must be dealt with by you and not the Trust. However, the ACS Administrator or a Planning Manager must be advised of the circumstances surrounding the conviction.

Level of Care:

• By signing this Code of Conduct you acknowledge that you are strictly prohibited from exceeding the level of care for which you have been trained. You will provide the appropriate care and attention for all patients that you transfer to and from treatment centres.

Public Image:

• The general public have a right to a professional and caring service. All volunteers must always present themselves in a well-groomed and clean manner. Their driving skills must set a positive example to other road users.

• All volunteers should project a professional image at all times. Conduct with members of NHS Staff at treatment centres must be professional and courteous at all times. It is recognised that difficulties can arise between volunteers and treatment centre staff. Volunteers are therefore advised to be acutely aware of this and act accordingly reporting matters to designated managers if they consider it appropriate.

• A sympathetic manner must be demonstrated to patients and relatives. Tact and diplomacy must be demonstrated to members of the public at all times.

Publicity:

• You are not permitted to release any publicity items whatsoever in connection with the Trust, make any public comment or speak to the press about your involvement or role as an ACS Volunteer, without prior consent.

Acceptance of Gifts or Hospitality:

• Patients and other ambulance service users are appreciative of the service they receive and often like to show their appreciation by offering tips (gratuities). All Volunteers must courteously refuse such offers.

• All other offers of gifts or hospitality must be reported to the ACS Administrator and dealt with in accordance with the Trust’s Hospitality policy.

• In cases of doubt volunteers should consult with the ACS Administrator, PTS Control or a Planning Manager.

Miscellaneous:

• The Trust reserves the right to cease to use you as an ACS Volunteer at any time should you not comply with this Code of Conduct or if you are convicted of a criminal offence.

• Patients will be transported using the shortest, most practical route. • Over claiming of expenses will be investigated and any potential fraudulent claims will be

withheld until investigations have been completed. Any proven fraud may lead to criminal prosecution.

• Should any of your circumstances change you are obliged to inform the Trust. • Volunteers are required to familiarise themselves with the Health & Safety Regulations

encompassed within the Health and Safety General policy Statement Appendix E.



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Rehabilitation of Offenders Act 1975: • Prior to being accepted as an ACS volunteer you will be requested to consent to the

Criminal Record Bureau ( CRB ) carrying out a search to determine any convictions against you.

• By signing below you agree to an enhanced CRB Check being carried out. • Have you ever been convicted of an offence or received a formal caution/bound over

order? Please circle answer Yes or No and sign to authorise CRB check.

Yes No Signature __________________________ Date____________ Data Protection Act 1998. As a result of being selected as a volunteer with the Trust it is necessary to hold data on our systems in respect of your voluntary activity. Such data includes your name, address, telephone/ Fax numbers, skills, driving details, car insurance, MOT and training records, etc. We will also hold sensitive personal data including details of your physical or mental health or condition (Health Questionnaire). The commitment or alleged commitment of any offence by you, any proceedings for an offence committed or alleged to have been committed by you including the outcome or sentence in such proceedings (CRB Check) You are required to give your consent to the Trust, to hold and process personal data. This personal data is held for the purpose of administration and management of your participating as a volunteer and Trust business. Processing includes obtaining, recording or holding information or data and carrying out operations on the information or data. This data will not be forwarded to a 3rd party, without prior consent, unless we are legally bound to do so. I hereby consent to the Trust holding and processing personal data (including sensitive personal data) based on the information provided above. Name _____________________ Signature ________________ Date___________



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Declaration: I understand that registration as an ACS Volunteer will be made subject to the accuracy of information given on my ACS Application and CRB Disclosure Application. To withhold, falsify or omit relevant information may lead to removal of my registration as an ACS Volunteer if duly registered. I have read the ACS Policy and Code of Conduct and agree to abide by the terms and conditions stated therein. I understand that he Ambulance Car Service is a Voluntary Role, and as such does not constitute any Contractual arrangement or any Contract of employment, specified or implied, with The North East Ambulance Service NHS Trust.

I also understand that as a Volunteer, I declare a clear understanding of the Volunteer Status, by signing and returning a copy of this policy.

I confirm that as a Volunteer I may cease to be available as a Volunteer at any time, and the North East Ambulance Service NHS Trust may also cease to use me as a Volunteer, without being required to give any formal notice.

In the event of cessation of use a Volunteer, I agree that I will return all items issued, and belonging to the North East Ambulance Service within 14 working days.

NAME SIGNATURE DATE Two Copies of the policy have been provided. One for your retention and one which must be returned to Ambulance Headquarters, with declarations signed and dated.



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Appendix B Listed below are the Trust Designated Officers: Designated Officer Responsibility ACS Administrator/Planning Manager Mileage Claims ACS Administrator/Planning Manager Driving Licence Checks ACS Administrator/Planning Manager Insurance Checks ACS Administrator/Planning Manager Telephone Claims ACS Admin/Occupational Health Manager Fitness Checks ACS Administrator/Planning Manager Vehicle Checks ACS Administrator Notification of Change of Vehicle Training Manager Driving Assessment ACS Administrator/Planning Manager RTA ACS Administrator/Planning Manager Injury to Patient Planning Manager General Management Planning Manager Untoward Incident Planning Manager Overall Scheme Management



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Appendix C

NORTH EAST AMBULANCE SERVICE NHS TRUST

ACS TRAVEL & SUBSISTENCE REIMBURSEMENT RATES

1. POLICY SCOPE

This document relates to all volunteers of North East Ambulance Service NHS Trust,

and provides details of the claimable expenses paid by the Trust.

2. PURPOSE

2.1 To reimburse the expenses incurred wholly, exclusively and necessarily in the performance of the journeys allocated to the volunteer.

2.2 An audit of travel and subsistence arrangements will be included in the Audit

programme annually

3. JOURNEYS BY CAR

3.1 A mileage rate of 39p per mile will be paid to volunteers for official journeys undertaken on behalf of the Trust.

3.2 Claimable journeys are those which start and end at the volunteers’ home and should

only include official journey mileage. Any private mileage should be deducted and shown on the applicable log sheet.

3.3 Other costs incurred in the course of patient transport may also be claimed, e.g.

tunnel and road tolls, but under no circumstances will parking or speeding fines be paid by the Trust.

4. SUBSISTENCE

4.1 Short Overnight Stays - Where a volunteer stays overnight in a hotel, guest-house

or other commercial accommodation with the agreement of the Planning/Day Control Manager, the overnight Subsistence Rates are as follows:-

• Accommodation - Accommodation should always be booked in advance by the Trust.

The cost of meals taken as a result of Trust Activity will be reimbursed on an actual and receipted basis, up to the limits detailed below. Production of a valid receipt of expenditure must be provided. • Meal Allowance – A meal allowance to cover the actual cost of meals purchased

and where these have not been provided can be reclaimed on production of a valid receipt of expenditure up to the values as follows :-

Breakfast - £5.00 (where this is not included with the accommodation) Lunch - £5.00 Evening Meal - £15.00



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4.2 Meal allowances do not cover the costs of alcoholic beverages. Where these are purchased the cost must be met by the volunteer.

4.3 Meal allowances are not cumulative and unused amounts may not be carried forward. 4.4 Such payments will not be made where meals were provided free.

5. TELEPHONE COSTS 5.1 A contribution of £10.00 per month shall be made to volunteers for the use of a

mobile phone and calls made, whilst undertaking journeys on behalf of the Trust. 5.2 The telephone number of the mobile must be provided to the ACS Administrator. 6. CLAIMING REIMBURSEMENT

6.1 Travel costs can only be claimed retrospectively by completing the relevant section

of the Trust’s ACS Claim form, and attaching all completed journey log sheets for the period of the claim. This must be fully completed and signed by the volunteer.

6.2 A contribution of £1.25p per month can be claimed against the cost of postage of

claim forms and log sheets.

6.3 Any expenditure incurred as a result of approved overnight subsistence should be detailed on the ACS claim form and receipts attached.

6.4 Once completed, the claim form must be signed by the volunteer and forwarded to

the ACS Administrator, with all completed log sheets, for checking, authorisation and subsequent payment.

6.5 Reimbursement of expenses will be made by BACS automated payment. It is aimed

that payments will reach the volunteers bank account no later than 10 working days after submission to the ACS Administrator and a remittance advice note posted to the volunteer.

6.6 Any potential discrepancies will be fully investigated and the claim withheld until any

investigation is completed which may result in a delay to payment. Any proven fraudulent claims will continue to be withheld and may result in criminal prosecution proceedings

6.7 All claim forms and supporting documentation shall be retained for a period of at

least six years. The volunteer should also retain a copy of the claim form for their own records. However, this does not include log sheets, and all log sheets should be returned to the Trust with the claim form.



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Appendix D


Explanation of the law to ban the use of handheld mobile devices whilst driving The ban on the use of hand held mobile devices whilst driving comes into force on 1st December 2003 and the following paragraphs have been extracted from a memo from Orange for your information: Timing On 24 June 2003, the Government announced its intention to ban the use of handheld mobile devices whilst driving. The offence applies to those driving any mechanically propelled vehicles including motorbikes, but not to cyclists. The Government intends the ban to come into effect on 1 December 2003. Legislation The ban will be introduced by The Road Vehicles (Construction and Use) (Amendment) (No.•) Regulations 2003, which will amend the existing Road Vehicles (Construction and Use) Regulations 1986. It is an offence under section 42 of the Road Traffic Act 1988 to contravene these regulations. The Offence What devices are included? It will be an offence for anyone driving a motor vehicle to use any type of handheld mobile device designed for use on the Orange, Vodafone, O2, T-Mobile or Three GSM or UMTS networks. This will obviously include all products currently supplied by Orange. Using a personal digital assistant (PDA) either with a data card inserted or connected to another mobile device via Bluetooth, infrared or any other means may well also be an offence. The ban will not apply to any other form of two-way radio (including TETRA) operating on other radio frequencies, regardless of the type of equipment being used or how it is held or used. What does handheld mean? The device will be treated as handheld if it is or must be held whilst being used. Most obviously this would include holding it in the hand, but cradling it in the shoulder or holding it by any other means would also result in the offence being committed. The offence will only be committed if the driver is physically holding the handset in some way. Therefore, the law will not require the handset to be physically restrained in a cradle or by any other means. However, the offence will be committed as soon as the driver holds the handset. Therefore drivers will have to consider whether it is practically possible to use the handset (e.g. dial or answer a call) without holding it, if it is not secured in a cradle.



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Furthermore, existing legislation already requires a driver to “have proper control of the vehicle”. Drivers still always need to comply with this requirement, in addition to the new requirement specifically not to use a handheld mobile device. Therefore, they cannot rely on the fact that they are not actually holding the handset e.g. if it is loose on the passenger seat, because if they are not in proper control of the vehicle, they will still be committing a separate offence. Similarly, in more extreme cases, drivers could also be guilty of careless or dangerous driving, even if they are not actually holding the handset. What type of hands free equipment will be allowed? As the driver must be holding the handset in order to commit the offence, the use of any type of hands free equipment will mean that the handset can potentially be lawfully used while driving. However, drivers using any hands free equipment that does not include a cradle e.g. personal hands free kits or Bluetooth headsets/car kits must be aware that the offence will be committed if they are also holding the handset. The use of hands free equipment will not by itself prevent the offence being committed, if the handset is being held at the same time. Nevertheless, the type of hands free equipment that can be used lawfully includes, but is not limited to, the following:- fully integrated car kits with cradles fully integrated Bluetooth car kits without cradles (not currently supplied by Orange, other than in the smart car) easy install i.e. cigarette lighter car kits with or without cradles ‘wired’ personal hands free kits Bluetooth headsets mobile devices with integrated loudspeakers (even if not used in conjunction with any other type of hands free equipment) What actions are prohibited? The offence will be committed if the driver is making a voice call or performing any ‘interactive communication function’. An ‘interactive communication function’ would certainly include reading, writing or sending a text or photo message or accessing WAP. But it should be assumed that ‘doing’ anything on a mobile device (even simply scrolling through the menu) may lead to the offence being committed. Therefore in order to be certain of not committing an offence, drivers should avoid holding a mobile device at any time or for any purpose whatsoever whilst driving. It should be noted that ‘driving’ means whenever the engine is switched on, even if the vehicle is stationary e.g. at traffic lights.



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Alan will provide text to replace this appendix

Appendix E


Risk Management General Policy Statement

1. The North East Ambulance Service NHS Trust regards the promotion of Risk

Management as a mutual objective for management and employees at all levels. This Policy applies to all employees, as well as to non-employees who may be exposed to risks as a result of the Trust’s undertakings.

2. It is the policy of the Trust to provide and maintain, so far as is reasonably

practicable, all plant, systems of work (including safe use, handling, storage and transport of substances and articles), places of work and working conditions, suck that they are safe and with minimal risks to employees, as well as to non-employees, and to provide such information, instruction and training as is necessary for this purpose. Adequate resources will also be provided, i.e., time, money and people, to improve Risk Management.

3. The Trust will, following risk assessments, strive to reduce all significant risks to the

lowest level reasonably practicable throughout the continual re-appraisal of working methods and introduction of suitable safety measures. During 2003/2004, the Trust will strive to:

1 Reduce the number, and severity, of injuries caused by risk: 2 Trust Managers are charged with ensuring that risk assessments are undertaken throughout their area of responsibility on a pr-active basis. 3 Operate vehicles in a safe, efficient and effective manner in an aim to minimise risk to employees and others affected by such operations. 4 Improve compliance with the requirements of the NHS Controls Assurance Project 5 Reach Level two of the Clinical Negligence Scheme for Trusts 6 NEAS intends to roll out departmental risk registers to all directorates, initially identifying high-level risks but eventually registering all risk within a particular area of work.

4. The Trust will provide such resources as may be necessary to enable it, and all its

employees to successfully carry out Risk Management responsibilities. 5. All employees must, as a condition of employment, co-operate with the Trust with

regards Risk Management and ensure:

Taking reasonable care to minimise risk resulting from their activities:

Formatted: Bullets andNumbering

Formatted: Bullets andNumbering



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Reporting any adverse incidents, dangerous working conditions and nay shortfalls in the Trust’s Risk Management arrangements:

Working safely at all times, within their training, by always following safety instructions, making full use of protective equipment and following good Risk Management practices.

6. The allocation of duties and responsibilities for Risk Management and the

arrangements made to implement this policy are set out in the Risk Management File, held at all locations / IT network.

7. This policy will be displayed in all Trust premises, and, in order to ensure that it is

kept up to date, will be reviewed annually. Signed: ………………………… Chairman Date: ………………… Signed: ………………………… Chief Executive Date: …………………



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Appendix F

CONFIDENTIALITY CLAUSE FOR VOLUNTEERS 1 Background In the UK there are several Acts of Parliament that deal with issues of security, confidentiality and privacy of personal information. Under these Acts volunteers are bound to comply with the requirements as individuals can face action for breach of the requirements as there is personal liability specified within some of the legislation.

2 Your responsibilities to NEAS During the time you are volunteering for NEAS you will have access to confidential information that can identify a patient, a member of staff or another volunteer and/or business in confidence. You are required to preserve the confidentiality of any such information and this obligation shall continue indefinitely. You will not at any time during your period with NEAS (except as so far as is necessary in the course of your role) or afterwards, disclose to any person any confidential information. Confidential information includes, but is not limited to, all information of a secret or confidential nature relating to the affairs of any person whose information is held within the Trust. This will include: patients, patient’s relatives and friends, employees, other volunteers and any business or affairs of any other person to whom the Trust has an obligation of confidentiality and/or secrecy. Confidential information can also be business information such as waiting times for patients, financial information relating to the Trust etc. Given the highly confidential nature of the journeys you will undertake you should understand that any breach of this clause would be considered as very serious and result in the cessation of use as a volunteer. Should you breach this clause after you have ceased to be a volunteer, the Trust may take legal action against you.



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Appendix G

Infection Prevention and Control The North East Ambulance Service (NEAS) NHS Trust is committed to reducing the risks of healthcare associated infection and serious communicable diseases through a strategy aimed at dealing proactively with the outcomes and continually developing safer working practices. The Trust must comply with The Health and Social Care Act 2008, Code of Practice for the NHS on the prevention and control of healthcare associated infections this confirms the Trust’s commitment to the control of infection and to set the strategic direction for infection control initiatives. Criteria 1d of The Code of Practice states:

“relevant staff, contractors and other persons whose normal duties are directly or indirectly concerned with patient care receive suitable and sufficient information on, and training and supervision in, the measures required to prevent and control the risks of infection.”

It is your responsibility to adhere to infection control guidance in order to promote cleanliness and reduce infections. Hand hygiene must be undertaken correctly to prevent the spread of infection. Personal protective equipment must be used in accordance with infection prevention and control guidance. You should also attend any training appropriate your role. Microbiology / Spread of Infection 1. The Chain of Infection

The process through which infection can be spread from one susceptible host to another is known as the chain of infection. If the chain is broken then infection will be prevented.

Infectious Agent: • Microorganism/germ/virus

Reservoir: • Patients • Staff • Equipment • Environment e.g. dust, soil • Animals / insects • Food / Water



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Portal of Exit / Entry: • In order to cause disease a pathogen must have a way to enter the body – a

portal of entry. To transmit to another host it must be able to leave the body via a portal of exit. The route of entry and exit may be different, for example enteric infections enter the mouth and leave in the faeces, or they may be the same, for example, respiratory tract infections.

• Microorganisms use a range of different routes to find new hosts and one

microbe may be able to spread by using more than one method.

The modes of spread of infection: • It is important to remember that the one feature that distinguishes infection from

all other disease is that it can be spread i.e. one person can ‘catch it’ from another, or via a vector (crawling or flying insects). Infection can also be caused by the environment, such as tetanus following a gardening accident.

An infectious disease can be transmitted by:

• Direct Contact – e.g. kissing, sexual contact, physical contact with an infected

site, such as contact with discharge from wounds or skin lesions e.g. shingles, impetigo

• Indirect – through sneezing or coughing, or when an intermediate carrier is

involved in the spread of pathogenic microbes from the source of infection to another person e.g. hands, insects

• Fomite: is defined as an object which becomes contaminated with infected

organisms and which subsequently transmits those to another person e.g. bedpans, urinals, thermometers, oxygen masks, or practically any inanimate object.

• Hands: of healthcare workers are probably the most important vehicles of

cross-infection. The hands of patients can also carry microbes to other body sites, equipment and staff.

• Aerosols: Transmission of infection occurs when microbes exhaled or

discharged into the atmosphere by an infected person are inhaled by another person e.g. chickenpox, mumps. The common cold and influenza are often cited as examples, but it is likely that hands and fomites are also important in the spread of respiratory viruses.

• Ingestion: Infection can occur when organisms capable of infecting the gastro-

intestinal tract are ingested. When these organisms are excreted faecally by an infected person, faecal-oral spread is said to occur. Organisms may be carried on fomites, hands or in food and drink e.g. Hepatitis A, salmonella, campylobacter.



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• Inoculation: Infection can occur following a ‘sharps’ injury when blood contaminated with, for example Hepatitis B virus, is directly inoculated into the blood stream of the victim, thereby causing an infection. Inoculation includes blood splashes to the eye. Humans and animal bites can also spread infection by the inoculation mode.

• Vectors: Any intermediate agent which can carry an infection between

humans/other animals. Crawling and flying insects are an obvious example of intermediate carriers and need to be controlled. Insect bites may cause infections such as malaria.

• Absorption: This is not a route of entry for infection, except in some tropical diseases.

Susceptible Host / Person at Risk:

Some people are at increased risk of infection: • Elderly • Very young • Immunocompromised • Chronic illness • Receiving certain medications e.g. steroids • Anyone with a break in the bodies defences e.g. surgical wounds, skin lesions,

indwelling devices such as intravenous lines / catheters • Someone whose behaviour increases their risk for a particular disease e.g. HIV

2. Personal Protection 2.1 Standard Principles / Precautions of Infection Prevention and Control

2.1.1 Standard Precautions include:

1. Hand washing and skin care – the skin is a protective barrier, micro-organisms can be washed off. Breaks in the skin, cuts and abrasions can provide an entry/exit point for infective microbes and should be covered with waterproof dressings.

2. Protective clothing – reduce the risk of substances contaminating you

by placing a barrier between the substance and yourself i.e. clothing, goggles, masks.

2.2 Hand Hygiene Facilities

2.2.1 Hand washing facilities within the trust must not compromise standards

by being dirty or poorly maintained. 2.2.2 Hand washing facilities should be adequate and conveniently located.

Moist skin wipes and personal issue alcohol hand rub are provided for operational staff to use as an alternative method of hand hygiene when hand washing facilities are not available at point of patient care.



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2.2.3 The wearing of gloves is not an alternative to hand hygiene. 2.3 Hand Washing and Skin Care

2.3.1 Hand hygiene is the single, most effective method of preventing cross-

infection.

2.3.2 There are two populations of micro-organisms found on the skin. The resident bacteria live in the deeper skin layers, they are not readily transferred and are usually not harmful. Transient micro-organisms do not normally live on the skin but are both readily acquired and transferred by touch. In clinical settings hands can cause cross infection by transferring these transient micro-organisms between patients but are easily removed by simple hand decontamination procedures. The wearing of gloves is not an alternative to hand hygiene.

2.3.3 Hands should be washed:

Before –

• Patient contact • Taking a break / going home • Putting on protective clothing • Eating, drinking, handling food

After –

• Contact with patient surroundings • Direct contact with a patient • Cleaning equipment / environment • Hands become visibly soiled • Removal of gloves • Going to the toilet, blowing nose or covering a sneeze

2.3.4 The World Health Organisation (WHO) Five Moments for Hand Hygiene:



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2.4 Hand Washing Technique

2.4.1 Hand washing is probably the most important method of protecting the patient and staff. Hand washing technique poster must be displayed above/next to hand wash basin. Hands should be washed at the point of care; the patient’s immediate environment in which healthcare staff-to-patient contact or treatment is taking place, as this represents the time and place at which there is the highest likelihood of transmission of infection via healthcare staff whose hands act as mediators in the transfer of micro-organisms..

2.4.2 Alcohol handrub is the recommended product in all patient care situations

except when:

• Hands are visibly soiled. • The patient is experiencing vomiting and/or diarrhoea. • There is direct hand contact with bodily fluids i.e. if gloves have

forgotten to be worn.

2.4.3 Most clinical areas of hospitals have hand washing facilities available and these should be utilised whenever necessary.

2.4.4 When unable to access hand washing facilities it may be necessary to

use other methods to decontaminate the hands. Alcohol handrub can be used effectively, although should not be used as an alternative if a hand basin is available.

2.4.5 Alcohol gel will not penetrate through soil such as blood or dirt, so hands should ideally be cleaned before gel is applied. If hands are not soiled, gel can be used alone. When using a gel, apply 5 – 10ml to visibly clean hands and rub using the hand washing technique, until the alcohol has evaporated and hands are dry. Only 3 -4 applications of alcohol gel should be used before hands will need to be washed as they will become ‘tacky’.

2.5 Skin Care

2.5.1 A healthy, intact skin provides an effective barrier against infection. It is

important to keep the skin in good condition by using the correct hand washing method, drying hands thoroughly and regular use of hand cream.

2.5.2 All cuts and abrasions should be covered with an impermeable

waterproof dressing prior to and during any period of duty. The dressing’s integrity must be checked regularly while on duty and replaced if necessary. Any member of staff with extensive skin lesions must seek advice from the Occupational Health department e.g. eczema. Avoid unnecessarily subjecting skin to laceration in social / domestic activities e.g. DIY or gardening – cover arms and use gardening gloves.



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2.5.3 Moisturiser creams should be used regularly following hand washing. The moisturiser helps to prevent dry skin, which in turn will reduce the risk of lesions developing. Hand cream should preferably not be shared, but used direct from dispensers or tubes for single person use only.

2.6 Hand cleaning techniques- poster



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3. Personal Protective Equipment (PPE)

The choice of protective clothing selected depends on the anticipated risk of exposure to body fluid during the particular activity. Many activities involve no direct contact with body fluid and do not require the use of protective clothing.

Gloves - disposable The function of gloves is primarily to protect staff and patients, and to reduce the transmission or micro-organisms during healthcare provision.

• Do not wear gloves unnecessarily, as prolonged or indiscriminate use may cause adverse reactions and skin sensitivity.

• Gloves must be worn whenever contact with body fluids, mucous membranes or non-intact skin is anticipated, when dealing with contaminated equipment or with a patient with an infection or suspected infection. However emergency treatment should not be withheld in the absence of gloves but in these circumstances hands should be thoroughly washed as soon as possible.

• Choice of size in the selection of gloves should be made on comfort –

not too tight as to become restrictive, but also not too loose as to compromise grip and dexterity.

• Decontaminate hands after removing gloves.