introduction… · web viewpalliative care is treatment aimed at relieving the symptoms associated...

CNTW(C)01

Appendix 4

End of Life Conveyance PolicyDocument Control Sheet

Q Pulse Reference Number POL-CCPS-CP-5

Version Number 03

Document Author Head of Clinical Care and Patient Safety

Lead Executive Director Sponsor

Director of Clinical Care and Patient Safety

Ratifying Committee Quality Committee

Date Ratified 24 March 2016

Date Policy Effective From 24 March 2016

Next Review Date 01 March 2019

Keywords End of Life Care, Transport, Vehicles, Palliative, Vulnerable patients, End of Life Care Strategy, DNACPR, Dedicated Transport.

Unless this copy has been taken directly from the Trust Quality Management site (Q-Pulse) there is no assurance that this is the most up to date version.

This policy supersedes all previous issues.

Version No 03 of 21POL-CCPS-CP-5

End of Life Conveyance Policy

Version Control - Table of Revisions

All changes to the document must be recorded within the ‘Table of Revisions’.

Version number

Document section/ page number

Description of change and reason (e.g. initial review by author/ requested at approval group

Author/ Reviewer

Date revised

0001 All New Policy Head of Clinical Care & Patient Safety

01 December 2008

0002 All Revised Policy Head of Clinical Care & Patient Safety

01 December 2009

0003 All Revised Policy Head of Clinical Care & Patient Safety

31 March 2012

0004 All Revised Policy to incorporate Deciding Right

Clinical Practice Manager

31 July 2013

V01 Sections:1, 2.1, 4.7, 5.1

Revised Policy content and transferred to the new template. Uploaded to Q Pulse 5 as version 01 (V01).

Clinical Practice Manager

30 September 2014

V02 All Revised Policy, policy name change was originally End of Life Transportation Policy.

Head of Clinical Care & Patient Safety

31 October 2015

V3 12 Update of the associated documents Head of Clinical Care & Patient Safety

21 April2017

This page should not be longer than one single page.

Version No. 03 of 21


Table of Contents1. Introduction 5

2. Purpose 5

2.1 Objectives of the Service 5

2.2 The key outcomes that the proposed service will deliver are: 6

3. Scope 6

4. Duties - Roles & Responsibilities 6

4.1 Trust Board 6

4.2 Chief Executive 6

4.3 All staff 6

4.4 The Chief Operating Officer 7

4.5 The Medical Director and Clinical Advisory Group 7

4.6 The Director of Clinical Care and Patient Safety 7

4.7 The Head of Clinical Care and Patient Safety 7

4.8 All Operational Staff 7

4.9 The Head of Education and Development 7

4.10 The Quality Committee 7

4.11 The Patient Safety Group 8

4.12 EOC Manager and all EOC staff (A&E and PTS) 8

5. Glossary of Terms 8

6. Policy Content 9

6.1 Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) 9

6.2 Response standards 9

6.3 NEAS call handler 9

6.4 Palliative care ambulance crew 10

6.5 A clinician (doctor or nurse) 10

6.6 Transportation of patients who have an active infection 10



6.7 Transportation of vulnerable patients 10

6.8 Transportation of bariatric patients 11

6.9 Transportation of patients requiring oxygen 11

6.10 Children requiring oxygen during transportation 11

6.11 Deterioration of patient’s condition during transport 11

6.12 Referrals 12

6.13 How to make a referral 12

6.14 Inappropriate referrals 13

7. Training Required for Compliance with this Policy 13

8. Equality and Diversity 13

9. Monitoring Compliance with and Effectiveness of this Policy 14

9.1 Compliance and Effectiveness Monitoring 14

Compliance and Effectiveness Monitoring Table for this policy 15

10. Consultation and Review of this Policy 16

11. Implementation of this Policy 16

12. References 16

13. Associated Documentation 16

14. Appendices 16

14.1 Appendix 1 – Operational Detail 17

14.2 Appendix 2 - Booking Process 19

14.3 Appendix 3 – Call Handling Process 20



1. IntroductionNorth East Ambulance Service NHS Foundation Trust (‘the Trust’) acknowledges its responsibility for the provision of optimum patient care.

End of Life Care is an important part of palliative care, and usually refers to the care of a person during the last stage of their life, from the point at which it has become clear that the person is in a progressive state of decline. This policy is designed to assist the Trust in managing transport for patients who are at or near the end of their lives whether the request is for transport only or for patients who require urgent transport due to a clinical need.

2. PurposeThe purpose of the service is to provide responsive and timely patient transport for patients with end of life care needs, who need to be transported to their preferred place of care.

In addition to supporting the discharge of patients at the end of life, the service will also serve end of life patients with complex needs who require admission to a Hospital or Hospice for symptom management.

Provide a dedicated transport resource supported by staff with additional clinical and support skills in order to operate a flexible and responsive service to patients registered with a GP in the NEAS operational area.

Respond at short notice to requests for transport of end of life care patients.

Improve the provision of transport for patients at the end of life, enabling them to be cared for and die in the place of their choice.

2.1 Objectives of the Service

Provide a dedicated, streamlined and efficient transport service for patients with palliative and end of life care needs.

Transport patients in a bespoke vehicle, designed for comfort and dignity.

Transport patients together with their carers.

Reduce waiting times for transport for patients and their carers.

Enable rapid discharge to patient’s preferred place of care.

Reduce length of stay in hospital.

Provide equity in the provision of transport.



Effectively manage resources to ensure appropriate risk management, equity of available services, equity of access to services and value for money.

Provide management information related to demand for transport and unmet need.

To support the delivery of the National End of Life Care Strategy.

2.2 The key outcomes that the proposed service will deliver are:

A dedicated service that will benefit patients, carers, health and social care professionals, and health and social care providers

Helping patients achieve their choice of preferred place of care by reducing

delays in discharge and transfer caused by transport issues

Ensuring appropriately trained personnel who will provide quality care to end

of life patients during transit

Providing effective ways of working with professionals

Providing better coordination and connectivity between hospital, ambulance

and the community

Capturing data about the transport provision required by palliative care

patients

Capturing information relating to demand for transport and unmet need

3. ScopeThis policy applies to all staff, volunteers and contractors who are providing clinical care to patients.

4. Duties - Roles & ResponsibilitiesThe following section details the responsibilities of specific individuals and groups involved in compliance with this document.

4.1 Trust Board

The Trust Board is responsible for gaining assurance that this policy is complied with.

4.2 Chief Executive

The Chief Executive has overall responsibility for ensuring that all staff are equipped to comply with requirements and we have robust policies and procedures in place.



4.3 All staff

All staff within North East Ambulance Service NHS Foundation Trust are responsible for ensuring that the principles outlined within this policy are universally applied.

4.4 The Chief Operating Officer

The Chief Operating Officer has operational responsibility to ensure that all operational staff adheres to the policy and procedures outlined within this document.

4.5 The Medical Director and Clinical Advisory Group

The Medical Director with guidance from the Clinical Advisory Group is responsible for providing guidance and support to the Trust in respect of the clinical standard of practice for End of Life care in accordance with the UK Ambulance Services Clinical Practice guidelines (JRCALC 2013) and for ensuring that all clinical and appropriate non-clinical staff deliver care in accordance with this policy.

4.6 The Director of Clinical Care and Patient Safety

The Director of Clinical Care and Patient Safety has overall responsibility for ensuring the quality of care for patients of the North East Ambulance Service and is responsible for the development of robust policies; providing assurance to the Trust Board that this policy is being complied with and the content remains accurate and up to date.

4.7 The Head of Clinical Care and Patient Safety

The Head of Clinical Care and Patient safety is responsible for ensuring the standards of care delivered for End of Life Care Patients is practiced and maintained. The Head of Clinical Care and Patient Safety must maintain a local profile by attending relevant networks to develop and drive integrated care for End of Life Care patients.

4.8 All Operational Staff

All operational staff are responsible for ensuring that the treatment they deliver to patients is in line with JRCALC and local Trust guidelines; adhering to best practice and that Advance Decision are followed within the principles of Deciding Right and legislation of the Mental Capacity Act in respect of ADRT’s.

4.9 The Head of Education and Development

The Head of Education and Development is responsible for addressing Trust-wide and individual training needs in respect of End of Life Care as directed by the Clinical Care and Patient Safety Directorate.



4.10 The Quality Committee

The Quality Committee is responsible for overseeing the quality of care that is delivered to patients by reviewing clinical incidents involving End of Life Care patients and any audit relating to End of Life Care

4.11 The Patient Safety Group

The Patient Safety Group will assess the effectiveness of the policy and provide a gap analysis and action plans for the Quality Committee to monitor.

4.12 EOC Manager and all EOC staff (A&E and PTS)

The EOC manager is responsible for monitoring compliance with this procedure in the allocation of appropriate transport for this patient group. All EOC staff are responsible for complying with this procedure.

5. Glossary of TermsThis policy uses the following terms:

Term Description

Advance Care Planning Advance Care Planning (ACP) is a process of discussion between an individual and his/her care provider. The process of ACP is to make clear a person's wishes in anticipation of deterioration in their condition.

ADRT A legal documentation of an Advance Decision to Refuse Treatment

DNA CPR DNAR DNR

A document supporting the decision to not initiate cardiopulmonary resuscitation

EHCP Emergency Health Care Plan (A patient care plan for management in an anticipated emergency)

EoL Care Refers to the care of patients in the final hours or days of their lives and also more broadly, care of all those with a terminal illness or terminal condition that has become advanced, progressive and incurable.

Palliative Care Palliative care is treatment aimed at relieving the symptoms associated with serious illnesses and improving a patient's quality of life.

EOC Emergency Operation CentreDirector of Clinical Care and Patient Safety

An executive member of the Trust Board, with the professional responsibility for advising on clinical matters.

Chief Operating Officer An executive member of the Trust Board who has overall accountability and for ensuring the implementation of all Policies and Procedures relating to Operations with all Operational Teams



Term Description

JRCALC Joint Royal Colleges Ambulance Liaison Committee

Advanced Technician A person who holds the IHCD proficiency certificate in Ambulance Aid and has completed a qualifying period of 12 months Emergency and Urgent Activity.

Emergency Care Support Worker (ECSW)

A person who provides support to the Lead Clinician

Emergency Care Assistant (ECA)

A person who provides support to the Lead Clinician, Qualified to NVQ Level 2 in Health Care Support (From 2014 only).

Emergency Care Technician (ECT)

A person who holds an accredited qualification in Ambulance Aid & has completed qualifying period of 12 months Emergency and Urgent Activity.

The Trust North East Ambulance Service NHS Foundation Trust

6. Policy Content6.1 Do Not Attempt Cardiopulmonary Resuscitation (DNACPR)

It is expected that all end of life patients being transferred to their preferred place of care will have a valid DNACPR form. However the patient must not be refused transport because the DNACPR order is either not in place or invalid.

6.2 Response standards

We will aim to have a dedicated vehicle on scene to collect a patient within one hour of receiving the booking request. Requests for the dedicated transport will be prioritised according to patient type and need.

If this response standard is not met, the NEAS Call Handler will contact the person who placed the booking, and the patient if the person who placed the booking is no longer with the patient immediately, as per the ring back procedure, to communicate this delay, with an explanation and an updated expected time of collection.

Requests for transporting patients to a care setting for treatment or investigation and to be returned back to their home/hospice/hospital do not meet the referral criteria for this service. Referrers making such requests should be signposted to the relevant booking procedure for the Patient Transport Service in the CCG area the patient resides in.

6.3 NEAS call handler

As part of the regionally agreed protocol for patients with a DNACPR decision in place, the NEAS Call Handler will, as part of their questioning protocol, routinely ask whether there is a DNACPR decision in place for the patient.

The NEAS Call Handler will need to clarify at this point, if any relatives who may be



travelling with the patient are aware of the DNACPR decision.

The caller must be informed to have the original copy of the DNACPR decision available for the crew to view and confirm its content on arrival and that the document should be ready to be transferred with the patient in an appropriate format.

The caller is further reminded that the original copy of the DNACPR decision is required to be retained with the patient for the duration of the journey(s).

6.4 Palliative care ambulance crew

The palliative care ambulance crew must ensure that the DNACPR form is passed to the family/carer to be placed in the patients care plan.

When the crew arrive at the ward or care setting they must ask the member of staff responsible for the patient for the original copy of the DNACPR decision.

Upon receipt of the DNACPR form the crew needs to check that it has been fully completed:

Patient information in full – Box 1

All Sections, particularly sections 1-3, 5, 6 and 7

Where appropriate any specific ambulance instructions – this may

include contact details of a member of the patient’s medical team and

an agreed destination in the event of death in the ambulance for those

patients who may be deemed seriously ill.

If a patient who is expected to die does not have a DNA CPR in place

and suffers a cardiac arrest whilst the crew are in attendance, the lead

clinician (i.e. Ambulance Technician) should follow the JRCALC

guidelines in respect of when to initiate CPR page 37 paragraph 3 of

JRCALC 2013.

Staff must remember that discretion must be maintained at all times.

The crew must record on their Patient Record Form that they are conveying the patient with a completed and valid DNACPR decision.

6.5 A clinician (doctor or nurse)

A clinician (doctor or nurse) should facilitate discussion with the patient (where appropriate) and the patient’s family about their preferred destination for the patient’s body should death occur in transit, which should be detailed on the DNA CPR order if in place and should occur before the transporting crew arrive on scene.

6.6 Transportation of patients who have an active infection

Patients transferring with an active infection such as C Diff must be highlighted to NEAS at the time of the booking to allow NEAS to allocate sufficient time for cleaning



of the vehicle between patients. Where possible, patients with an active infection should be transported at the end of the day.

6.7 Transportation of vulnerable patients

Patients that require additional support on the journey can be transported with a relative or a Registered Nurse/Health Care Assistant.

6.8 Transportation of bariatric patients

A bariatric patient will be defined as anyone regardless of age, who has limitations in health and social care due to their weight, physical size, shape, width, health, mobility, tissue viability and environmental access with one or more of the following area:

Has a Body Mass Index (BMI) > 40 kg/m² and or are 40kg above ideal weight for height (NICE 2004)

Exceeds the safe working load (SWL) and dimensions of the support surface such as a bed, chair, wheelchair, couch, trolley, toilet, and mattress.

Any patient who meets the above requirements must be clearly stated when placing a booking with NEAS. The Palliative Care vehicles are standard ambulances capable of transporting patients up to127kg/20 stone. NEAS has access to an ambulance capable of transporting bariatric patients. Ideally the Ambulance service will require at least 72 hours’ notice in order to undertake a Patient Moving/Handling Risk Assessment and Plan.

6.9 Transportation of patients requiring oxygen

The palliative ambulance has; on its vehicle an oxygen cylinder and portable oxygen units. Patients can be transported with up to 100% oxygen.

The prescribed dose of oxygen required during transportation must be given at the time of booking by a health care professional.

6.10 Children requiring oxygen during transportation

Children requiring the use of oxygen during transportation must be accompanied by their parent/carer/health care professional who will administer the oxygen to the child.

The patient must use their own mask or cannula.

6.11 Deterioration of patient’s condition during transport

If there has been no discussion with the patient and/or family, and no preferred destination stated at the time of booking, should apparent death occur during transportation, the crew will contact the NEAS Dispatch Officer via radio to request a Paramedic. Once the Paramedic has verified the death, the patient’s body can be transported to the nearest mortuary facility.

In the event that the crew believes death might be imminent and there is no Registered Nurse support accompanying the patient, the crew should:



Pull in at the side of the road.

If the crew believe the patient has died they must record the time they observed the patient takes his or her last breath. The crew should also note who was present at that time.

Where the booking form states the preferred destination should death occur in transit, the crew will request that arrangements are made for the patient’s body to be transported to the preferred destination.

Where the booking form does not state the preferred destination should death occur in transit, if the patient was being conveyed to a hospital, hospice or nursing home, the crew should continue to convey the patient to the destination and the hospital, hospice or nursing home should verify the death.

If the patient was being conveyed to their home, the crew should continue to convey the patient to the destination. Upon arrival at the patient’s home, the crew should request Paramedic support via the NEAS Dispatch Officer. The NEAS Paramedic will verify death.

The NEAS Paramedic will document verification in the ePRF and in any records carried by the patient.

6.12 Referrals

The overriding aim of the referral process is to ensure that referrers accessing the service are able to do so easily and are provided with a timely response.

Referrals which meet the criteria outlined below can be made by any health or social care professional.

The patient resides in and requires transport within the NEAS operational area.

The patient has a valid and current DNACPR order, where appropriate, with a copy available for the transport crew. Note: the patient will not be refused transport because the DNA CPR order is either not in place or invalid.

The patient is near the end of life and is being transferred to their preferred place of care.

The patient is an end of life patient with complex needs who requires admission to a Hospital or Hospice for symptom management.

6.13 How to make a referral

Referrals should be made by ringing the ‘Urgent’ line on 0191 414 3144 and calls should only be made when the patient is ready to travel.

Please note – this is not a dedicated helpline for end of life/palliative care transport requests. Other types of calls requesting urgent ambulance transport are received on this line. If your call is not answered immediately please remain on the line as the



calls are queued and the call handlers are aware of your call. When your call is answered clearly state you are requesting palliative care transport.

Bookings can be taken between 08:30 -17:00; however the booking line will be available 24 hours a day to receive any cancellations.

Requests for transport received by the booking line outside of the operational hours of the dedicated vehicles, and which cannot wait until the dedicated vehicles next become available, should be managed by following the ‘urgent’ call booking and handling processes, utilising the Trusts core emergency care vehicles when the palliative care dedicated transport is not in operation. These requests will be managed as ‘urgent’ requests and prioritised as a 1, 2 or 4 hour response.

The last booking for same day transport must be made by 17:00 hours.

The booking process for individuals placing a request for transport is mapped out in a flowchart as Appendix 2.

NEAS Call Handlers receiving requests should follow the process set out in Appendix 3.

6.14 Inappropriate referrals

If a referral is deemed to be inappropriate, the following action will be taken:

Explanation of referral criteria to the referrer

Redirection of the call to the appropriate service

7. Training Required for Compliance with this PolicyThe crews that have been contracted in to deliver this initiative have received additional palliative care training from one of the hospices within the region. This training was extended to include call handling and dispatch from NEAS. Any additional training compliments the training already delivered within the curriculum to ensure staff have a good understanding of the philosophy of palliative care.

8. Equality and DiversityThe Trust is committed to ensuring that, as far as is reasonably practicable, the way we provide services to the public and the way we treat our staff reflects their individual needs and does not discriminate against individuals or groups on the grounds of any protected characteristic (Equality Act 2010). An equality analysis has been undertaken for this policy, in accordance with the Equality Act (2010).

An equality analysis has been undertaken for this policy, in accordance with the internal Equality Policy and the Equality Act (2010).

Details of this assessment are stored within the central register for Equality Analysis



Assessments maintained within the Equality and Diversity team within the Communications and Engagement department.

9. Monitoring Compliance with and Effectiveness of this Policy

9.1 Compliance and Effectiveness Monitoring

Arrangements for the monitoring of compliance with this policy and of the effectiveness of the policy are detailed below.



Compliance and Effectiveness Monitoring Table for this policy

Process in the policy

Monitoring and auditKey Performance Indicators (KPI)/

Criteria

Method Who By Committee Frequency Learning/ Action Plan

Compliance with the policy

Contact Centre dispatch proceduresComplaints and compliments regarding transport delays for End of Life Care patientsResponse Times

Informatics, complaints and compliments.

Clinical Audit Team and Strategy, Contracting and Performance.

Patient Safety Group and Contracting and Performance Meeting

Monthly Action Plan will be developed and the action plan will be monitored by the Patient Safety Group and Contracting and Performance Meeting. Learning will take through development plans and supervision for call takers, dispatchers, ops crews and EOC clinicians



Process in the policy

Monitoring and auditKey Performance Indicators (KPI)/

Criteria

Method Who By Committee Frequency Learning/ Action Plan



10. Consultation and Review of this PolicyThis policy has been reviewed by the Patient Safety Group; Contracting and Performance team and has been reviewed in consultation with the End of Life Regional Cancer Network.

11. Implementation of this PolicyOnce ratified this policy will be available to all staff via Q Pulse.

12. ReferencesThis document refers to the following guidance, including national and international standards:

UK Ambulance Services Clinical Practice guidelines (2013) Department of Health (2008) End of Life Care Strategy; Promoting High Quality Care for

Adults at the End of Their Life National Institute for Health and Care Excellence (NICE) (2011) Quality Standard for End

of Life Care for Adults Leadership Alliance for the Care of the Dying

13. Associated DocumentationThis policy relates to and impacts upon...

This policy refers to the following Trust documents:

Manual Handling Procedure ref SOP-CCPS-HS-6.

14. AppendicesAppendix 1 - Operational Detail Appendix 2 – Booking ProcessAppendix 3 – Call Handling Process



14.1 Appendix 1 – Operational Detail

Three dedicated vehicles and crew will be available 7 days a week, including weekends and Bank Holidays, operating as follows:

Vehicle sign PALN1 – 10am-6pm; NEAS North Division (Cumbria Northumberland, Newcastle, North Tyneside).

Vehicle sign PALC2 – 9am-5pm; NEAS Central Division (South Tyneside, Gateshead, Sunderland and North Durham.

Vehicle sign PALS3 – 11am-7pm; NEAS South Division (Durham Dales, Darlington, Hartlepool & Stockton and South Tees).

Outside Dedicated Vehicle Times

It should be noted that outside of these times, should there be a need for transport, then requests will be managed by Emergency Care following the ‘urgent’ call processes.

These vehicles will be equipped to transport patients at the end of life comfortably and efficiently. Vehicles will be ambulances with a tail lift for loading, trolley bed and two seats. Additional equipment and customisation will include:

Forward-facing seats to reduce the possibility of patients or relatives being travel sick.

Vehicle specification:

Stretcher bed incorporating specialist pressure-relieving mattress Piped oxygen supply with high flow regulators Climate air-conditioned saloon Curtains or blinds for windows Disposable pillows Space to secure oxygen concentrator if it is required to be transported with the patient Standard blankets IV infusion hanging points AED Defibrillator Receiving (vomit) bowls, urine bottles, bed pans Tissues Clinical waste bags Dressing packs Basic Life Support equipment First Aid equipment Drinking water for patients

Staff Skills

In order that the dedicated transport is staffed appropriately and can handle all types of End of Life transport requests, additional skills and competencies of the crew will be expected. These will include:

Good understanding of the philosophy of palliative care Good communication skills



Comfort skills for patients and carers Good understanding of emotional issues Information to be collected from staff before someone is transported Airway management Oxygen management Use of stretchers Familiarity with signs of imminent death Supporting carers when symptoms of imminent death arise Dealing with death Dealing with DNA CPR orders Understanding of Advance Care Planning and Deciding Right principles



14.2 Appendix 2 - Booking Process

Booking Process for individuals wanting to request Palliative Care Transport ensure your request for palliative care transport meets the referral criteria in section 3

Ring NEAS on 0191 414 3144 between 08:30-17:00 Monday to Sunday and only when the patient is ready to travel

Upon your call being answered, state you are requesting Palliative Care Transport

Provide the following information to the NEAS Call Handler:

Your name and contact details

Patients full name

Patients Date of Birth

Patients NHS Number

Location of Patient

Destination of Patient

Mobility of Patient

Inform the NEAS Call Handler if any of the following apply:

Patient has a valid and current DNACPR in place, and if relatives are travelling with patient, whether they are aware of DNACPR decision

If the patient is defined as Bariatric

If patient has a C Diff infection

Patient is a vulnerable patient and will be accompanied by a relative or Registered Nurse/Health Care Assistant

To cancel a booking ring 0191 414 3144 (line open 24 hours a day for cancellations only)

Requests for same day transport must be made by 17:00.



14.3 Appendix 3 – Call Handling Process

NEAS Call Handling Process to be followed when receiving calls for palliative care transport.

Upon answering the call and Caller informs you they are requesting Palliative Care Transport:

Triage as normal, selecting ‘Urgent’ in Incident Type, and select the relevant Provider from Requester Type field and log the following information:

Requester name and contact details

Patients full name

Patients Date of Birth

Patients NHS Number

Location of Patient

Destination of Patient

Mobility of patient

Ask the following information if not forthcoming:

Does the Patient has a valid and current DNACPR in place, and if relatives are travelling with patient, whether they are aware of DNACPR decision – select DNR box if appropriate

Inform Person placing booking the DNACPR must be available for the transport crew to view upon arrival and that original copy must transfer with the patient

Add any other information offered: If the patient is defined as bariatric log in the ‘Instructions’ field All other information such as patient has a C Diff infection, is on oxygen etc. -

log in case notes Between 08:30-17:00 - Select ‘Palliative Care’ in the case reason field Between 17:00- 08:30 - Select ‘Palliative Care OOH’ in the case reason field Between 08:30-17:00 - Confirm whether patient is ready to travel and Select

‘1 hour’ response time Between 17:00-08:30 - Confirm whether patient is ready to travel and Select

either the ‘1, 2 or 4 hour’ response time requested

Complete booking and add into crew notes that the patient has a DNACPR and save and close, transferring to the Dispatch Desk.


introduction… · web viewpalliative care is treatment aimed at relieving the symptoms associated...

Documents