PATIENT TRANSPORT POLICY AND PROCEDURES. Documentation Control

Transcription

1 PATIENT TRANSPORT POLICY AND PROCEDURES Documentation Control Reference Approving Body HS/EI/005 Directors Group Date Approved 3 Implementation Date 3 NUH version 3 (July 2008) Supersedes Consultation Date of Completion of Equality Impact Assessment Target Audience Supporting Documents and References Primary Care Trust, Finance, Transport Booking Team, PTS Handover Group, EMAS 22 June 2010 All staff and public Travel Cost Scheme, Traffic Management Policy, National Guidance for Eligibility for Non Emergency Patient Transport Review Date April 2013 Lead Executive Author/Lead Manager Further Guidance/Information Director of Operations Alan Farrar Deputy Director of Operations Jo Tomlinson Asst Head of Property Services (Land and Property) Antonia Kingaby, EIA Officer Patient Transport Booking Office

2 Contents Paragraph Title Page 1 Procedure Statement 4 2 Introduction 4 3 Responsibilities 5 4 Eligibility Criteria 6 5 Patients in Receipt of Mobility Allowance 7 6 Financial Assistance 8 7 Escorts/Attendants 8 8 Booking procedure (Monday Friday) 9 9 Bariatric Patients Fast Track / Patient with a rapidly deteriorating condition Discharge ( Includes inter hospital transfers/home visits) Special Discharge Situations (On the day requests including weekends) Emergency Inter-Hospital Transfers How to Book Discharge Transport Equality and Diversity Statement Equality Impact Assessment Statement Environmental Impact Assessment Statement We Are Here For You Standards Mission Statement 14

3 Contents Paragraph Title Page Appendix 1 Eligibility flow chart 16 Appendix 2 Mobility Codes 17 Appendix 3 Equality & Environmental Impact Report 18 Appendix 4 Discharge Flow Chart for Patient with Rapidly Deteriorating Condition 22 Appendix 5 Employee Record of Having Read the Policy 25 We Are Here For You Standards Compliance Assessment 26

4 1.0 Policy Statement 1.1 Nottingham University Hospital NHS Trust is committed to ensuring that the Patient Transport Service provided to the Trusts patients is a high quality, punctual and professional Service that will support and complement the provision of health care at Nottingham University Hospitals NHS Trust and meets the needs of the patients we serve. 1.2 We will do this with our partners who commission and or provide patient transport. 1.3 Whatever the role we play, NUH will ensure that s its staff are always respectful of people s individuality, privacy and dignity, that we take the time to listen and hear what people say, we take ownership of delivering the help that is required, we look and behave professionally. We involve patients/carers as partners, helping them to be clear about their condition, choices, care plans and how they might feel. We understand the important role that patients and family s feelings play in helping them feel better and aim to offer a responsive service, simplify processes and work to solve patients/carers frustrations. 2.0 Introduction 2.1 This document provides information for all members of staff and the public: information needed to provide a quality, punctual and professional Patient Transport Service that will support and complement the provision of health care at Nottingham University Hospitals NHS Trust. 2.2 Non-Emergency Patient Transport will only be approved and arranged where it has been identified by the patients GP or Consultant that the patient s health would suffer through the use of public or private transport and there is a clear medical need. As per the national policy for eligibility for non emergency patient transport

5 2.3 Each patient should be able to get to and from the hospital in a reasonable time and in reasonable comfort without detriment to their medical condition. 2.4 Non emergency patient transport should be the exception not the rule, therefore there must be strict adherence to the procedure 2.5 This service is only provided to patients receiving treatment from/or at Nottingham University Hospitals NHS Trust. 3.0 Responsibilities * Trust Board - is responsible for ensuring a professional transport service which meets the needs of the patients. * Primary Care Trust (PCT) - are the commissioners for the service and will ensure the service is fit for purpose. * Delete as appropriate 3.1 Chief Executive - is ultimately accountable for ensuring the patients experience when visiting the hospital is a positive one Although the Patient Transport Service is provided by the Primary Care Trust. The Chief Executive delegates to the Operations Director the responsibility of ensuring that the service provided does not impact on the patient experience or service delivery. 3.2 The Primary Care Trust - shall have management responsibility for PTS. 3.3 Transport Booking Officers shall be responsible for accurate booking of transport, helping to minimize abortive journeys and ensuring appropriate application of the eligibility criteria. All reasons for granting and refusing transport must be clearly documented on the booking system. They will take into account details contained within the notes section of the booking to ensure that all relevant details are taken into account when reviewing transport needs and or modes of transport. Access to book on line will only be granted once training has been passed. Training will be facilitated by the provider.

6 3.4 Individual NUH Members of Staff - shall be accountable for ensuring they abide by the Patient Transport Procedures. This is applicable to all forms of Transport used for moving patients into or from the Trust. Staff should ensure that all requests are assessed against the eligibility criteria and abortive journeys minimised Access to book on line will only be granted once training has been passed. Training will be facilitated by the provider. All reasons for granting and refusing transport must be clearly documented on the booking system. 3.5 Transport Providers all staff engaged with transporting patients in to and out from the Trust shall ensure that they minimize abortive journeys and ensuring that the eligibility criteria has been appropriately applied. The Transport Providers will be monitored against key performance indicators established by the PCT to ensure that the service commissioned is provided. 3.6 Contract review group - This PCT lead group meets to discuss those contracts that the trust holds and participates in at PCT review meetings with the patient transport providers 3.7 East Midlands Ambulance Service (EMAS) is the sole provider of Patient Transport Services (PTS) and responsible for ensuring that services are available at all times, this includes procuring additional 3 rd party transport providers when required. 3.8 They will be responsible for the management of their vehicles and will comply with the NUH policy on Traffic Management. 4.0 Eligibility Criteria 4.1 Patients attending hospital appointments do not have an automatic right to non emergency patient transport 4.2 It is the patients responsibility to make their way to and from hospital. 4.3 However, transport will be provided, but only if a clear medical need has been identified either by the patients GP or Consultant Further

7 clarification may be sought from the GP or Consultant by the booking team when reviewing travel options and or criteria. 4.4 For non emergency patient transport, the patient s identified medical needs should be identified as one of the following criteria: The patient requires skilled assistance when transferring to and from a vehicle, (for example, being on a stretcher, due to dementia, physical disabilities or mental capacity issues). The patient has a disability or condition that makes it difficult, impossible or undesirable for them to be conveyed by alternative transport, (for example dementia, physical disabilities or mental capacity issues) The patient has a condition whereby skilled assistance during the journey may be required, (for example severe epilepsy, dementia) Stretcher Patients. The patient has a disability or condition that may result in risk or embarrassment to the patient or others during transport, (for example severe epilepsy, dementia and mental capacity issues). 4.5 For those who do not meet the eligibility criteria, other transport options must explained, for example the Medilink service or public transport Options. These can be found on the Trust intranet The WRVS also supplies a Volunteers car driver s transport scheme, providing transport services for patients and visitors in need. To Contact the WRVS Voluntary Drivers Scheme Tel: extension Patients in receipt of Mobility Allowance 5.1 What is Mobility Allowance? Mobility Allowance is the second component of the Disability Living Allowance (DLA) and is used to pay for the cost of your travel either by taxi or public transport, or with the Motability Scheme you exchange your mobility allowance for a car.

8 5.1.3 Patients in receipt of Mobility Allowance should make their own way to hospital and are not automatically entitled to none emergency patient transport unless a clear medical need has been identified. (Please refer to point 4.0 regarding eligibility criteria) 5.2 Phone number and web site details of DLA Disability Living Allowance Unit Warbreck House Warbreck Hill Blackpool Lancashire FY2 0YE Phone number (Helpline) Text phone Opening Hours: Monday to Friday 7.30 am to 6.30 pm 6.0 Financial Assistance 6.1 Patients who do not fit the eligibility criteria for non emergency patient transport may obtain a cash refund for travel to the hospital when travelling by public transport or private car, if they are in receipt of one of the following: Income support Working families tax credit Income-based job-seekers allowance 6.2 Patients arriving by public transport must bring the receipt/ticket and their proof of benefit with them. They must go to hospital administration offices at either campus to make their claim. 6.3 Patients arriving by private car may be able to apply for petrol costs current rate per mile up to the cost of public transport fare. Proof of benefits must also be provided at the time of the claim. 6.4 Further details of the hospital travel cost scheme can be found at

9 visitors/transport/ 7.0 Escorts/Attendants 7.1 Escorts/attendants are allowed to accompany patients in non emergency patient transport as long as the escort/attendant fits into one of the following criteria and the patient has a clear identified medical need as outlined in point 4.4 Professional from a nursing home or school Accompanying a minor (under 16 years of age). The escort/attendant for a minor must be a responsible adult. 7.2 Accompanying a patient with special needs e.g. the patient is aphasic, blind, confused, has learning disabilities or needs skilled assistance for the journey 8.0 Booking Procedure Monday - Friday Outpatients, Admissions, Day Cases, 8.1 A minimum of 24 hours and maximum of 4 weeks notice is required to register a request for none emergency patient transport 8.2 ANY CANCELLATION NOT NOTIFIED WITHIN 24 HOURS MAY RESULT IN ADDITIONAL CHARGES BEING RAISED AND OR A DISRUPTION TO OPERATIONAL SERVICES. 8.3 This can have a far reaching effect on the level of patient care such as: Increased cost Delay in treatment Missed appointments Increased waiting times 8.4 If your Consultant or GP have advised that you have a medical condition that may entitle you to none emergency patient transport, the patient or their representative should contact the Transport Booking Office on between the hours of 9.00am 4.00pm, Monday to Friday. 8.5 It is vital that the patient or their representative states if the patient will require an escort/attendant to be with them and on which part of the

10 journey. (Please refer to section 7 for eligibility criteria for escorts/attendants) 8.6 If specialist equipment is required for use by the patient during the journey, the patient or their representative must state this when making the booking for none emergency patient transport. 8.7 Patients may travel in specially adapted wheelchairs if they have them. 8.8 Patients, who are able to transfer from a wheelchair to a seat, will not be able to bring their own wheelchair. Wheelchairs are available on arrival at hospital. 8.9 If the patient s mobility will differ on the homeward journey please make this clear when making the booking If a patient needs to be admitted to the main hospital from the Day Surgery Unit, contact ambulance control x Day Hospitals should make bookings directly with the transport provider. (Please do not forget to cancel a regular booking if one day s journey is not required for any reason) 8.14 The Trusts named taxi provider must not be used for the transportation of patients. All PTS journeys should be provide by EMAS 9.0 Bariatric Patients. Bariatric Patients are those greater than 21 stone in weight, although weight must not be the only consideration the patients build must also be assessed. Therefore, EMAS will need to undertake a risk assessment prior to transportation. 24 hours notice within the East Midlands and 48 Outside is required Fast track/ Patient with a Rapidly Deteriorating Condition EMAS are committed to providing a quick service for these patients. The procedure for Fast Track booking is: Telephone PTS Control Room on rather than book online Ask to speak to a team leader Provide with relevant information: DNAR status Consider if family wish to travel with patient Consider the need for direct transfer

11 Consider if Oxygen is needed Consider mobility is a stretcher needed. Contact Hospital Palliative Care Team (City campus ext / QMC campus ext 68402) if you require any further guidance The information sheet at Appendix Four must be completed and followed in all cases Discharge (includes inter hospital transfers and home visits) 11.1 A patient s journey home should be discussed with the patient upon admission. It is expected that all patients will make their own arrangements unless there is a medical need for non emergency patient transport Where medical need has been identified, transport should be booked in advance of the discharge date where possible. If the discharge address is out of the East Midlands if possible 48 hours notice should be given and it may be that the patient can only be discharged at the weekend A patient with a date for elective surgery and where it is known they will be in hospital for less than 48 hours and they live out of the East Midlands should have their discharge transport arranged prior to their admission. The eligibility for transport must be established at pre op assessment, and duly cancelled if appropriate, by the member of staff receiving the information Discharge transport after an emergency admission must be ordered as soon as possible after discharge date is known It is the responsibility of ward staff to notify the transport provider that the patient is ready to leave the ward The patient is not ready to go until all of the following are in place: - Medication Doctor s letter Home care package Therapy aids DNAR ( Do not attempt resuscitation ) paperwork 11.7 The patient must be made ready with the transport provider. The ward should ensure that the patient is ready to leave at the time they are booked. Any delays caused or arrivals outside of the agree times must

12 be reviewed either internally or with the provider to ensure re occurrence is minimised If the patient is not ready to leave the ward when the ambulance crew arrives, the crew is not required to wait The patient s discharge could be delayed for at least 24 hours with the obvious implications for the ward and the waiting list NO PHONE CALL BOOKINGS WILL BE ACCEPTED. The only accepted method of booking is PTS Online or when the system is down fax. Any fault with the system must be reported to EMAS immediately on (office hours) DNAR paperwork must be completed at ward level and travel with the patient. The transport provider will also need to know who is aware of the order i.e. the patient / relatives etc The transport provider must be notified of any communicable illness such as MRSA and Clostridium Difficile Special Discharge Situations On the day requests, including weekends 12.1 It will be necessary to contact the EMAS control room ext (77) It must be stressed that the patient MUST be ready for discharge, as described above, before this request is made Inter hospital transfers/home visits are dealt with in the same way as a discharge. If the receiving hospital is a long distance away, extra time must be given to the ambulance service. At least 48 hours notice must be given Long Distance discharges/transfers must be discussed with EMAS liaison staff prior to making a booking. At least 48 hours notice must be given Weekend discharge/transfers must be booked on the day by calling the EMAS control room 13.0 Emergency Inter Hospitals Transfers

13 13.1 A patient who requires specialist treatment on the journey from the hospital e.g. a patient with intravenous drips in situ, a patient with uncontrolled epilepsy or unconfirmed fractures, will be transported by the accident and emergency department of EMAS by contacting How to Book Discharge Transport 14.1 Only the staff designated by the Ward Manager or their deputy may make transport bookings Refer to Appendix 3 to establish patient s mobility needs (never use the wheelchair option UNLESS the patient has his/her personal wheelchair with them on the ward) Please use the PTSonline system wherever possible. You may use printed form SN789 in person to EMAS 14.4 Each time the patient requests transport they must be asked if anything has changed since their last visit regarding their mobility or condition. These changes must be recorded on the booking system Highlight any special instructions. E.g. Any infectious disease, DNAR, MRSA (identify site, is it covered?), C Diff. Oxygen (how much) It is important that the any access difficulties (like steps) at the home address are identified. Does the patient need to be carried upstairs? 14.7 Book any equipment to travel with the patient e.g. walking frame Note that only one small bag will be carried in the transport. Relatives must remove all other luggage. In special circumstances and after negotiation with EMAS extra luggage may travel with the patient. 15. Equality and Diversity Statement 15.1 All patients, employees and members of the public should be treated fairly and with respect, regardless of age, disability, gender, marital status, membership or non-membership of a trade union, race, religion, domestic circumstances, sexual orientation, ethnic or national origin, social & employment status, HIV status, or gender re-assignment.

14 15.2 All trust polices and trust wide procedures must comply with the relevant legislation (non exhaustive list) where applicable: Equal Pay Act (1970 and amended 1983) Sex Discrimination Act (1975 amended 1986) Race Relations (Amendment) Act 2000 Disability Discrimination Act (1995) Employment Relations Act (1999) Rehabilitation of Offenders Act (1974) Human Rights Act (1998) Trade Union and Labour Relations (Consolidation) Act 1999 Code of Practice on Age Diversity in Employment (1999) Part Time Workers - Prevention of Less Favourable Treatment Regulations (2000) Civil Partnership Act 2004 Fixed Term Employees - Prevention of Less Favourable Treatment Regulations (2001) Employment Equality (Sexual Orientation) Regulations 2003 Employment Equality (Religion or Belief) Regulations 2003 Employment Equality (Age) Regulations 2006 Equality Act (Sexual Orientation) Regulations Equality Impact Assessment Statement 16.1 NUH is committed to ensuring that none of its policies, procedures, services, projects or functions discriminate unlawfully. In order to ensure this commitment all policies, procedures, services, projects or functions will undergo an Equality Impact Assessment Reviews of Equality Impact Assessments will be conducted inline with the review of the policy, procedure, service, project or function 17. Environmental Impact Assessments 17.1 The purpose of an Environmental Impact Assessment is to make sure that when carrying out its public functions (or implementing policies and practices related to those functions) the trust considers the likely impact of the policy or procedure in causing change to the environment, and whether this change is harmful or helpful.

15 17.2 This may involve direct effects such as changes in the use of resources, waste levels, or energy, (as some examples). Further guidance on environmental impacts may be found in: Sustainable Development - Environmental Strategy for the National Health Service ( and Sustainable Operations on the Government Estate ( ) Policies will not be accepted for ratification without a completed Environmental Impact Assessment. 18. We Are Here For You Standards mission statement: 18.1 This Trust is committed to providing the highest quality of care to our patients, so we can pledge to them that we are here for you. This Trust supports a patient centred culture of continuous improvement delivered by our staff. The Trust established the Values and Behaviours programme to enable Nottingham University Hospitals to continue to improve patient safety, outcomes and experiences. The set of twelve agreed values and behaviours explicitly describe to employees the required way of working and behaving, both to patients and each other, which would enable patients to have clear expectations as to their experience of our services

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

18 Appendix Two New or Replacement Code C Patient Mobility code explained Fully Mobile - Car transport Use of Mobility code explained Journeys by Voluntary Car Service/Out of area Journeys/Journeys transported by Private Hire C1 Fully Mobile - Car transport Ambulance Car (PTD) A1 A2 WC1 Fully mobile - unable to get into a car - single crew Hand seat patient - able to transfer/travel in a normal ambulance seat but requires the assistance of a double crew Own wheelchair (wheelchair bound) patient unable to transfer or travel in a normal seat within ambulance - Access to and from property manageable by one person ONLY Single Crew Ambulance - no attendant Double Crew Ambulance - Driver and attendant Single Crew Ambulance with ability to transport patient in own wheelchair

19 WC2 ST AE NP Own wheelchair (wheelchair bound) patient unable to transfer and travel in a normal seat within ambulance - due to access/egress - medical need Stretcher required - Patient needs to lay during transportation A&E Ambulance Technician/Paramedic trained staff Non Patient Transport Double Crew Ambulance with ability to transport patient in own wheelchair - Driver and Attendant Double Crew Ambulance with stretcher facility A&E Ambulance Technician/Paramedic trained staff required due to medical need

20 Section One: Equality and Environmental Impact Assessment Appendix 3 What is being assessed? Is the policy/function/service/project Policy Guideline Procedure Plan Existing Proposed Service Name of Policy or Service Non Emergency Patient Transport Name of Responsible Manager Alan Farrar Give a brief description, aims and objectives of the Policy/Guideline/Procedure/Plan/Service This policy provides information for all members of staff and the public on the use of Non-Emergency Patient Transport. Transport will only be approved and arranged where it has been identified by the patients GP or Consultant that the patient s health would suffer through the use of public or private transport and there is a clear medical need. As per the national policy for eligibility for non emergency patient transport Changing/Reviewed Is the policy/guideline/procedure/plan/service being assessed relevant to: Staff Patients Stakeholders Environment Will there be a requirement to consult on the proposed Policy, Guideline, Procedure, Plan or Service? Yes No If Yes who will be consulted? Staff Patients Stakeholders 20

21 Section Two: Screening Checklist Does your Policy, Guideline, Procedure, Plan or Service contain any statements or actions which may potentially impact upon any of the following Areas? Age Gender (Male, Female and Transsexual) Race Sexual Orientation Religion or Belief Disability Dignity & Human Rights Working Patterns Social Deprivation Air Land Water Resource Depletion YES If Yes please complete the Full Impact Assessment in section 4 EQUALITY ENVIRONMENTAL Yes Yes NO If No please give reasons on the summary sheet in section 3 No No No No No No No No No No 21

22 Section Three: Summary of Screening COMPLETE THIS SECTION IF YOU HAVE ANSWERED NO IN THE SCREENING SECTION Please state your reasons below giving as much information as possible including any relevant data to support your findings Equality Environment The Patient Transport Procedure does not discriminate against any of the equality strands as the criteria states that eligibility is on identified medical grounds. There is no identified impact on land or water Date EIA Completed Please state the monitoring and review arrangements: State the names of those involved in the EEIA assessment: 21 June 2010 Once ratified this procedure should follow NUH guidelines for review. Name A Kingaby P Peck Position EEIA Officer Travel and Security Co-ordinator Once completed this section will be added to the policy with section 1 (if you identified both yes and no include sections 1, 3 and 4) as the penultimate appendix to the policy. 22

23 Section Four: Full Impact Assessment Plan COMPLETE THIS SECTION IF YOU HAVE ANSWERED YES IN THE SCREENING SECTION Equality/ Environmental Area Potential/Possible Impact identified Action Required Target Date Responsible Person/s Expected Outcome Air Emissions from vehicles Ensure that all vehicles are serviced on a regular basis inline with SLA ongoing EMAS Better fuel usage Resource Depletion Natural depletion of vehicles used for transport No action required as the depletion/renewal of vehicles is a natural process EMAS Once completed this section will be added to the policy with section 1 (if you identified both yes and no include sections 1, 3 and 4) as the penultimate appendix to the policy. Date EIA Completed State the names of those involved in the EEIA assessment: Name Position 23

24 21 June 2010 A Kingaby P Peck EEIA Officer Travel and Security Co-ordinator 24

25 Name: ID Number: Insert Patient Sticker Appendix Four Discharge Flow Chart Patient with a Rapidly Deteriorating Condition Name (Print) Full Signature Initials Profession Date Please tick relevant boxes as appropriate Date / initial Fast Track Fast Track eligible - Complete & fax Fast Track referral form with information on prognosis & care needs required City Fast track Co-ordinator Fax County Fast Track Co-ordinator / Fax Other - State: Fax Place of Discharge Home Nursing Home Residential Home Relatives Home Patient & Family / Carer Understanding Patient aware of diagnosis Carer aware of diagnosis Patient aware of prognosis Carer aware of prognosis Confirm understanding of plan of care (fast track) / future care Environment - If any of the following apply discuss with community team Does the patient live alone- can the nurse gain access Smoking patient/carer Alcohol misuse patient/carer Aggression patient/carer 25

26 Equipment OT referral Requested Supplied Bed & mattress Commode/urinal/catheter & stoma bags/pads Hoist & training Mouth Sponges/gloves/aprons/sheets Syringe driver & key for locked box / Syringes Other: Care Needs- Social Work referral Assess care needs over a 24 hour period & discuss with family / carer Clarify package of care & document on patient / carer discharge information sheet Community Referrals District Nurse DN referrals / (Out of Hours) with verbal update (medication requirements / need for sitter service / syringe driver use) Fax written referral to District Nurse GP Provide verbal update & discuss NEMS - Out of hours registration via Special Patient Note / GSF status / Registration of End of Life Care Decision Form / Anticipatory prescribing Fax written referral to GP Nurse Specialist referral & verbal update if required For Nottingham City PCT Care Home discharges EOLC Implementer ext Transport Confirmed date / time of discharge: / hours Fax End of Life Care Decision Form to EMAS prior to discharge as relevant EMAS & speak to team leader relating to the following as appropriate Rapidly deteriorating & wish for care at home Single patient travel direct to destination Family requesting travel with the patient Place of care (upstairs/downstairs) Additional equipment i.e. oxygen/syringe driver Date/initial Medication pre-emptive prescribing for symptoms Dosette Subcutaneous prn medication (last days of life) Syringe driver Water for injection for s/c meds Oxygen - Complete HOOF Fax HOOF to confirm installation Wound dressings/catheters/sheaths 26

27 Patient & / or carer understanding of medication Fax TTO form to District Nurse & GP If plan coordinated by discharge coordinator, arrangements / plan confirmed by registered nurse prior to discharge Date/Time Additional information Initial 27

28 Appendix Five EMPLOYEE RECORD OF HAVING READ THE PROCEDURE PATIENT TRANSPORT POLICY AND PROCEDURES I have read and understood the principles contained in the named procedure. Print Full Name: Signature: Date: 28

29 We Are Here For You Compliance Assessment To what extent is your Policy or Trust-wide Procedure affected by the following We Are Here For You values? Please rate each value from 1 3 (1 being not at all, 2 being affected and 3 being very affected) 1. Polite and Respectful Whatever our role we are polite, welcoming and positive in the face of adversity, and are always respectful of people s individuality, privacy and dignity. 2. Communicate and Listen We take the time to listen, asking open questions, to hear what people say; and keep people informed of what s happening; providing smooth handovers. 3. Helpful and Kind All of us keep our eyes open for (and don t avoid ) people who need help; we take ownership of delivering the help and can be relied on. 4. Vigilant (patients are safe) Every one of us is vigilant across all aspects of safety,

30 practices hand hygiene and demonstrates attention to detail for a clean and tidy environment everywhere. 5. On Stage (patients feel safe) We imagine anywhere that patients could see or hear us as a stage. Whenever we are on stage we look and behave professionally, acting as an ambassador for the Trust, so patients, families and carers feel safe, and are never unduly worried. 6. Speak Up (patients stay safe) We are confident to speak up if colleagues don t meet these standards, we are appreciative when they do, and are open to positive challenge by colleagues. 7. Informative We involve people as partners in their own care, helping them to be clear about their condition, choices, care plans and how they might feel. We answer their questions without jargon. We do the same when delivering services to colleagues. 8. Timely We appreciate that other people s time is valuable, and offer a responsive service, to keep waiting to a minimum, with convenient appointments, helping patients get better quicker and spend only appropriate time in hospital

31 9. Compassionate We understand the important role that patients and family s feelings play in helping them feel better. We are considerate of patients pain, and compassionate, gentle and reassuring with patients and colleagues. 10. Accountable Take responsibility for our own actions and results 11. Best Use of Time and Resources Simplify processes and eliminate waste, while improving quality 12. Improve Our best gets better. Working in teams to innovate and to solve patient frustrations Total Score 28 31