NHS Forth Valley mental health emergencies
- The Duty Doctor/ANP and Certifying Medical Practitioner will determine the need for an escort.
- Where an escort is required the duty doctor/ANP will liaise with the duty charge nurse (Page 0009) or contact the intended admitting ward.
- A pragmatic risk assessment will determine the most appropriate mode of transport for the patient and if Police Scotland should be advised asked to attend the scene.
- If police are asked to attend, the mode of transportation should be agreed between health professionals and the police.
- Police transportation or detention in a police cell should be avoided wherever possible.
Arranging transport to hospital
- The Certifying Medical Practitioner is responsible for organising transport to hospital.
- Receiving service assumes responsibility once contacted by Certifying Medical Practitioner, following detention.
- Duty of care remains with Certifying Medical Practitioner, until the staff from the receiving service are with the patient.
Certifying Medical Practitioner should inform the Duty Doctor/ANP by contacting the Single Point of referral on 01324-567250.
Provide the following information to Single Point of Contact:
- Patient's name and date of birth
- Confirmation of detention
- Details of the presentation
- Location of detention
- Their own contact phone number
- Any risks associated with the case to date
- The level of agitation demonstrated by the patient to date.
- Escort staff should be a 1st level registered nurse with, at least one other member of staff, not including the driver.
- Preferred transport is by hospital people carrier.
- In exceptional cases, an ambulance may be required to safely bring the patient to hospital.
- For ambulance transport escort staff must still attend the patient’s location and await the ambulance with the patient.
- Personal transport is acceptable, if in accordance with risk assessment.
Transport by car/people carrier, if:
- There is a minimal risk of violence.
- No acute physical illness.
- Patient is reasonably compliant.
- Whether patient is informal or detained.
Ambulance transport, if:
- Patient is physically ill.
- Patient is grossly intoxicated.
- Patient has received sedation.
- Whether patient is informal or detained.
Police car/van if:
- There is imminent risk of violence
- Risk cannot be managed in other means of transport.
- Only if patient is detained.
Transport by family or friends:
- Most commonly used for informal patients.
- May be possible for some detained patients (assess for risk).
The patient should be transported to hospital within 1 hour, to minimise stress for both patient and staff.
In case of delay, the situation should be escalated as per Pathway for escalation of transport to hospital.
- Risk to staff may increase once a patient has been informed of detention.
- Staff should remain vigilant for verbal an non-verbal cues of impending violence.
- If a patient is agitated in their own home and does not rapidly respond to verbal de-escalation, staff should immediately remove
themselves, and anyone else aside from the patient, from the environment. - Police should be called to provide assistance.