Arranging transport to hospital

• 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.

• 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.