• 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.


Determining need for an escort 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 to hospital

  • 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).

In case of delay in transportation

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.

In case of aggression when awaiting transport

  • 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.

Editorial Information

Last reviewed: 28/05/2021

Author(s): Julia Ferrari, Joe McGhee, Duncan Westall, William McFadden, Heather Tainsh , Susan Sutherland, Marie White , Anne Cook, Justin McNicholl, Douglas Armstrong, Dr Nabila Muzaffar, Dr Stuart Affleck, Dr David Cumming, Andrew Angus, Jackie Maher, Rose Mills, Vincent Hughes..