Medico legal aspects of transfers

Key points All our actions should be based on: • Beneficence (doing good) • Non-maleficence (doing no harm) • Justice (fair treatment for all) • Autonomy (respect for patient’s wishes)

Aim to maintain the same professional and personal conduct that would be considered ‘good clinical practice’ in the normal working environment. The Consultant in charge of the ICU transfer must take ultimate responsibility for the appropriateness of the transfer with adequately trained and experienced staff

Legality The patient remains the responsibility of these staff until formal handover has been completed at the receiving hospital A legal record of the transfer process being an essential piece of documentation. In the event of advice being offered by telephone, little legal guidance is available

Transfer Documentation 3 coloured pages White goes to receiving hospital Pink to the NENC Network for Audit Blue for patients notes in transferring hospital Future is electronic The books are developed by the North East and North Central Network for Adults in Critical Care. There are 3 forms through carbon. All sections need to be completed by the transferring hospital by whom ever is in charge of the transfer. The White sheet goes to the receiving hospital. The pink sheet goes to the NENC Network for audit purpose and the blue goes to referring hospital patients notes.

Transfer Documentation

Governance Completing the NENC LONDON ODN transfer form is mandatory and is the joint responsibility of the doctor and nurse on transfer A comprehensive handover needs to be done at the receiving unit and the NENC LONDON ODN transfer form should be signed by the receiving clinician to document their acceptance of the patient. This form contains a pre transfer checklist, as well as the transfer record. As such it provides a vital part of the patient’s medical record. A copy should be in the patient’s notes at both the receiving and referring units and one copy lodged with NENC LONDON ODN Office, 4th floor at the Royal Free Hospital.

Telephone advice A telephone advice is simply guidance Accept or give only clear and precise instructions with appropriate documentations and records. If phoning for advice – clearly document times of call and who you spoke to, grade and the Consultant in charge for the Specialty

Insurance In the event of an individual being required to escort a patient outside of their place of employment, personal and professional indemnity will be provided by the employing Trust. The transfer vehicle becomes an extension of that individuals work environment for the duration of the transfer and return

Safety Therefore only transfer if needed High speed transfers should be exception Few minutes gained rarely benefit the patient Wear your seatbelt and stop if needed Must be able to justify the risks