GP/Medical Practitioner ensures hospital bed available. ASW, Medical Practitioner and relevant others carry out an assessment on how best to convey the person safely to hospital

The GP/medical practitioner, who has made the medical recommendation, should clarify if a bed in a psychiatric or learning disability hospital has already been identified by the doctor in the general hospital. If not, the medical practitioner should contact the hospital in the Trust area responsible for the person whose detention is sought to secure a bed. If a bed is not available consultation should take place with the person/persons responsible for bed management in that Trust to ensure that a bed is located in another Trust.

An assessment of how best the person can be conveyed to hospital should be carried out by the ASW and the recommending medical practitioner.

Who has responsibility for ensuring that the person is conveyed to hospital?

If the patient is to be transferred to the psychiatric or learning disability hospital within 2 days of the medical recommendation (Form 3), the applicant will have responsibility for ensuring that a person is conveyed to hospital. In most situations the applicant will be the Approved Social Worker.

The ASW has a professional responsibility for ensuring that:

  • The person is transported in the most humane and least threatening mode of transport consistent with the needs and the safety of the person and any escort/s;
  • All the legalities have been observed in relation to the process;
  • All necessary arrangements are made for the person's conveyance to hospital and that the Patient is properly admitted to the hospital.

What if the patient's discharge from the general hospital needs to be delayed?

Where it has not been possible to transfer the patient to the mental health or learning disability hospital within the 48 hour holding period, the ASW will not normally be involved. In these circumstances consultation should take place between staff in the general and psychiatric or learning disability hospital to agree arrangements for the safe conveyance of the patient when medically fit for transfer. It is expected that the patient will be transferred by ambulance, accompanied by staff from either hospital.

How will the person be conveyed to hospital?

The Code states that the person will normally be conveyed to hospital by ambulance or other vehicle provided by NIAS.

If the person is medically fit for discharge from the general hospital within the 48 hour application period then the ASW will have the responsibility of ensuring that the person is safely conveyed to hospital.

The ASW should carry out an assessment, if possible in consultation with the medical practitioner and others involved, and consider how best the person can be safely conveyed to hospital. The most appropriate means of transport will depend on and take account of the person's own individual circumstances, needs and wishes and an assessment of the risks that may exist for both the person and others involved in the process.

However in those exceptional circumstances where the patient has been admitted for assessment or detained in hospital for treatment under the Order in the general hospital, and is being transferred when the ASW is unlikely to be involved, those arranging transfer should be mindful of the guidance given to ASWs in the Code of Practice.

The outcome of the assessment may be: 20 or 22 or 25