1. Purpose
This policy sets out how the Service checks crew fitness for shift, manages fatigue and illness, records driving-hours controls and supports Staff after assault, patient death, road traffic collision or another serious event.
The policy is written for independent ambulance services where scheduled transfers, urgent journeys, event cover and vehicles over 3.5 tonnes may create driving-hours and welfare risks.
2. Sources to verify before adoption
- Regulation (EC) No 561/2006, Article 6: https://www.legislation.gov.uk/eur/2006/561/article/6
- Road Transport (Working Time) Regulations 2005: https://www.legislation.gov.uk/uksi/2005/639/contents
- GOV.UK, drivers' hours assimilated rules: https://www.gov.uk/drivers-hours/eu-rules
- GOV.UK, drivers' hours for buses, coaches and minibuses: https://www.gov.uk/drivers-hours/passenger-carrying-vehicles
- GOV.UK, drivers' hours rules and guidance: https://www.gov.uk/government/collections/drivers-hours-rules-and-guidance
- GOV.UK, tachographs: https://www.gov.uk/tachographs
- Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 18: https://www.legislation.gov.uk/uksi/2014/2936/regulation/18
- Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013: https://www.legislation.gov.uk/uksi/2013/1471/contents
- Workplace (Health, Safety and Welfare) Regulations 1992: https://www.legislation.gov.uk/uksi/1992/3004/contents
3. Scope
This policy applies to:
- all employed, bank, agency and subcontracted Crew working on Service jobs
- pre-shift fitness checks
- illness, fatigue, medication, alcohol and drug concerns
- driving-hours and working-time controls
- tachograph use where the vehicle requires it
- vehicles over 3.5 tonnes or passenger-carrying vehicles where current source material brings them into scope
- crew assault by a patient, family member, carer, bystander or other person
- staff welfare after serious incidents
This policy does not replace the Service's employment contract, occupational health process, disciplinary policy, health and safety policy or legal advice.
4. Fitness for shift
The Service checks that Crew are fit to work before they start patient-facing duty.
4.1 Pre-shift self-declaration
Crew confirm before shift that they are fit to work.
The declaration covers:
- fatigue
- illness or symptoms that may affect safe work
- medication that may affect driving, judgement or manual handling
- alcohol or drug use that may affect safe work
- injury or pain that may affect moving and handling
- emotional distress that may affect safe work
- ability to drive the assigned vehicle category
- ability to complete the planned shift length safely
Crew must tell the Operations Manager if anything changes during the shift.
4.2 Manager review of fitness concerns
Where a fitness concern is raised, the Operations Manager:
- removes the person from patient-facing duty where safety may be affected
- checks whether replacement cover is needed
- records the concern factually
- seeks clinical, occupational health or HR advice where required
- considers whether the concern affects driving, patient handling, judgement or professional registration
- agrees return-to-duty steps
The Service treats fatigue and illness as safety issues before they become performance issues.
4.3 Intoxication on shift
If Staff suspect that a crew member is intoxicated on shift, they escalate immediately.
The Operations Manager:
- stops the person from driving or patient-facing work
- makes the patient, Crew and public safe
- arranges safe transport from the scene where needed
- preserves factual evidence
- records an incident
- considers police, DVSA, professional regulator, commissioner or CQC notification advice where relevant
- starts the HR or disciplinary process
- reviews whether rota, supervision or culture contributed to delayed escalation
The Service does not allow the person to return to duty until the review and return-to-work decision are complete.
5. Driving-hours and tachograph control
The Service identifies which vehicles and journeys are covered by assimilated drivers' hours rules, domestic rules, working-time rules or tachograph requirements.
Regulation (EC) No 561/2006 Article 6 includes this load-bearing wording: "The daily driving time shall not exceed nine hours." Staff check the current legislation.gov.uk text and GOV.UK guidance before setting rota, route and relief arrangements.
The Operations Manager records:
- vehicle weight category
- whether tachograph rules apply
- driver assigned
- driver licence category
- planned driving time
- planned duty time
- rest and break plan
- second-driver or relief-driver arrangement where needed
- tachograph evidence where required
Staff do not calculate driving-hours limits from memory. They check the current statutory and GOV.UK source material before agreeing long-distance, standby, event-cover or multi-leg shifts.
6. Welfare after assault or serious incident
The Service supports Crew after assault, patient death, road traffic collision, clinical deterioration, cardiac arrest, safeguarding event or another serious event.
6.1 Crew assault
If a crew member is assaulted, Staff:
- make the crew member and patient safe
- contact police where there is immediate risk or a criminal allegation
- arrange medical assessment where needed
- remove the crew member from duty where continuing is unsafe
- record the incident
- consider RIDDOR reporting where the current source material requires it
- inform the commissioner, event organiser or receiving facility where contract or safety arrangements require it
- offer welfare follow-up
- review whether the booking, risk information, scene safety or escort arrangement should change
The Service does not normalise assault as part of ambulance work.
6.2 Serious incident welfare follow-up
After a serious incident, the Operations Manager or delegated manager:
- completes an immediate welfare check
- agrees whether the crew member should continue the shift
- offers debrief at a suitable time
- signposts occupational health or counselling support where available
- records time away from duty where needed
- checks whether the incident affects training, supervision or rota decisions
- schedules follow-up with the crew member
The incident review separates staff welfare from performance review. Staff can need support even where their actions were appropriate.
7. Responsibilities
- Registered Manager: owns this policy, ensures staffing and welfare governance is in place and signs off annual review.
- Lead Clinician: advises on clinical fitness, post-incident support and return-to-duty decisions where clinical judgement is involved.
- Operations Manager: manages pre-shift fitness checks, rota safety, driving-hours controls, tachograph evidence and incident escalation.
- Crew: declare fitness honestly, follow driving-hours controls and stop work where fatigue, illness or distress affects safe practice.
- Fleet Lead: confirms vehicle category, tachograph requirements and any vehicle-specific driver requirement.
- All staff: escalate fitness, intoxication, assault, driving-hours and welfare concerns promptly.
8. Recording requirements
The Service keeps the following records:
- pre-shift fitness declaration
- rota and duty-time record
- vehicle allocation
- driver licence category check
- tachograph record where required
- driving-hours review record
- fatigue or illness concern
- intoxication concern incident record
- crew assault incident record
- RIDDOR consideration record where relevant
- welfare check and debrief record
- return-to-duty decision
- improvement action record
Records are kept in the Service governance records and are available for internal review, CQC review, commissioner review and external review where required.
9. Audit cadence
The Service uses the following Verivius default audit rhythm unless current drivers' hours, tachograph, working time, CQC, RIDDOR, commissioner or local source material requires a different rhythm:
- Per shift: Crew complete fitness declarations and Operations staff check rota safety.
- Per vehicle, where tachograph rules apply: Staff record tachograph evidence according to current statutory and GOV.UK source material.
- Weekly: the Operations Manager reviews fatigue concerns, rota gaps, driving-hours concerns and open welfare follow-up.
- Monthly: the Registered Manager reviews assaults, serious incidents, sickness patterns and return-to-duty decisions.
- Annually: the Service audits this policy against current drivers' hours, working time, tachograph and welfare source material.
Audit findings are recorded as improvement actions with an owner and review date.
10. Version control and review date
The Service keeps a controlled copy of this policy. The footer or document-control table records:
- policy owner
- version number
- date approved
- next review date
- changes made since the last version
- source material checked during the review
11. Related records
- Staff record
- Rota record
- Driving-hours record
- Vehicle register
- Tachograph record
- Incident register
- RIDDOR reporting policy
- Crew clinical scope and JRCALC competency policy
- Vehicle defect, MOT and roadworthiness policy
- Risk register
- Improvement action register
Review cadence: annual or on regulatory change, whichever sooner. Owner: Registered Manager.