Crew welfare, fitness for shift and driving hours policy (ambulance)

1. What the regulation says

Sufficient numbers of suitably qualified, competent, skilled and experienced persons must be deployed in order to meet the requirements of this Part. (Reg 18(1): the headline duty)

receive such appropriate support, training, professional development, supervision and appraisal as is necessary to enable them to carry out the duties they are employed to perform. (Reg 18(2)(a): support, training, supervision and appraisal)

The full text of Regulation 18 is at https://www.legislation.gov.uk/uksi/2014/2936/regulation/18. The primary driving-hours duties sit in road traffic and working-time law (Regulation (EC) No 561/2006, the Road Transport (Working Time) Regulations 2005 and the tachograph rules), and the applicable limits depend on vehicle type, passenger seats, weight, PSV status, route type, commercial use and any exemption, so the Service checks the current GOV.UK drivers' hours and tachograph guidance before setting rota, route and relief arrangements. Where this policy and the regulation diverge, the regulation wins.

2. Plain-English summary

You have to deploy enough suitably qualified, competent, skilled and experienced staff to meet Part 3. Staff have to receive appropriate support, training, professional development, supervision and appraisal. Where staff are health or social-care registered professionals, they have to be enabled to give their regulator evidence of meeting professional standards.

Separately, crew fitness for shift and driving hours are governed by road traffic and working-time law. Staff must not calculate driving-hours limits from memory; they must check the current statutory and GOV.UK source material before agreeing long-distance, standby, event-cover or multi-leg shifts.

3. 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.

4. 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.

5. Fitness for shift

The Service checks that Crew are fit to work before they start patient-facing duty.

5.1 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.

5.2 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.

5.3 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.

5.4 Operational fitness concern workflow

When a fitness concern arises before or during a shift, Staff use this workflow:

1. Stop the risk: prevent driving, patient handling or clinical work where the concern may affect safety.
2. Protect current patients: arrange replacement cover, a safe stopping point or clinical escalation without leaving a patient unsupported.
3. Record facts: document what was reported or observed, the time, the work affected and any immediate action. Do not record unsupported conclusions.
4. Obtain advice: involve the Operations Manager and seek clinical, occupational-health, HR, DVSA or emergency advice as the circumstances require.
5. Make the duty decision: record whether the person is removed, restricted, redeployed or permitted to continue, who made the decision and why.
6. Close the loop: set welfare follow-up, evidence needed for return to duty and any incident, supervision, rota or improvement action.

No manager may use staffing pressure as the reason to override an unresolved safety concern.

6. 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.

Driver-hours rules depend on vehicle type, passenger seats, weight, PSV status, route type, commercial use and any exemption. The Service must not apply a single nine-hour rule without checking the current GOV.UK drivers' hours and tachograph guidance.

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.

7. 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.

7.1 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.

7.2 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.

8. 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.

9. Recording requirements

Each fitness, fatigue or driving-hours exception record must include the crew member, shift and vehicle, date and time, concern raised, immediate restriction, reviewer, advice obtained, decision, rationale and follow-up owner. The Service also 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.

10. 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.

11. 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

12. Related policies and records

• Staff record
• Rota record
• Driving-hours record
• Vehicle register
• Tachograph record
• Incident register
• RIDDOR reporting policy
• Ambulance crew clinical scope and JRCALC competency policy
• Ambulance vehicle defect, MOT and roadworthiness policy
• Incident reporting, investigation and learning policy
• Risk management and risk register policy
• Risk register
• Improvement action register

Review cadence: annual or on regulatory change, whichever sooner. Owner: Registered Manager.

13. Sources and further reading

This template is based on CQC's guidance for providers and managers, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and other topic-specific legislation and guidance listed below. It is a starting point for adaptation, not a substitute for legal, clinical, HR, safeguarding or specialist professional advice.

• Verivius ambulance compliance guide: the five-policy pack, checklists, regulations and sector guidance
• CQC Regulation 18: Staffing
• CQC Regulation 12: Safe care and treatment
• HSE fatigue guidance
• Road traffic law (Road Traffic Act)
• Working Time Regulations and the Road Transport (Working Time) Regulations 2005 (https://www.legislation.gov.uk/uksi/2005/639/contents)
• Regulation (EC) No 561/2006, Article 6 (https://www.legislation.gov.uk/eur/2006/561/article/6)
• 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)
• GOV.UK drivers' hours: assimilated EU rules (https://www.gov.uk/drivers-hours/eu-rules)
• GOV.UK drivers' hours: passenger-carrying vehicles (https://www.gov.uk/drivers-hours/passenger-carrying-vehicles)
• 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)
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 18 (https://www.legislation.gov.uk/uksi/2014/2936/regulation/18)

14. When to seek further advice

Seek specialist advice where the issue involves serious harm, safeguarding, deprivation of liberty, restraint, children, professional misconduct, controlled drugs, radiation, termination of pregnancy, infection outbreak, water safety, employment dismissal, DBS barring referral, or regulatory enforcement.

15. Document control

This sample policy template was issued by Verivius. It is a template, not a substitute for legal advice or the provider's own policy-development process. Where this template and live law or regulator guidance diverge, the live source wins.