Sample policy · Patient transport

Patient assessment, fitness for transport and journey planning policy (patient transport)

Statutory anchor: Regulation 9 (person-centred care), Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (SI 2014/2936). This policy also engages Regulation 11 (need for consent) and Regulation 12 (safe care and treatment). · primary source

1. What the regulation says

The care and treatment of service users must be appropriate, meet their needs, and reflect their preferences. (Reg 9(1): the headline duty)

carrying out, collaboratively with the relevant person, an assessment of the needs and preferences for care and treatment of the service user (Reg 9(3)(a): collaborative assessment)

This policy also engages Regulation 11 (need for consent):

Care and treatment of service users must only be provided with the consent of the relevant person. (Reg 11(1): the headline duty)

And Regulation 12 (safe care and treatment):

Care and treatment must be provided in a safe way for service users. (Reg 12(1) (the headline duty))

assessing the risks to the health and safety of service users of receiving the care or treatment, (Reg 12(2)(a) (risk assessment))

doing all that is reasonably practicable to mitigate any such risks, (Reg 12(2)(b) (risk mitigation))

The full text is at https://www.legislation.gov.uk/uksi/2014/2936/regulation/9, https://www.legislation.gov.uk/uksi/2014/2936/regulation/11 and https://www.legislation.gov.uk/uksi/2014/2936/regulation/12. Where this policy and the regulation diverge, the regulation wins.

2. Plain-English summary

Care and treatment must be appropriate, meet the service user's needs, and reflect their preferences. The regulation lists nine specific things you have to do to deliver person-centred care, including: assessment with the service user, designing care to meet their preferences, involving them and the people supporting them in decisions, providing information, making reasonable adjustments, and considering well-being when meeting nutritional and hydration needs.

You can only provide care or treatment with the consent of the relevant person. If the service user is 16 or over and lacks capacity, follow the Mental Capacity Act 2005. Care and treatment must also be provided in a safe way, which includes assessing the risks of the care or treatment and doing all that is reasonably practicable to mitigate those risks.

3. Purpose

This policy sets out how the Service checks patient fitness for transport, plans safe journeys and escalates when a patient's needs do not match the booked vehicle, Crew or equipment.

The policy is written for planned patient transport, including hospital-to-hospital transfer, hospital-to-home discharge, clinic transport, bariatric transport and end-of-life transport.

4. Scope

This policy applies to:

This policy does not allow the Service to accept a journey beyond its registered activity, insurance, vehicle, equipment, staffing or clinical scope.

5. Patient assessment and fitness-for-transport workflow

The Service uses a layered assessment process before and during the journey.

  1. Booking staff gather the minimum information: an incomplete request is held rather than treated as accepted.
  2. The dispatcher tests the match: patient need is compared with registration scope, crew competence, vehicle, equipment and journey conditions.
  3. Crew repeat the safety check on arrival: loading starts only if the patient and circumstances still match the accepted plan.
  4. Any mismatch triggers a pause: Crew contact the control point or Lead Clinician and do not rely on informal reassurance.
  5. The outcome is recorded: accept, amend, delay, redirect or decline the journey, with the decision-maker and rationale.

5.1 Booking assessment

The booking facility or referring clinician confirms the patient's transport need and fitness to travel.

The booking record must include:

The Service does not treat a booking request as automatic acceptance. The Operations Manager or delegated dispatcher checks that the journey matches available Crew, vehicle, equipment and route plan.

5.2 Crew on-arrival check

Crew complete an on-arrival check before loading the patient.

Crew check:

If the patient's presentation does not match the booking, Crew pause loading and contact the control point or Lead Clinician.

5.3 Capacity and consent for transport

The Service treats consent to transport as decision-specific.

Section 1 of the Mental Capacity Act 2005 includes this load-bearing wording: "A person must be assumed to have capacity unless it is established that he lacks capacity." Staff check the current legislation.gov.uk text before using this policy.

Crew support the patient to decide where possible. Support may include:

Where the patient may lack capacity for transport, Crew contact the Lead Clinician or referring clinician before transport continues unless an immediate safety issue prevents delay. The record explains the decision, advice received and least restrictive option used.

5.4 Bariatric assessment and equipment match

The Service confirms bariatric need before accepting the job.

The booking and dispatch record checks:

Crew stop and escalate if the equipment, vehicle or staffing on arrival does not match the patient's need.

6. Journey planning

The Service plans the journey before dispatch and updates the plan if the patient's needs change.

6.1 Standard journey plan

The Operations Manager or delegated dispatcher records:

The plan considers road conditions, distance, patient comfort, collection access and receiving-facility availability.

6.2 Long-distance journey plan

For long-distance transfer, the Service records additional planning.

The plan includes:

Staff do not calculate oxygen need from memory. They use current equipment instructions, local clinical guidance and the patient's documented prescription or care plan.

6.3 End-of-life transport

For end-of-life transport, the Service keeps the journey calm, dignified and aligned to the patient's plan.

The booking record checks:

Crew do not interpret DNACPR as a full care plan. They follow the transport plan, current clinical advice and their local escalation route.

7. Deterioration en route

If a patient deteriorates during transport, Crew act within role, training and scope.

Crew:

The incident review checks whether the booking information, on-arrival check, crew scope, vehicle allocation or journey plan should have identified the risk earlier.

8. Responsibilities

9. Recording requirements

The following fields must be recorded for every accepted, amended, delayed, redirected or declined journey: booking source, patient need, assessment time, assessor, crew and vehicle match, identified risks, decision, rationale, advice received, escalation, decision-maker and the date and time the outcome was communicated. The Service also keeps the following records:

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 CQC, MCA, commissioner, RCN or local source material requires a different rhythm:

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:

12. Related policies and records

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.

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

Version Date Author Changes
v1 2026-06-10 Verivius (sample) Conformed to the Verivius policy standard: added statutory anchor, verbatim regulation quotes, plain-English summary, sources and document control. Original operational sections preserved.
v1.1 2026-07-19 Verivius (sample) Made the transport acceptance workflow explicit, added decision evidence fields and linked companion policies.
v1.2 2026-07-21 Verivius (sample) Made the evidence fields explicit for every journey decision and communication outcome.

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.

What good looks like here

Written from an ex-CQC inspector's chair, but the point is safe, well-led care your team can stand behind. Each row shows what strong evidence looks like, what thin evidence looks like, and where the expectation comes from.

Patient transport is the setting where the assessment and the journey are separated by hours and by people who never meet. A ward or booking facility describes the patient in the morning, and a crew arrives in the afternoon at a bedside or a front door with no clinician beside them, working from information that has already aged. The specific risks live in that gap: a stretcher and tail-lift found not to fit at the patient's door, an oxygen cylinder sized for a journey that then runs long, consent to travel assumed from a booking rather than asked for, and deterioration in a moving vehicle where there is no call bell and no resuscitation team. The written decision trail matters because it is the only way the receiving unit, the next crew and the Lead Clinician can see why this journey was accepted, amended or declined, and because the person and their family are entitled to know what was planned for their comfort, positioning, toileting and dignity over a long road journey. Getting that right is first a matter of safe, person-centred care, and the inspection value follows from it rather than the other way round.

  1. The crew on-arrival check actually changes a decision when the patient does not match the booking, rather than a booking being accepted on paper. Where presentation and booking differ, crew pause loading and call the control point or Lead Clinician instead of loading the patient on informal reassurance from whoever is at the door.

    Strong evidence: On-arrival crew check record, plus the recorded journey outcome (accept, amend, delay, redirect or decline) showing the decision-maker and rationale (Sections 5 and 5.2).

    Weak evidence: A tick against "on-arrival check completed" on every job in the file, with the journey outcome recorded as accept every single time. Where the crew note does record something different at the door, such as new confusion, a new oxygen mask or a patient now on a stretcher, the patient is loaded against the original plan anyway, with nothing to show the changed risk was reassessed, no clinical advice sought and no named decision-maker.

    Our recommended baseline. Not a legal or regulatory requirement, but a sensible standard we suggest where the rules leave the detail to you. Adapt it to your service.

  2. A declined or amended journey carries the same decision trail as an accepted one. The real-world failure is a service that documents acceptances well but leaves refusals, held incomplete bookings and post-arrival changes with no assessor, no identified risk and no rationale, so the next person handling that patient's booking cannot see why the journey was turned down.

    Strong evidence: Per-journey record of booking source, patient need, assessment time, assessor, crew and vehicle match, identified risks, decision, rationale and escalation (Section 9), with the weekly review of incomplete booking assessments, rejected journeys and journeys changed after the on-arrival check (Section 10).

    Weak evidence: Accepted journeys carry a full record while declines and held bookings survive only as a cancelled line in the dispatch system or a phone note saying "not suitable", with no assessor named, no risk identified and no rationale. The review of incomplete booking assessments, rejected journeys and post-arrival changes either is not happening or produces a count with no named improvement actions and no owner.

    Our recommended baseline. Not a legal or regulatory requirement, but a sensible standard we suggest where the rules leave the detail to you. Adapt it to your service.

  3. Consent to transport is treated as decision-specific, and a possible lack of capacity is escalated to the Lead Clinician or referring clinician before the journey continues, rather than assumed from the booking. What harms people is transport that went ahead on a capacity concern with no record of the decision, the advice received and the least restrictive option used.

    Strong evidence: Capacity or consent concern record explaining the decision, the advice received and the least restrictive option used, with escalation to the Lead Clinician or referring clinician (Sections 5.3 and 9).

    Weak evidence: A signature box or a "patient consented" tick on the journey sheet, applied identically to every patient, including those the crew's own notes describe as drowsy, distressed or too confused at the door to follow the explanation. Where a capacity concern is written down at all, there is no record of what support to decide was offered, who was contacted, what advice came back or why the option used was the least restrictive.

    A legal duty. This comes from legislation that applies to your service, so meeting it is not optional. The exact provision is cited beneath the badge.

    Mental Capacity Act 2005 ss.1(3), 1(6), 2(1) and 4 (applied to carers by s.5), with Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, reg 11(1) and (3)

  4. Deterioration en route is followed by an incident record and a review that asks whether the booking information, on-arrival check, crew scope, vehicle allocation or journey plan should have caught the risk earlier, not just a record that crew responded in the moment.

    Strong evidence: Deterioration record plus incident and improvement action records, with the incident review checking whether the risk was identifiable earlier (Sections 7 and 9).

    Weak evidence: An incident form that stops at what the crew did in the moment, such as stopped the vehicle and called the emergency services, with the review section blank or reading "crew acted appropriately, no further action". Nothing tests the booking information, the on-arrival check, the crew's scope, the vehicle allocated or the journey plan, so a patient with the same profile is accepted again the following week on the same thin information.

    What the regulator expects to see. Not a law in itself, but CQC judges you against it, so an inspector will look for it and expect a reason where you depart from it.

  5. For bariatric jobs, need is confirmed before acceptance and equipment, vehicle and staffing are matched, rather than discovered at the patient's door. What costs a patient both dignity and safety is a bariatric booking taken without an equipment and access plan, and crew who did not stop when what they found on arrival did not match the need.

    Strong evidence: Bariatric transport plan covering weight, transfer method, crew numbers, vehicle capacity, stretcher, ramp, tail-lift and restraint suitability, route access and a contingency plan if equipment does not fit the environment (Sections 5.4 and 9).

    Weak evidence: A bariatric booking with the weight field empty, or filled in as "bariatric" with no figure, and a plan that names a vehicle but not the transfer method, the number of crew, the stretcher, ramp and tail-lift safe working limits, or access at collection and destination. The quiet giveaway is a job that completed on time with no incident, where the crew note mentions extra hands borrowed from ward staff, or a lift or stretcher worked above its stated safe working limit, so the equipment was neither safe for that use nor used in a safe way.

    A legal duty. This comes from legislation that applies to your service, so meeting it is not optional. The exact provision is cited beneath the badge.

    Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, reg 12(2)(e); Manual Handling Operations Regulations 1992, reg 4(1)(b)(i); Lifting Operations and Lifting Equipment Regulations 1998, reg 8

  6. For long-distance and oxygen-dependent journeys, oxygen and medicine continuation are planned from current source material and the documented prescription, not calculated from memory. A cylinder that runs short mid-journey leaves a patient in distress at the roadside.

    Strong evidence: Long-distance journey plan recording oxygen need and cylinder capacity checked against current source material, and a medicine continuation plan supplied by the referring clinician (Section 6.2).

    Weak evidence: A long-distance journey sheet with an oxygen box ticked and a cylinder size written down, but no flow rate, no expected journey duration, no cylinder duration taken from the current equipment instructions and no spare-cylinder contingency for delay or breakdown. Medicines due during the journey appear as a crew recollection or a verbal handover rather than the referring clinician's documented prescription and written continuation plan.

    The instructions from the maker of a product, device, or medicine. Following them is how the item is used safely, and for medical devices it is effectively expected.

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Last verified 20 July 2026

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Last reviewed 21 July 2026