Thames Valley & Wessex Adult Critical Care Transfer Service
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Thames Valley & Wessex Adult Critical Care
Transfer Service
Information for Thames Valley Critical Care Units
Service [interim] provided by South Central Ambulance Service
February 2021
Craig Heigold – Service Team Leader
Issue date: 22/02/2021 version: 1.4Adult Critical Care Transfer Service (ACCT)
Thames Valley & Wessex Adult Critical Care Transfer Service
As the COVID-19 pandemic continues, critical care units across England are likely to come under significant pressure at various times. We anticipate this will require the
movement of critically unwell patients for capacity rather than primary clinical reasons.
Transfer of a critically ill adult is complex, involving multiple stakeholders, potential fail points and is rare in normal times. To safely scale up patient transfer activity,
South Central Ambulance Service (SCAS) in partnership with the Thames Valley & Wessex Critical Care Network have set up a dedicated [interim] Adult Critical Care
Transfer Service to support all non-time critical/urgent and non-clinical (capacity) adult critical care transfers and repatriations.
The primary aims of the service are to enable:
• Streamlined referral and transfer of patients across the region
• Dedicated vehicles, equipment and trained staff (Service will initially start across footprint without doctors & specialist equipment)
• Planned repatriation of patients to their local hospital (not step down in care)
• Reduced duplication of effort for all organisations involved in transfer processes
• Improved patient care and outcome
Owing to the nature of transfers to and from multiple locations, it is expected that hospitals will accept ACCT’s processes, including honouring repatriation SLA’s that
have been previously agreed.
A Patient Transfer Request Form must be completed for each transfer, this form is embedded in the subsequent slides and shared electronically.
The ACCT Service has been operational since Monday 14th December 2020 and the hours of operation are now 10:30 – 2300 daily.
• Email: SCAS.ACCT@nhs.net
• Phone: 0300 303 4147 Thames Valley
• Phone: 0300 303 5229 Hampshire and Wessex
Issue date: 22/02/2021 version: 1.4Adult Critical Care Transfer Service (ACCT)
Units may wish to print and laminate the following slides for easy reference.
0300 303 4147
ACCT Contact
Patient Transfer request form
Phone (1030 – 2300) 7/52 SCAS.ACCT@nhs.net required for all transfers
Transfer request form
Email 24/7 **Remember to include contact details for someone
who will be on duty. Booking form v1.3
Issue date: 22/02/2021 version: 1.4Adult Critical Care Transfer Service (ACCT)
NHS E/I Approved National Healthcare Professional Ambulance Response
IFT Level 1 (IFT 1) Category 1 (7 Minute mean response time)
This level of response should be reserved for those exceptional circumstances when a facility is unable to provide immediate life-saving clinical intervention such as resuscitation and
requires the clinical assistance of the ambulance service in addition to a transporting resource. Examples would include cardiac arrest, anaphylaxis, life-threatening asthma, obstetric
emergency, airway compromise and cardiovascular collapse (including septic shock).
IFT Level 2 (IFT 2) Category 2 (18 Minute mean response time)
This level of response is based on the need for intervention and management rather than the patient’s diagnosis. Immediately Life, Limb or Sight (Globe trauma) Threatening (ILT)
situations which require immediate management in another facility should receive this level of response. For instance, immediate neurosurgery, patients going directly to theatre at the
new facility would be an IFT Level 2. In addition, patients requiring limb saving surgery or mental health patients being actively restrained where appropriate advanced airway
management is not available should be dealt with in the same manner. Other examples may be patients with sepsis, myocardial infarction, CVA, acute abdomen, acute ischaemic limb,
acute pancreatitis, major gastrointestinal haemorrhage and overdose requiring immediate treatment.
IFT Level 3 (IFT 3) 1 or 2 hour locally commissioned response
This level may be requested for patients who require urgent transfer between acute hospitals. Examples may be patients who require urgent investigations to inform ongoing care such
as CT, MRI, ultrasound or who need an urgent assessment by a specialist. Mental Health emergency admissions and patients with respiratory conditions, or suspected fractures (not
due to major trauma) are examples that may be suitable for a Level 3 response.
Out of service scope – use existing pathways
IFT Level 4 (IFT 4) 4 hour locally commissioned response
This is for all other patients who do not fit the above definitions and require transfer by ambulance for ongoing care but do not need to be managed as an emergency. Examples may
be patients being admitted directly under specialty teams as well as those being admitted to emergency departments for further investigation who do not require emergency
investigation or treatment immediately upon arrival.
Within service scope
Issue date: 22/02/2021 version: 1.4Adult Critical Care Transfer Service (ACCT)
Adult (18+) patient needs to be transferred
No
Service without doctors from Is this Time Critical or Urgent due to
- Capacity reasons or repatriation
clinical need?
14th December 2020 - Step-up of care e.g. Major trauma,
Burns, Vascular, Neuro etc
Between 10:30 - 23:00
Out of service scope
Yes Time Critical
Complete referral form* for each patient and
You will need to arrange a bed and provide clinical email to: SCAS.ACCT@nhs.net
- Use normal referral pathways e.g. Major
escorts as per existing process.
trauma, Burns, Vascular, Neuro etc
Expect call-back within 1 hour
Please refer to SCAS transfer guidelines. For clinical discussion contact ACCT:
0300 303 4147
Phone the ambulance service to arrange
Yes Urgent
Time Critical transport on: Overnight between 23:00 - 10:30
Thames Valley 0300 123 9826
Thames Valley 0300 123 9822 You can still make a referral out of hours by
emailing the referral form*
to: SCAS.ACCT@nhs.net for review by the
ACCT team the next day.
*Referral Form Template:
Key Information: (Service without doctors)
Within service scope Booking form v1.3
Transfer team will include Paramedic only team, you will need to provide clinical escorts/equipment (excluding transfer trolly)
Issue date: 22/02/2021 version: 1.4Adult Critical Care Transfer Service (ACCT)
Adult (18+) patient needs to be transferred
No
Service with doctors Is this Time Critical or Urgent due to
- Capacity reasons or repatriation
clinical need?
Go live TBC - Step-up of care e.g. Major trauma,
Burns, Vascular, Neuro etc
Between 10:30 - 23:00
Out of service scope
Yes Time Critical
Complete referral form* for each patient and
You will need to arrange a bed and provide clinical email to: SCAS.ACCT@nhs.net
- Use normal referral pathways e.g. Major
escorts as per existing process.
trauma, Burns, Vascular, Neuro etc
Expect call-back within 1 hour
Please refer to SCAS transfer guidelines. For clinical discussion contact ACCT:
0300 303 4147
Phone the ambulance service to arrange
Yes Urgent
Time Critical transport on: Overnight between 23:00 - 1030
Thames Valley 0300 123 9826
Thames Valley 0300 123 9822 You can still make a referral out of hours by
emailing the referral form*
to: SCAS.ACCT@nhs.net for review by the
ACCT team the next day.
Key Information: *Referral Form Template:
Within service scope Booking form v1.3
Transfer team will include fully equipped Consultant and Paramedic team (information on following slides)
Issue date: 22/02/2021 version: 1.4Adult Critical Care Transfer Service (ACCT)
Paramedic transfer team (from 14th December 2020) includes:
• Paramedic led – additional transfer training
• Emergency Care Assistant – additional transfer training
• Fully equipped emergency ambulance
• Stryker™ patient stretcher (318kg max capacity) – combined with Paraid™ adaption below to create transfer trolly
• Paraid™ equipment bridge, equipment rails, poles, I.V stands, power distribution bar and onboard oxygen storage (2x BOC CD cylinders)
• Hamilton™ T1 transfer ventilator
• Zoll™ X series patient monitor (includes invasive BP module)
• Lucas™ 3 chest compression device
• National Standard CCU Transfer Bag
• Vacuum transport mattress *at request
• Electronic patient clinical record
Issue date: 22/02/2021 version: 1.4Adult Critical Care Transfer Service (ACCT) Fully equipped medical transfer team (TBC when doctors go live) includes: • Consultant led • Paramedic – additional transfer training • Emergency Care Assistant – additional transfer training • Fully equipped emergency ambulance • Stryker™ patient stretcher (318kg max capacity) – combined with Paraid™ adaption below to create transfer trolly • Paraid™ equipment bridge, equipment rails, poles, I.V stands, power distribution bar and onboard oxygen storage (2x BOC CD cylinders) • Hamilton™ T1 transfer ventilator • Zoll™ X series patient monitor (includes invasive BP module) • 4 x Graseby™2100 syringe drivers • Abbott™ i-STAT Point of Care blood testing • Portable Ultrasound • Fluid/blood warming • Lucas™ 3 chest compression device • Video laryngoscope • National Standard CCU Transfer Bag • Vacuum transport mattress *at request • Electronic patient clinical record Issue date: 22/02/2021 version: 1.4
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