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Registration Number: {{org_field_registration_no}}

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Requesting Medical Support: GP, Paramedic, and Specialist Services Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} has a clear, structured, and efficient process for requesting medical support from GPs, paramedics, and specialist services. Prompt access to medical assistance is essential for maintaining the health, safety, and well-being of the people we support and ensuring compliance with CQC regulations.

This policy ensures that:

• Medical support is requested promptly and appropriately based on clinical needs.
• Staff follow clear escalation pathways for GPs, emergency paramedic support, and specialist services.
• All interactions with healthcare professionals are documented accurately and in compliance with GDPR and CQC standards.
• People we support receive timely, person-centred, and safe medical care in emergencies and non-emergency situations.
• Care home staff are trained and competent in recognising when to seek medical support.

2. Scope

This policy applies to:

• All staff, including carers, nurses, team leaders, and managers, involved in identifying health concerns and escalating medical support requests.
• People we support, ensuring their medical needs are met efficiently.
• GPs, emergency paramedic services, and specialist clinicians, supporting continuity of care.
• Management teams, responsible for overseeing compliance and reporting requirements.

3. Legal and Regulatory Compliance

This policy aligns with:

CQC Regulations (Health and Social Care Act 2008, Regulated Activities Regulations 2014)

• Regulation 9 (Person-Centred Care) – Ensures timely access to healthcare professionals for individual health needs​.
• Regulation 12 (Safe Care and Treatment) – Requires appropriate medical support to prevent harm and deterioration​.
• Regulation 13 (Safeguarding Service Users from Abuse and Improper Treatment) – Ensures medical concerns are escalated to prevent neglect​.
• Regulation 17 (Good Governance) – Requires accurate documentation and monitoring of medical interventions​.

Other Relevant Guidance and Regulations

• The Care Act 2014 – Defines responsibilities for requesting medical support.
• NHS Framework for Urgent and Emergency Care – Sets out protocols for accessing urgent medical services.
• The Mental Capacity Act 2005 – Ensures that medical decisions are made in the best interests of individuals who lack capacity.
• General Data Protection Regulation (GDPR) & Data Protection Act 2018 – Governs confidentiality when sharing medical information.

4. Requesting Medical Support: Step-by-Step Process

4.1. Identifying When to Seek Medical Support

Staff must be trained to recognise signs of illness, deterioration, or medical emergencies.

Non-Emergency (GP or Specialist Referral) Signs:

• Persistent symptoms (e.g., fever, ongoing pain, infections, respiratory issues).
• Deterioration in mobility, cognition, or mental health.
• Unexplained weight loss or nutritional concerns.
• Medication side effects or adverse reactions.
• Routine medical reviews or chronic condition management (e.g., diabetes, heart disease).

Emergency (999 Paramedic) Signs:

• Severe breathing difficulties (e.g., gasping, choking, severe asthma attack).
• Loss of consciousness or unresponsiveness.
• Suspected stroke (FAST test: Facial drooping, Arm weakness, Speech difficulties, Time to call 999).
• Suspected heart attack (chest pain, breathlessness, nausea).
• Severe bleeding or trauma.
• Acute confusion, seizures, or severe allergic reactions (anaphylaxis).

4.2. Requesting GP Support for Non-Urgent Medical Needs

• Staff must record symptoms and observations before contacting a GP.
• The GP must be contacted via phone or digital healthcare systems (e.g., NHS e-consult).
• Family members or legal representatives must be informed where appropriate.
• GP visits may be conducted in person or remotely via video consultation.
• Follow-up care plans must be documented, ensuring adherence to the GP’s recommendations.

4.3. Contacting NHS 111 for Urgent Advice

For urgent but non-life-threatening concerns, NHS 111 should be contacted for medical advice.

• A senior staff member or nurse should provide a full clinical history to NHS 111.
• NHS 111 may:
  • Arrange an out-of-hours GP visit.
  • Direct the case to paramedic support.
  • Provide self-care guidance, reducing unnecessary hospital visits.

4.4. Calling Emergency Services (999) for Life-Threatening Situations

In medical emergencies, staff must:

• Dial 999 immediately and provide:
  • The person’s name, age, and medical history.
  • A clear description of symptoms and condition.
  • The care home’s exact location and access instructions.
• Administer first aid or CPR if trained and safe to do so.
• Ensure clear access for the ambulance crew upon arrival.
• Inform management and next of kin immediately.
• Record all details in the person’s care notes, including times, symptoms, and paramedic actions.

4.5. Referrals to Specialist Services

Where specialist medical input is required, referrals may be made to:

• Tissue Viability Nurses (TVN) – For pressure ulcers and wound management.
• Mental Health Crisis Teams – For urgent psychiatric concerns.
• Palliative Care Teams – For end-of-life care planning.
• Falls Prevention Teams – For recurrent falls and mobility assessments.
• Speech and Language Therapists (SALT) – For swallowing difficulties (dysphagia).

Referrals must be documented, tracked, and followed up, ensuring timely intervention.

5. Documenting and Communicating Medical Requests

5.1. Accurate Record-Keeping

All medical requests must be clearly recorded in the person’s care records, including:

• Date, time, and reason for requesting medical support.
• Symptoms and observations recorded before escalation.
• Name and role of the healthcare professional contacted.
• Advice given and any actions taken.
• Follow-up care required.

Records must comply with CQC documentation standards and GDPR regulations.

5.2. Informing Next of Kin and Legal Representatives

• Family members or legal representatives must be informed as soon as possible after requesting medical support.
• If the person lacks capacity, decisions must follow the Mental Capacity Act 2005 best interest principles.

6. Staff Training and Responsibilities

6.1. Training on Medical Escalation Procedures

All staff must receive mandatory training covering:

• Recognising signs of deterioration and when to escalate concerns.
• How to request medical support from GPs, NHS 111, or paramedics.
• Emergency first aid and CPR training (for designated staff).
• Using digital medical request systems, ensuring efficient communication.

Refresher training is conducted annually or as required.

6.2. Role of Managers in Medical Support Requests

Managers are responsible for:

• Ensuring staff adhere to correct escalation pathways.
• Reviewing incident reports related to medical interventions.
• Conducting post-incident debriefs where emergency services are involved.

7. Monitoring and Compliance

To ensure compliance with this policy:

• Monthly audits review medical support requests, ensuring adherence to best practices.
• CQC inspections include checks on medical escalation processes.
• Feedback from staff and people we support is used to improve medical response efficiency.

8. Related Policies

• CH11 – Safe Care and Treatment Policy​.
• CH13 – Safeguarding Adults from Abuse and Improper Treatment Policy​.
• CH17 – Infection Prevention and Control Policy​.

9. Policy Review

This policy will be reviewed annually or sooner if CQC regulations, NHS guidelines, or operational needs change.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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