CHW128-Requesting Medical Support: GP, Paramedic, and Specialist Services Policy
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Requesting Medical Support: GP, Paramedic, and Specialist Services Policy
1. Purpose
The purpose of this policy is to ensure that all residents at {{org_field_name}} receive timely, appropriate, and effective medical support when required. This policy sets out how our care home manages requests for General Practitioner (GP) services, paramedic attendance, and specialist medical support, ensuring the best possible health outcomes for residents. It outlines the roles and responsibilities of staff, the process for accessing medical care, and how we maintain clear communication with healthcare professionals, residents, and families. This policy aligns with Care Inspectorate Wales (CIW) regulations and the Health and Social Care (Quality and Engagement) (Wales) Act 2020 to ensure high-quality healthcare support for all residents.
2. Scope
This policy applies to all residents, ensuring they receive appropriate medical care when needed. It applies to all care and nursing staff, who are responsible for monitoring residents’ health and escalating concerns. It applies to external healthcare professionals, including GPs, paramedics, hospital teams, and specialist clinicians. It applies to families and next of kin, ensuring they are involved in key medical decisions where appropriate.
3. Related Policies
This policy aligns with Safe Care and Treatment Policy (CHW11)​, Medication Management and Administration Policy (CHW21)​, End of Life and Palliative Care Policy (CHW38)​, Infection Prevention and Control Policy (CHW17)​, Mental Capacity and Deprivation of Liberty Safeguards Policy (CHW39)​.
4. Identifying When Medical Support is Needed
Care staff play a critical role in monitoring residents’ health and identifying when medical support is required. Staff must be trained to recognise signs that indicate the need for GP consultation, paramedic attendance, or specialist intervention. Signs that medical support may be needed include sudden changes in physical health, signs of infection or fever, persistent pain, breathing difficulties, confusion or sudden cognitive decline, refusal to eat or drink, falls or injuries, worsening of chronic conditions, end-of-life care needs. Staff must record and report any concerns promptly and escalate medical support without delay when necessary.
5. Requesting GP Services
Residents have the right to access a GP for both routine check-ups and urgent medical concerns. Each resident is registered with a GP, either through their personal choice or via the care home’s preferred local GP practice.
5.1. Routine GP Appointments
Routine appointments are requested for ongoing medical conditions, medication reviews, planned vaccinations, and non-urgent health concerns. Care staff must document the resident’s symptoms and liaise with the GP’s surgery to schedule a suitable appointment. Staff must ensure that families or next of kin are informed when a routine GP visit is scheduled.
5.2. Urgent GP Consultations
An urgent GP visit should be requested when a resident presents with sudden or concerning symptoms that are not immediately life-threatening but require prompt medical review. This includes uncontrolled infections, worsening chronic illness symptoms, new unexplained pain, sudden confusion, or worsening mobility issues. Staff must contact the resident’s GP practice and request an urgent consultation. If a same-day visit is not possible, staff must assess whether paramedic support is required instead.
6. Requesting Paramedic Support (999 Calls)
Paramedic services must be called in any medical emergency where a resident’s condition requires urgent medical intervention or hospital admission. A 999 call should be made immediately for: Severe breathing difficulties or suspected respiratory failure, unresponsive or unconscious residents, suspected stroke (FAST symptoms: Face drooping, Arm weakness, Speech difficulty), chest pain or suspected heart attack, suspected fractures or severe injuries from falls, suspected sepsis (slurred speech, extreme shivering, no urine output, breathlessness, skin discolouration), choking or severe allergic reactions, sudden severe pain with unknown cause. When calling 999, staff must clearly state: “This is an emergency call from {{org_field_name}} care home. We have a resident experiencing [describe symptoms]. They are [age] years old, have [list any relevant medical conditions], and their current observations are [heart rate, breathing rate, blood pressure, temperature, oxygen saturation if available].”
While waiting for paramedics, staff must stay with the resident, ensure they are as comfortable as possible, and continue monitoring their vital signs. If the resident is being transferred to the hospital, staff must ensure all relevant medical records and medications accompany them.
7. Requesting Specialist Medical Services
Some residents require ongoing specialist care, which must be arranged proactively by the care team.
7.1. Referrals to Specialist Services
GPs will typically refer residents to specialist medical teams, including geriatrics, cardiology, neurology, respiratory specialists, mental health services, or palliative care teams. Staff should support this process by ensuring appointments are attended, communicating with specialists, and documenting any treatment plans provided.
7.2. Community Nursing and Therapy Services
Residents may require community nursing input for wound care, catheter management, diabetes monitoring, or palliative care support. Care staff must liaise with district nursing teams to ensure timely interventions. Specialist therapies such as physiotherapy, occupational therapy, and speech and language therapy (SALT) should be arranged for residents requiring mobility rehabilitation, swallowing assessments, or communication support.
7.3. Mental Health and Dementia Support
Residents experiencing mental health deterioration, distress, or behavioural challenges may need referral to Community Mental Health Teams (CMHTs) or dementia specialists. Staff should ensure that mental health referrals are made via the resident’s GP or directly through local mental health support services.
8. Family Communication and Consent
8.1. Keeping Families Informed
Families must be informed promptly when a resident requires medical attention, except where the resident has specifically requested otherwise. Staff must document all communication with next of kin regarding GP visits, emergency hospital transfers, or specialist referrals.
8.2. Consent for Medical Treatment
Residents with mental capacity have the right to make their own medical decisions. If a resident lacks capacity, decisions about medical treatment must be made in their best interests, following the Mental Capacity Act 2005. This may involve consulting next of kin, an advocate, or a legally appointed decision-maker.
9. Record-Keeping and Documentation
All requests for medical support must be fully documented in the resident’s care plan. Staff must record the reason for the medical request, symptoms observed, the healthcare professional contacted, advice given, any treatments started, and the resident’s response to care. Records must be kept up to date and made available for CIW inspections.
10. Training and Staff Responsibilities
All staff receive training on recognising medical emergencies, calling for help, and following CIW-compliant procedures. Staff responsible for making medical requests must be trained in effective communication with GPs, paramedics, and specialist services. Senior care staff and managers oversee medical request procedures and ensure compliance with CIW regulations.
11. Policy Review
This policy will be reviewed annually or sooner if: CIW regulations change, new best practice guidelines are introduced, or staff or resident feedback suggests improvements.
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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