{{org_field_logo}}

{{org_field_name}}

Registration Number: {{org_field_registration_no}}

---

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 structured, timely, and effective approach to requesting medical support from General Practitioners (GPs), paramedics, and specialist services for our service users. This policy aligns with CQC regulations, the Health and Social Care Act 2008, the Care Act 2014, and the NHS Constitution to safeguard the health and well-being of those in our care.

This policy aims to:

• Ensure timely access to appropriate medical professionals.
• Protect the rights and dignity of service users while receiving healthcare.
• Promote proactive healthcare planning through regular medical reviews.
• Ensure compliance with CQC’s fundamental standards regarding safe care and treatment.
• Support staff in recognising when medical assistance is required and how to escalate appropriately.

2. Scope

This policy applies to:

• All staff members, including permanent, temporary, agency, and volunteers.
• All service users receiving care within {{org_field_name}}.
• Healthcare professionals involved in providing medical support.
• Families, advocates, and external agencies involved in a service user’s healthcare decisions.

3. Legal and Regulatory Compliance

This policy must be implemented in accordance with all applicable legislation and regulatory requirements in England, including:

• Health and Social Care Act 2008, including the regulatory framework governing registered health and adult social care services.
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, including:
  • Regulation 9 – Person-centred care: care and treatment must be appropriate, meet the person’s needs and reflect their preferences.
  • Regulation 10 – Dignity and respect: people must be treated with dignity and respect, including when accessing healthcare and receiving support with medical needs.
  • Regulation 11 – Need for consent: care and treatment must only be provided with the consent of the relevant person, or otherwise in accordance with the Mental Capacity Act 2005 or other lawful authority.
  • Regulation 12 – Safe care and treatment: risks to people’s health and safety must be assessed and reasonably practicable steps taken to mitigate those risks. The provider must have arrangements to respond appropriately to clinical and medical emergencies and to changes or deterioration in a person’s health.
  • Regulation 13 – Safeguarding service users from abuse and improper treatment: people must be protected from abuse, neglect and improper treatment.
  • Regulation 17 – Good governance: accurate, complete and contemporaneous records must be maintained and systems must be in place to assess, monitor and improve the quality and safety of the service and manage risks to people’s health, safety and welfare.
  • Regulation 18 – Staffing: sufficient numbers of suitably qualified, competent, skilled and experienced staff must be deployed. Staff must receive the support, training, professional development, supervision and appraisal necessary to carry out their duties. This includes learning disability and autism training appropriate to the person’s role.
  • Regulation 20 – Duty of candour: the organisation must act in an open and transparent way and must follow the statutory duty of candour requirements where a notifiable safety incident occurs.
• Care Quality Commission (Registration) Regulations 2009, including requirements to notify CQC without delay of specified incidents where the statutory notification criteria are met.
• Care Act 2014, including duties relating to wellbeing, prevention and safeguarding adults with care and support needs.
• Mental Capacity Act 2005 and its Code of Practice, where a person may lack capacity to make a particular decision about healthcare, treatment or related arrangements.
• Health and Care Act 2022, including the statutory requirement for staff working for the purposes of regulated activities to receive learning disability and autism training appropriate to their role.
• Data Protection Act 2018 and UK General Data Protection Regulation, in relation to the lawful, secure and proportionate processing and sharing of health and personal information.

Staff must also have regard to current CQC statutory guidance and relevant nationally recognised clinical and NHS guidance when supporting people to access healthcare or responding to deterioration or medical emergencies.

4. Identifying the Need for Medical Support

4.1 Routine Medical Care

Service users must have regular access to healthcare to maintain their well-being. This includes:

• Routine GP check-ups and monitoring of chronic conditions.
• Annual health reviews and preventative screenings.
• Vaccinations and health promotion support.
• Medication reviews to ensure effective treatment.

4.2 Urgent Medical Needs

Staff must be trained to identify signs of medical distress and escalate accordingly. Urgent needs include:

• Sudden illness or deterioration (e.g., high fever, severe pain, unresponsiveness).
• Breathing difficulties or suspected heart problems.
• Serious infections requiring immediate attention.
• Signs of a stroke (FAST test).
• Severe mental health crises (e.g., suicidal ideation, severe anxiety episodes).

4.3 Emergency Medical Situations

Staff must call 999 without delay where they reasonably believe that a person is experiencing a life-threatening or serious medical emergency, or where current NHS emergency guidance indicates that 999 emergency assistance is required.

Examples may include, but are not limited to:

• cardiac arrest or suspected heart attack;
• severe breathing difficulty or respiratory distress;
• signs or symptoms of a stroke;
• severe injury, major trauma or uncontrolled bleeding;
• a severe allergic reaction or suspected anaphylaxis;
• loss of consciousness or a significant change in level of consciousness;
• seizures where emergency assistance is indicated, including prolonged or repeated seizures or a first known seizure;
• suspected serious poisoning or overdose;
• immediate risk to life arising from a mental health crisis or self-harm; or
• any sudden or severe deterioration where delay in obtaining emergency medical assistance may place the person at significant risk.

Staff must not delay calling 999 while attempting to contact a GP, manager, family member, representative or other professional.

Staff must follow instructions given by the emergency call handler and provide first aid or other emergency assistance only within their training and competence.

Where relevant information is available, staff should provide emergency healthcare professionals with accurate information about the person’s presenting condition, known diagnoses, allergies, medicines, communication requirements, reasonable adjustments, advance care planning and other information necessary for safe assessment and treatment.

All actions, observations, advice received and outcomes must be recorded accurately and contemporaneously in the person’s care records.

5. Procedures for Requesting Medical Support

5.1 Contacting a GP

Staff must:

1. Call the service user’s registered GP and explain the concern clearly.
2. Provide a full medical history, including medications and symptoms.
3. Arrange an appointment (in-person, telephone, or home visit as necessary).
4. Document all communications in the service user’s care records.
5. Follow up on GP recommendations and ensure medication/treatment plans are updated.

If the GP is unavailable, staff must:

• Call NHS 111 for non-emergency medical advice.
• Seek pharmacist consultation for minor ailments where appropriate.

5.2 Contacting Ambulance and Urgent Medical Services

Where a person is experiencing, or is reasonably suspected of experiencing, a life-threatening or serious medical emergency, staff must call 999 without delay.

For an urgent medical concern that is not an emergency, staff must seek appropriate clinical advice, which may include contacting the person’s GP, the relevant out-of-hours GP service, NHS 111, or another appropriate healthcare professional.

Staff must:

1. Give the call handler or healthcare professional clear and accurate information about the person’s current condition, symptoms, observations where these have been taken by a competent member of staff, relevant medical history, medicines, allergies and known risks.
2. Explain any communication needs, learning disability, autism, sensory impairment, cognitive impairment, reasonable adjustments or other support requirements that are relevant to the person’s assessment and treatment.
3. Follow the instructions and clinical advice given by the emergency or healthcare professional, provided that staff remain within their own role, training and competence.
4. Ensure that relevant healthcare information accompanies or is made available to the receiving healthcare service where this is necessary for safe and effective care and where the information can lawfully be shared.
5. Discuss with the person whether they wish to be accompanied or supported when attending hospital or another healthcare service. Where the person requires staff support because of assessed care, communication or safety needs, appropriate arrangements must be made in accordance with their care plan, risk assessment and commissioned support arrangements.
6. Where the person lacks capacity to decide about relevant support arrangements, any decision made on their behalf must comply with the Mental Capacity Act 2005 and must be made in their best interests, taking account of the person’s wishes, feelings, values and relevant views of those who should be consulted.
7. Notify the person’s family member, representative or advocate where the person has consented to this, where there is other lawful authority to share the information, or where disclosure is otherwise lawful and necessary.
8. Record the concern, observations, advice sought, advice received, actions taken, information shared, transfer arrangements and outcome in the person’s care records without unnecessary delay.

If the person’s condition deteriorates while staff are seeking non-emergency advice, staff must reassess the situation and call 999 immediately where emergency assistance becomes necessary.

5.3 Accessing Specialist Services

Referrals to specialist healthcare providers must be:

• Requested via GP for planned specialist interventions.
• Urgently arranged if symptoms suggest a specialist review is needed (e.g., oncology, neurology, psychiatric assessment).
• Followed up to ensure timely appointments and continued care.

Staff must work closely with NHS teams, district nurses, and allied health professionals to coordinate effective specialist care.

6. Ensuring Safe and Dignified Healthcare Access

6.1 Consent, Capacity and Refusal of Medical Treatment

A person’s consent must be sought before care or treatment is provided where consent is required. Staff must support the person to understand information about proposed healthcare, including the nature, purpose, likely benefits and material risks of the available options, in a way that is appropriate to the person’s communication needs.

A person aged 16 or over must be presumed to have capacity to make a particular healthcare decision unless it is established, in accordance with the Mental Capacity Act 2005, that the person lacks capacity to make that specific decision at the relevant time.

Staff must not assume that a person lacks capacity because of their age, appearance, behaviour, diagnosis, learning disability, autism, mental health condition or because the person makes a decision that others consider unwise.

Before concluding that a person lacks capacity, all practicable steps must be taken to support the person to make the decision themselves. This may include providing information in an accessible format, using the person’s preferred communication method, involving appropriate communication support, allowing additional time and choosing an appropriate time and environment for the discussion.

Where there is reason to doubt the person’s capacity to make a particular decision, an appropriate decision-specific and time-specific mental capacity assessment must be undertaken and recorded by the person responsible for determining capacity in relation to that decision.

Where a person lacks capacity to make the relevant decision and a decision must be made on their behalf, the decision must be made in accordance with the Mental Capacity Act 2005 and in the person’s best interests. The decision-maker must:

• consider all relevant circumstances;
• encourage and support the person’s participation as fully as possible;
• consider whether the person may regain capacity and whether the decision can safely wait;
• consider the person’s past and present wishes and feelings, beliefs and values and any other factors the person would be likely to consider;
• consult appropriate family members, carers, advocates or others interested in the person’s welfare where it is practicable and appropriate to do so; and
• choose the least restrictive available option where the purpose can be achieved effectively in a less restrictive way.

Family members or advocates do not automatically have legal authority to consent to or refuse medical treatment on behalf of an adult who lacks capacity. Staff and healthcare professionals must establish whether any person has relevant legal authority, such as a valid and applicable health and welfare Lasting Power of Attorney, a Court of Protection deputyship or a relevant court order.

Any valid and applicable advance decision to refuse treatment must be identified and respected in accordance with the Mental Capacity Act 2005. Where there is uncertainty about its validity or applicability, staff must inform the treating healthcare professional without delay and appropriate legal or clinical advice must be obtained.

A person who has capacity to make the relevant decision has the right to refuse medical assessment, treatment or admission to hospital, even where staff or healthcare professionals consider the decision unwise or believe that refusal could result in serious harm. Staff must not coerce, threaten or improperly pressure the person into accepting treatment.

Where a person with capacity refuses healthcare, staff must:

• listen to and respect the person’s decision;
• ensure, so far as is within their role, that the person has been given an opportunity to understand the available information and consequences;
• seek appropriate clinical advice where necessary;
• continue to offer appropriate care and support that the person is willing to accept;
• monitor the person’s condition in accordance with their care plan and clinical advice;
• escalate any deterioration appropriately; and
• accurately record the refusal, information and support offered, advice obtained, actions taken and outcome.

Treatment without consent must only occur where there is a lawful basis for doing so. Staff must not rely solely on perceived risk, family wishes or the organisation’s duty of care as authority to override a capacitous person’s refusal.

6.2 Safeguarding, Notifications and Duty of Candour

Staff must remain alert to signs that a person’s healthcare needs are not being met because of abuse, neglect, self-neglect, discriminatory practice, organisational abuse, coercion, wilful neglect, acts of omission or another safeguarding concern.

Where staff have reasonable cause to suspect that an adult with care and support needs is experiencing, or is at risk of, abuse or neglect and is unable to protect themselves because of those needs, the concern must be reported and escalated promptly in accordance with the organisation’s Safeguarding Adults Policy and applicable Care Act 2014 safeguarding procedures.

A person’s refusal of medical assessment or treatment must not, by itself, be treated as evidence that the person lacks capacity or that a safeguarding referral is required. Where the person has capacity to make the relevant decision, their decision must be respected, subject to any other lawful authority that applies.

Where a person’s refusal, behaviour or circumstances give rise to concerns about possible coercion, abuse, neglect, self-neglect, impaired decision-making or lack of capacity, staff must consider and respond to those concerns separately and in accordance with the Mental Capacity Act 2005 and safeguarding procedures.

Where staff suspect that another person is preventing or obstructing the person from obtaining necessary medical care, improperly influencing a healthcare decision, neglecting their healthcare needs or otherwise placing them at risk of abuse or neglect, this must be escalated immediately in accordance with safeguarding procedures.

The Registered Manager or delegated responsible person must consider whether an incident meets the statutory criteria for notification to the Care Quality Commission under the Care Quality Commission (Registration) Regulations 2009. Where notification is required, it must be submitted without delay and in the form and manner required by CQC.

Staff must not assume that every healthcare incident, GP contact, ambulance attendance or hospital admission requires a CQC notification. Whether CQC must be notified must be determined by applying the relevant statutory notification criteria.

Where an incident meets the definition of a notifiable safety incident under Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, the organisation must comply with the statutory duty of candour. This includes being open and transparent with the relevant person, providing the required account and information, offering an apology, providing reasonable support and maintaining the required written records.

Safeguarding referrals, CQC statutory notifications, incident reporting and the duty of candour are separate requirements. Completion of one does not remove the need to consider whether any of the others also apply.

6.3 Deprivation of Liberty in Supported Living

Supported living is a community setting. The Deprivation of Liberty Safeguards authorisation process applicable to care homes and hospitals must not be used as the legal authorisation process for a deprivation of liberty within a supported living arrangement.

Where care, supervision, restrictions or healthcare-related arrangements may amount to a deprivation of liberty in supported living, staff must escalate the matter promptly to the Registered Manager and the relevant commissioning or local authority professional so that the need for lawful authorisation can be considered. Where authorisation is required in a community setting, this is ordinarily through the Court of Protection.

When considering whether arrangements may amount to a deprivation of liberty, staff and managers must apply the current legal test and current government guidance. Following the Supreme Court judgment of 2 June 2026, the assessment is multifactorial and must consider the person’s individual circumstances, including the type, duration, effects and manner of implementation of restrictions, together with the person’s wishes, feelings and any indication of objection.

A person’s compliance must not automatically be treated as consent. Staff must pay particular attention to verbal and non-verbal expressions of wishes and feelings and to possible signs of objection, including attempts to leave, refusal or physical rejection of care or treatment, significant restrictions, restraint, one-to-one supervision used to prevent particular actions, or other restrictions on liberty.

Where there is doubt as to whether healthcare-related arrangements or other care arrangements amount to a deprivation of liberty, appropriate professional or legal advice must be sought and the matter must be referred to the relevant public authority for consideration of Court of Protection authorisation where required.

Any restriction must continue to comply with the Mental Capacity Act 2005, must be necessary and proportionate where applicable, must be kept under review and must not exceed the lawful authority in place.

7. Staff Training and Responsibilities

7.1 Training and Competence Requirements

The provider must ensure that staff have the qualifications, competence, skills, experience, support, training, supervision and professional development necessary to perform their duties safely.

Training requirements must be determined according to each worker’s role, responsibilities, the needs of the people they support and identified service risks.

All persons working for the purposes of the regulated activities must receive training on learning disability and autism that is appropriate to their role, in accordance with the statutory requirement introduced by the Health and Care Act 2022. The provider must assess the level of training required for individual staff and ensure that the training meets current statutory requirements and applicable standards.

Staff whose duties include responding to health deterioration or medical emergencies must receive appropriate training and demonstrate competence relevant to those duties. Depending on the person’s role and the needs and risks within the service, this may include:

• recognising deterioration and medical emergencies;
• emergency escalation and use of 999 and NHS 111;
• first aid and basic life support appropriate to the person’s role;
• responding to choking, seizures, anaphylaxis or other identified individual health risks;
• mental health crisis and suicide/self-harm escalation procedures;
• Mental Capacity Act 2005, consent and best-interests decision-making relevant to the person’s role;
• safeguarding adults;
• communication and reasonable adjustments;
• safe handling and sharing of health information; and
• accurate recording and reporting.

Staff must not undertake clinical procedures, observations, assessments or healthcare tasks unless these fall within their agreed role and they have received appropriate training, assessment of competence and, where required, delegation or authorisation from an appropriate healthcare professional.

The Registered Manager must maintain evidence of staff training needs assessments, completed training, competence assessments where required, refresher requirements, supervision and action taken where competence concerns are identified.

7.2 Roles and Responsibilities

• Support Workers & Carers: Identify risks, observe symptoms, and initiate medical requests.
• Senior Care Staff: Coordinate healthcare access and liaise with medical professionals.
• Registered Manager: Oversee policy compliance and quality monitoring of medical interventions.

8. Monitoring and Continuous Improvement

8.1 Documentation and Reporting

Accurate, complete, legible and contemporaneous records must be maintained in relation to healthcare concerns, medical support requested and actions taken.

Records must include, where relevant:

• the date and time the concern was identified;
• the person’s reported symptoms and presentation;
• relevant observations made by staff;
• any deterioration or changes identified;
• the person’s wishes and preferences;
• consent obtained or refused;
• any mental capacity assessment or best-interests decision relevant to the matter;
• the healthcare professional or service contacted and the date and time of contact;
• information provided to the healthcare professional;
• clinical advice or instructions received;
• action taken in response;
• medicines or treatment changes communicated by an authorised healthcare professional;
• hospital attendance, transfer, admission or discharge information;
• information shared with family members, representatives or advocates and the lawful basis or consent for doing so where relevant;
• safeguarding concerns or referrals where applicable;
• incidents and statutory notifications where applicable;
• follow-up actions, responsible persons and timescales; and
• the eventual outcome.

Significant changes in health needs, risks, treatment or healthcare instructions must be reflected promptly in the person’s care and support plan, risk assessments, health action plan or other relevant records.

Where healthcare professionals provide instructions or recommendations, staff must ensure that these are communicated to relevant staff and followed within the scope of the service’s responsibilities. Where instructions are unclear, inconsistent with existing instructions or cannot safely be implemented, clarification must be obtained from an appropriate healthcare professional without unnecessary delay.

Incidents must be reported internally in accordance with the organisation’s incident-reporting procedures. The Registered Manager or delegated competent person must separately consider whether the circumstances require a safeguarding referral, a statutory CQC notification, compliance with the duty of candour, notification to another statutory body, or another external report.

Records containing health information must be stored, accessed and shared securely and lawfully in accordance with applicable data protection and confidentiality requirements.

8.2 Quality Assurance and Policy Compliance

• Quarterly audits will be conducted on medical support requests and response times.
• Feedback from service users, families, and staff will be used to refine policies.
• Annual policy reviews will ensure compliance with CQC standards and NHS guidelines.

9. Related Policies

This policy should be read alongside the following organisational policies and procedures:

• Safeguarding Adults from Abuse and Improper Treatment Policy.
• Mental Capacity and Deprivation of Liberty Policy, including Court of Protection authorisation for supported living/community settings.
• Incident Reporting and Investigation Policy.
• Safe Care and Treatment Policy.
• Emergency Response and First Aid Policy.
• Duty of Candour Policy.
• Data Protection, Confidentiality and Information Sharing Policy.

10. Policy Review

This policy will be reviewed annually or sooner if significant regulatory or operational changes occur. Updates will be communicated to all staff, and refresher training will be provided where necessary.

---

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}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.