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COVID-19: Guidance for ambulance services

Public Health England have released new guidance regarding the growing risk to ambulance crews who are spending long periods of time with infected patients, in ambulances, as a result of the delays in handovers in Accident and Emergency Departments.

The delays in handovers with A&E are primarily as a result of the difficulties in maintaining social distancing, where possible, for infection control, alongside the high occupancy and severe operational pressures across all hospitals. This guidance has particularly been updated in light of the identification of new Covid variants of concern across the UK.

Further risks identified include oxygen supplies in ambulances running out.

The new guidance recommends some good practice precautions in the event of a delay in handing over patients at the receiving facility, urging all staff to adopt the following infection prevention and control procedures:

  • If more than one clinician is available, rotating them regularly, thereby allowing them time to change PPE and take on fluid;
  • keeping ventilation systems running which may require the engine to be kept running;
  • ensuring patients and any essential escorts wear surgical masks, as long as patient care is not compromised;
  • minimising the number of people within the patient compartment and avoiding sitting face-to-face with patients; and
  • decontaminating contact surfaces more frequently and during the delay if possible.

Furthermore, this updated guidance discusses the introduction of COVID-19 risk pathways for staff awareness as patients will be triaged into the appropriate care pathway by the receiving facility. There are additionally changes to patient cohorting aligned to these new pathways.

These three risk pathways are split into high risk, medium risk and low risk. The new guidance has outlined the risk pathways in further detail.

It is important to follow the local guidance specific to the Trust/area. This may require contact with the receiving unit prior to departure or on arrival to have a discussion regarding where to take the patient as this may not be the usual area within the hospital. The new guidance states that where there are confirmed cases with a positive result, patients can be transported in the same vehicle wearing surgical masks, with no social distancing required between patients.

For further detail regarding the guidance, please click here.

If you require further information, please get in touch.


Please note that this briefing is designed to be informative, not advisory and represents our understanding of English law and practice as at the date indicated. We would always recommend that you should seek specific guidance on any particular legal issue.

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