Ambulance Handover to Emergency Care Standard

Ambulance Handover to Emergency Care Standard

Emergency care needs fast, effective sharing of information. When clinicians have access to the information they need, they can better ensure safe and high-quality care for patients. To facilitate this, The Professional Record Standards Body (PRSB) has developed a standard for the information that is shared when care is transferred from ambulances to emergency departments.

On this page

Current release

Version: v1.0
> Standard model – Excel
> Supporting documentation (external link to NHS Standards Directory)

From 01 January 2026, this standard will be owned and managed by NHS England and is made available for reuse or amendment under the Open Government Licence v3.0 (OGL 3.0). A review of the ongoing requirement for this standard will be undertaken by NHS England. Details on this and any update to the standard will be published on the NHS Standards Directory. If you have any questions or feedback relating to this standard, please email: england.standards.assurance@nhs.net.

 

About this standard

The standard defines the information that should be transferred from an ambulance to an emergency department when or just prior to the patient being transferred.

The benefits of an implemented ambulance handover standard:

  • A consistent set of information available to the emergency care professionals through their own record system.
  • Improved patient safety as emergency care professionals will know what medications have been administered, what diagnostic tests have been done, whether the patient has any allergies and other important information obtained by the paramedics.
  • Improved efficiency through better workflow, continuity of care, and pre-arrival streaming based on clinical information.

 

Clinical leadership was provided by clinicians from the Royal College of Emergency Medicine and the College of Paramedics (CoP). The standard has been developed with the support of professionals and patients.

Summary table

This summary table gives an overview of the information transferred. The conformance (Conf) column indicates if the item is M – Mandatory, must be included, R – Required if the information is available or O – Optional.

 

Ambulance handover to secondary care – Version 1
Name Conf Description
Person demographics R The person’s details and contact information.
GP practice R Details of the person’s GP practice.
Legal information R Information about lasting power of attorney or deputies, mental capacity, deprivation of liberty of safeguards or mental health act status, and consent for information sharing
Safeguarding R The safeguarding details of the person.
Referrer Details R Details of the source of referral/contact for the ambulance
Individual requirements R The individual requirements of the person, covering reasonable adjustments, impairments and mobility
Health and care professional details R Name and details of health or care professional responsible pre-transfer and others present
Participation in research R Details of the person’s participation in research studies
Incident details M Details of ambulance incident including date/time, location, arrival and leaving time, time of arrival for handover, source of call, time of symtom onset.  Mostly provided by the local system.
Injury R Details of the person’s injury and of any drugs or alcohol used by the person
Relevant past medical, surgical and mental health history R The record of the person’s significant medical, surgical and mental health history. Including relevant previous diagnoses, problems and issues, procedures, investigations, specific anaesthesia issues, etc.
Presenting complaints or issues M The person’s chief complaint as assessed by the care professional, its acuity and other person reported problems and issues
Diagnoses R The clinical assessment by the ambulance of crew of the persons clinical situation at the conclusion of their treatment. This will be one of confirmed diagnosis, suspected diagnosis or chief complaint.
Clinical Summary R Summary of the encounter. Where possible, very brief. This may include interpretation of findings and results; differential diagnoses, opinion and specific action(s).
Treatments and interventions R Details of any treatments and interventions carried out
Social context R The social setting in which the person lives, such as their household, occupational history, and lifestyle factors. Also details of any dependents
Investigation results R Any investigation results
Observations R The record of essential physiological observations, using National Early Warning Score (NEWS2) where appropriate.
Assessments R Details of assessments completeted
Risks R Details of any risks related to the person including risk to self, to others, from others, or of infection
Allergies and adverse reactions M Details of any known allergies and adverse reactions, or statement of none known
Medications and medical devices R Details of any medications administered
Information and advice given R Information and advice given to the person
Person and carer concerns expectations and wishes R Details of the person and carer concerns, expectations and wishes, including an advance statement
Documents (including correspondence and images) O Details about documents and images related to the person.

Endorsement

The standard is endorsed by:

  • Association of Ambulance Chief Executives
  • Chartered Society of Physiotherapists
  • College of Paramedics
  • Royal College of Emergency Medicine
  • Royal College of Nursing
  • Royal College of Obstetricians and Gynaecologists
  • Royal College of Occupational Therapists
  • Royal College of Physicians
  • Royal College of Surgeons
  • Royal College of Psychiatrists

CHAT theory also explicitly addresses five areas which if addressed systematically will help overcome stakeholder differences in pursuit of the common goal:

1. Understanding the artefacts that characterise the group and its activity.
• The artefacts might be clinical settings or the forms and templates used to capture and share information. During the pilot we heard about hard copy Dialog response forms; locally generated templates for collating information from different systems; letters and emails to GPs; images, poems or other non-text artefacts that service users might want to include in their ‘about me’ or care plan.

2. Understanding the multi-views of the group. Such groups are always a community of multiple points of view, traditions and interests. 
• Different participants in the group will have different roles and will bring to the group and their roles their own histories, language, and ‘rules’. During our Stocktake preparations and workshops we worked with psychiatrists, mental health nurses, occupational therapists, social workers, transformation leads and voluntary sector representatives, all professions and interests with their own language, approaches professional ‘rules’ but united in their interest in care plans, care planning.

3. Activity systems (like the ICSs) take shape and get transformed over periods of time. ‘Historicity’ is a term coined to express how the group’s problems and potentials can only be understood against their own history. 

 

• ‘We’ve always done it this way’, ‘that didn’t work before’, ‘it’s always like this’, ‘it wasn’t always like this’, ‘they are changing things again’, are all typical statements that often frustrate those charged with overseeing change initiatives. Without addressing the experiences that lie behind such comments you risk repeating mistakes of the past, alienating your stakeholders or just not understanding the real starting point for your transformation project. This is particularly the case for the implementation of the PCSP standard, the success of which will be largely reliant on point-of-care practices and information protocols as well as having systems which are user friendly and appropriately configured.

4. The central role of contradictions as sources of change and development. Contradictions are not the same as problems or conflicts. Contradictions are historically accumulating structural tensions within and between activity systems. Collectively addressing contradictions in how policy, practice, culture and technology interact will empower teams to find genuinely novel solutions for apparently intractable challenges, like interoperability and shared care plan/planning. 

This links to the fifth principle that:

5. the possibility of expansive transformations in activity systems. As the contradictions of an activity system are aggravated, some individual participants begin to question and deviate from its established norms. In some cases, this escalates into collaborative envisioning and a deliberate collective change effort. “An expansive transformation is accomplished when the object and motive of the activity are re-conceptualised to embrace a radically wider horizon of possibilities than in the previous mode of the activity.”

Successful teams have the functional skills to lead a task, benefit from diversity, and are led in a way that creates time and space for reflection; the ability to take stock periodically, of the task and of the way in which the team is engaged in delivering it. Your stakeholder analysis [HYPERLINK] should help you assemble the most appropriate team and identify how the team interacts and relates to other stakeholders like sponsors, services users, etc.

The variation in the size, both in terms of population served and numbers of constituent organisations, and of complexity, between Integrated Care Systems, precludes the possibility of any prescriptive guidance on the way in which this team is assembled.

Engeström’s expansive learning cycle of learning actions explains how there are 7 stages of learning actions;