L3 Law PDF October 2020

Law: Legal Aspects Affecting the AAP  Law OBJECTIVE Discuss the main points of law which affect ambulance staff...

Law: Legal Aspects Affecting the AAP  Law OBJECTIVE Discuss the main points of law which affect ambulance staff and the implications on their work ©Department of Clinical Education & Standards  Law – English legal system Criminal Law-Maintain order Civil Law-Upholding and protect society individuals rights State v defendant Individual v individual Magistrate/ Judge & jury Judge(s) Beyond reasonable doubt Balance of probabilities Guilty/ Not guilty Liable / not liable Punishment= Resolution= fine/imprisonment compensation/damages ©Department of Clinical Education & Standards  Law Duty of Care It is the duty and responsibility of every professional ambulance person to exercise ALL REASONABLE CARE In both the management and the treatment of all patients ©Department of Clinical Education & Standards  Law Failure to provide reasonable care could result in a claim of negligence. This could be taken to a civil court. This is why there must be :- Set levels of competence for ambulance staff Adequate training to ensure staff meet this competency criteria ©Department of Clinical Education & Standards  Law – Clinical Negligence Duty of Care Breach of Consequence Duty Causation ©Department of Clinical Education & Standards  Law Scope of Practice You also have a responsibility to perform your duties to both the Requirements & Standards laid down by your employing Trust You must be aware of the danger of exceeding your scope of practice You must know when to pass the case on to a more senior clinician ©Department of Clinical Education & Standards  Law Confidentiality You will often come by information about patients which is confidential. You must only pass relevant information onto entitled parties. Remember information comes from many sources; you might be told something that you need to keep from the patient. ©Department of Clinical Education & Standards  Law The Caldicott Principles Justify the purpose(s) Don't use patient identifiable information unless it is necessary Use the minimum necessary patient-identifiable information Access to patient identifiable information should be on a strict need-to-know basis Everyone with access to patient identifiable information should be aware of their responsibilities Understand and comply with the law The duty to share information can be as important as the duty to protect patient’s confidentiality These help to protect patient identifiable information. ©Department of Clinical Education & Standards  Law When can confidentiality be breached? With consent Safeguarding Act or commissioning of a crime ©Department of Clinical Education & Standards  Law Personal Property You will often find patient`s personal property comes into your care. Get colleagues to help you record the items involved Keep them safe - while they are in your possession you are responsible for them Only give it to people who are entitled to them or have authority to receive them Obtain a signature when leaving the property with an authorised person ©Department of Clinical Education & Standards  Law Dying Declaration This is a statement given to you by a patient who believes they are about to die. It could be verbal or given in writing It could be relevant to: Their cause of death Circumstances of their death Personal wishes at the time of death ©Department of Clinical Education & Standards  Law It may be used in court as evidence if the patient`s death is connected with a charge of murder or manslaughter. But only if the patient`s death has been caused by: Violence Criminal action of someone else ©Department of Clinical Education & Standards  Law Recording a Dying Declaration Accurately record what was said as soon as possible If possible, ask the patient to sign it If you have a witness, ask them to sign it Record the time & date of the statement Any dying declaration should be given to Police with a statement ©Department of Clinical Education & Standards  Law Forcible Entry Article 8 of the human rights act states; “You have the right to have respect for your home, will also cover the right to enjoy your home without interference or intrusion by others and the right of access to and occupation of your home.” ©Department of Clinical Education & Standards  Law Ambulance staff have NO right in law to make forcible entry into someone's home BUT as ambulance staff, you can make a forcible entry acting in someone’s best interest To save a life Where someone is ` reasonably believed ` to need medical help ©Department of Clinical Education & Standards  Law Guidelines for Forcible Entry Inform EOC of your actions and justifications Request police attendance, but do not delay gaining access by waiting for them Remember to check for open doors, windows or neighbours with a key first Minimise damage during entry Secure premises or leave in care of a responsible person when you leave If Police have not arrived and you have to leave, inform EOC Remove patient to hospital without delay Remember, your safety is paramount ©Department of Clinical Education & Standards  Law Non-Conveyance of patients If you have been called in error, then record this on PRF/ePCR as `Not Required` If a patient declines hospital but requests to be conveyed home, then contact EOC for advice Record `Home by Request` on your PRF/eCPR and authorising controllers initials As an AAP you cannot discharge a patient from our care. This decision will be made by a more senior clinician ©Department of Clinical Education & Standards  Law Treated but Not Conveyed May occur when the patient has recovered either before the ambulance arrives or after aid is rendered on scene In most cases the patient should be assumed to require further assessment by a clinician and onward care. All decisions about the non conveyance of patients who have received aid must be made using Pathfinder and the Patient Referral Tool-discuss with Clinical Hub if necessary – AAP’s will not make these decisions. ©Department of Clinical Education & Standards  Law You must make every effort to assess and treat the patient and provide onward care. Where possible, 2 sets of clinical observations should be completed and recorded on the PRF/eCPR If this cannot be done, then document why. ©Department of Clinical Education & Standards  Law Refused Aid (Private Address) Encourage the patient to accept assessment/treatment and travel if necessary Ensure the patient has capacity to make the decision-use LA5 (AAP can only assist with capacity assessment) Inform EOC and contact Clinical Hub/GP for advice, especially if the patient is alone If still declining, then try to leave patient in the care of a responsible person Advise them to contact GP or dial 999 again if required Record all advice given, including any consequences of not attending hospital, on PRF/ePCR and if possible get the patient or responsible person to sign it- a completed copy of the PRF/ePCR and any additional paperwork must be left with the patient/responsible person ©Department of Clinical Education & Standards  Law Refused Aid (Public Place) Follow guidance from previous slide (private address). If the patient is alone, unable to leave scene unaided or you are concerned for their welfare, then you should contact EOC, request Police and await their arrival. ©Department of Clinical Education & Standards  Law Refused Aid (En-route) Follow normal guidance for refused aid in a public place Do not provide assistance to a patient alighting from your vehicle unless the patient`s actions are likely to cause injury or other danger Inform EOC of the circumstances If Police have been requested by you or by EOC then wait on scene with the patient until their arrival Remember, your safety is paramount ©Department of Clinical Education & Standards  Law Refused Aid (Overdose) Always encourage patient to travel Seek advice from clinical hub-we should not leave the patient in a dangerous situation without care If in a private address and the patient is still declining, contact GP and request their attendance Await arrival of GP and act under their instructions Record all instructions given and GP`s name, especially if being released from scene If in a public place, then request Police to attend scene Formal assessment of capacity may be required ©Department of Clinical Education & Standards  Law Searching of a Patient It may be necessary to search the patient or their belongings for identity or medical information Ensure that it is in the patients best interest Always try to have a witness present Ensure property is dealt with appropriately Ensure personal safety ©Department of Clinical Education & Standards  Law Suspected Criminal Offences If you are responding to a call and find it involves a criminal act e.g. assault, murder, terrorism. Inform EOC and request attendance of Police If on receipt of the call EOC suspect that an offence may have been committed, they will inform Police immediately after the ambulance has been despatched to scene Remember, your safety is paramount ©Department of Clinical Education & Standards  Law ANY QUESTIONS? ©Department of Clinical Education & Standards