How a Mental Health Transport Job Is Risk Assessed
September 22, 2023
At A Glance
Almost everything that determines whether a mental health transfer goes well is decided on the booking call, before a crew is allocated.
- Every call is risk assessed at the point of booking, not on arrival
- That assessment sets crew size, vehicle class, gender matching and whether uniform is appropriate
- The most useful information is often not clinical: who the person trusts, what they have been told, what is waiting at the door
- Feedback is collected after transfers and fed back into crew training
- Secure 24 is CQC registered and rated Good across all service areas
When a transfer goes badly, the review usually focuses on what happened in the vehicle. In our experience the decisive moment was earlier than that, and quieter: it was the phone call where the job was booked, and whether anyone asked the right questions.
A crew arriving without knowing that the person has not yet been told they are being moved, or that a family member is on their way, or that the last transfer ended in restraint, is a crew starting from behind. Our control room exists to close that gap before anyone is dispatched on a secure ambulance job.
Arranging a transfer right now?
24/7 dispatch, with our average call answered in under a minute.
What Happens on the Booking Call
Every call into the control room is logged and assessed rather than simply booked. The caller might be a ward manager, an Approved Mental Health Professional, a police officer, a care home manager or a family member, and each of them holds a different part of the picture.
The clinical detail matters: presentation, diagnosis where relevant, medication, physical health needs, mobility, and any history of absconding or of violence toward staff. But the questions that most often change how a job runs are the ordinary ones. Has the person actually been told this is happening? Who do they listen to? Is there a dog? Are there stairs? Is anyone else in the house who will react badly to a vehicle arriving?
Our call handlers are trained to build rapport rather than complete a form, because a caller who feels rushed gives you the fields and not the context. The context is where the risk lives.
How the Risk Assessment Shapes the Crew and the Vehicle
The assessment is not paperwork filed after the fact. It produces four decisions before anyone is dispatched.
- Crew size. Whether two is right, or whether the risk profile justifies more
- Vehicle class. A standard secure ambulance for most risk levels, a wheelchair-accessible variant where physical and mental health needs combine, or a Cell Secure Ambulance for the highest-risk journeys
- Crew composition. Gender-matched to the patient’s preference wherever it can be arranged, with male and female teams available as standard
- Presentation. Whether civilian clothes with PPE would be less alarming than uniform, which for someone with a difficult history of being detained can change the whole tone at the door
We do not add crew or upgrade the vehicle unless the assessment genuinely calls for it. Sending more than the job needs is not caution, it is billing, and it also makes the arrival heavier than it has to be.
Keeping a Patient Calm During Transport
The first ninety seconds set the journey. Crews introduce themselves by name, explain who they are and where the person is going, and answer questions directly. People in crisis are rarely reassured by vagueness, and being told the truth about a long journey is easier to manage than discovering it an hour in.
Verbal de-escalation is the primary tool and usually the only one. Where the clinical team supports it and the assessment allows, a familiar adult travelling in the vehicle is frequently the single most effective thing available, particularly for young people going into CAMHS placements a long way from home.
The vehicle itself does quiet work here. A lit, climate-controlled safe space with padded seating, a media screen and an unbroken line of sight to the crew means containment does not have to mean prolonged physical restraint. Restraint is a temporary response to a specific escalation, never the default way of holding someone still for two hours.
From dispatch
The single most useful answer we get on a booking call is to the question nobody thinks to volunteer: what happened last time this person was moved? If it went badly, we plan around it. If nobody asks, we find out at the door.
Handover, Paperwork and What Happens Afterwards
Handover documentation is completed at both ends, so the receiving team knows how the journey actually went rather than only that it happened. Where a journey involved any escalation, that is recorded properly, because a transfer that is later reviewed needs a reconstructable account rather than recollection.
Afterwards the job is debriefed internally. Patients and carers are often asked to complete a feedback form, and what comes back is used to shape training rather than filed as a satisfaction score. A crew who handled a difficult arrival well is worth more as a training example than as a statistic.
Want to speak to a trust already using Secure 24?
We will arrange a peer reference call with a Patient Safety or AMHP lead.
What Referring Teams Can Do to Help a Transfer Go Well
The most useful things a ward, AMHP team or family can pass on at the point of booking:
- Whether the person knows the transfer is happening, and how they responded when told
- How previous transfers went, particularly anything that escalated
- Who the person trusts, and whether that person can be present or reachable
- Anything about the environment at collection, including other people, pets, access and stairs
- Medication timing, so the journey does not cut across a dose
- Whether the destination is expecting them, and who will receive the handover
None of this is unusual to ask for, but it is frequently not offered, and a transfer built on incomplete information is where most avoidable difficulty starts. The same principles apply across planned patient transport as they do to detained conveyance.
Very calm approach to sensitive situations, dealt with dignity and respect to the individual. Very professional.
Rachale Kerbey
Verified Google review
Related Reading
- What Is a Mental Health Ambulance? How They Work in the UK
- Inside Our Secure Ambulances
- How Our Crews Are Trained
- How We Work With NHS Trusts and ICBs
Patient Care and Risk Assessment FAQs
How Is A Mental Health Transport Job Risk Assessed?
The assessment happens on the booking call, before a crew is allocated. It covers presentation, medication, physical health and mobility, any history of absconding or violence, and the practical environment at collection. That profile then sets crew size, vehicle class, whether a gender-matched crew is appropriate and whether civilian clothes would be less alarming than uniform.
What Information Should I Give When Booking A Transfer?
Whether the person knows the transfer is happening and how they reacted, how previous transfers went, who they trust and whether that person can be present, anything about the collection environment including other people, pets and access, medication timing, and who will receive the handover at the destination. The non-clinical details are often the ones that change how a job runs.
Can A Family Member Or Carer Travel With The Patient?
Often yes, where the clinical team supports it and the risk assessment allows. A familiar adult in the vehicle is frequently the most effective de-escalation tool available, particularly for young people. The decision sits with the referring clinical team, and seating and crew are planned around it once it is confirmed at the point of booking.
How Do You Keep A Patient Calm During A Long Transfer?
Crews introduce themselves by name, explain where the person is going and answer questions honestly, because vagueness rarely reassures anyone in crisis. Verbal de-escalation is the primary tool. The vehicle supports it: a lit, climate-controlled safe space with padded seating, a media screen and continuous line of sight to the crew means containment does not require prolonged physical restraint.
Will More Crew Be Sent Than The Job Needs?
No. Crew size and vehicle class follow the risk assessment, and we do not upgrade either unless the profile genuinely calls for it. Beyond the cost, sending more people than necessary makes the arrival heavier and more intimidating than it needs to be, which works against the transfer rather than for it.
What Happens After The Transfer Is Complete?
Handover documentation is completed at the destination so the receiving team knows how the journey went, and any escalation is recorded properly so the transfer can be reconstructed if it is later reviewed. The job is then debriefed internally, and feedback from patients and carers is used to shape crew training rather than filed as a satisfaction score.
Where does your mental health pathway lose time?
We will walk through your conveyance points and flag the friction.
