Safety notice: waiting to hand over COVID-positive patients


We recognise that pressures are growing in the NHS and we are working with acute partners to reduce the amount of time which you wait with patients outside emergency departments waiting to handover. The aim is still to be able to handover your patient within 15 minutes of arrival at hospital.

Should you be held on the back of an ambulance with a COVID-positive patient waiting to handover to hospital staff, please follow the below guidance to support your safety and that of your patient.

Rotate – resources with two clinically qualified members of staff must rotate the two clinicians every 15 minutes to ensure continual oversight of your patient’s condition. Keep a continual patient care record open during this time. The other clinician should stand outside or sit in the cab. Ensure that you doff PPE on exiting the rear of the vehicle and replace before re-entering. When working with a non-clinical crew mate, you should still aim to rotate every 15 minutes and ensure you are able to remain verbal contact with the non clinical member of staff throughout.

Ventilate – keep the engine running with the extraction fans on. At 15-minute intervals, ensure the rear doors are opened for one minute when rotating clinicians to allow circulation of air.

Escalate – monitor your patient and record a NEWS2 on the patient care record every 15 minutes. Escalate a deteriorating patient or a patient with a NEWS2 of 4 or more to the HALO or nurse in charge on arrival at the hospital and every 15 minutes that you are waiting.


  • Every patient should be attended wearing level 2PPE,regardlessoftheirCOVID status. Level 2PPE provides adequate protection from exposure to the virus.
    • Level 2 PPE includes a surgical face mask, gloves, apron, and eye protection.
    • A surgical mask should be replaced if damaged, visibly soiled, damp, uncomfortable or difficult to breathe through.
  • If an aerosol generating procedure (AGP) needs to be undertaken, level 3PPE should be donned.
    • Level 3 PPE includes FFP3 mask, gloves, fluid repellent coverall, and eye protection.

This Operations Notice can be downloaded as a PDF document below.

Staff are also reminded to be aware of the Extended handover escalation and cohorting guidance published in November, which is also downloadable below.

Published 17th December 2020

Updated 11th January 2021