AMBULANCE CAR SERVICE (ACS) INFORMATION SHEET
Introduction
Thank you for requesting details on the Ambulance Car Service (ACS),this is a voluntary transport service and does not constitute any contractual arrangements or contract of employment with the North East Ambulance Service. Our ACS volunteers are required to provide transport for non-emergency walking patients to and from hospitals and treatment centres, thereby leaving ambulances available for low mobility patients i.e. wheelchair and stretcher patients and allows ambulance when needed to support with emergency and urgent care transport.
The Basic Requirements
The basic requirements which must be met before being considered as a Volunteer Driver are that the volunteer must be:-
1)Availability
You will be asked to nominate certain days of the week when you will be available for ACS journeys. A volunteer can be available any time or day however, the biggest requirement for volunteer journeys falls between 0800 hours and 1800 hours. Journeys are normally planned on the previous day.
2)Physically and mentally fit
You will often be required to assist patients from their home, into your car and then again from the car to the hospital ward or department. There may also be suitcases/crutches/personal belongings to be carried.
A medical questionnaire will need to be completed. This is a confidential document and will only be seen by the Occupational Health Department.
3)Have internet access and a printer
We have now started to email drivers their log sheets rather than faxing them as done previously. In line with the confidentiality agreement the emails would be sent via a secure network called NHSnet and an account would be set up for each individual in order to retrieve their work. Once the email is opened it should be printed in order to submit your claim and then deleted.
4)Have a four door car in sound and clean condition
Cars must be six years old or less on commencement of voluntary duties, be four/five door design to allow free and easy access to and from the rear seats and must be maintained in clean condition, both internally and externally with front and rear seat belts fitted.
5)Covered by full Comprehensive Insurance
The North East Ambulance Service NHS Trust does not accept any responsibility or liability for damage or injuries arising from accidents. Therefore, it is most important that Volunteer Drivers ensure that their car is covered by a fully comprehensive policy and that they are authorised to use the car for the conveyance of patients and reimbursement of these expenses.
It is important that the volunteer checks the above points with their insurance company, as an insurance indemnity certificate will be required to be signed by all new drivers.
6)Undergo a driving assessment
Before being accepted as a volunteer, you will be required to take a driving assessment with an appropriate officer from the Trust.
7)Declare all driving convictions
All driving convictions, past present or pending, must be declared at the time of applying and also subsequently as an ACS driver.
8)MOT Certificates and Insurance
At the time of applying you will be requested to supply us with a copy of your current insurance certificate and MOT certificate (where applicable) and thereafter on an annual basis (MOT certificates being accepted as proof of road-worthiness).
9) CRB Checks
Owing to the nature of the Trusts’ business, volunteers will be subject to an Enhanced Criminal Disclosure check. Volunteers will only be accepted into the ACS subject to verification of details provided through the criminal record bureau check.
Payment of Expenses
Volunteers are not paid for their services but are reimbursed mileage expenses in arrears at a rate of 44p per mile. This can be claimed each month using the forms provided and then submitted direct to the ACS Administrator at NEAS, Bernicia House.
Conveyance of Patients and Escorts
Journeys are planned as efficiently as possible and will inevitably result in the transportation of more than one patient per car to save unnecessary duplication of mileage and expense.
Escorts should only be conveyed where booked or authorised by Control. No other passenger should travel as any spare seating may be needed for additional patients on return journeys. Animals must not be carried, the exception to this being guide dogs, with the consent of the volunteer.
Appointment Times
It is most important that the appointment times given are met, as many of the patients you will carry will be attending for specialised treatment and failure to meet these times may result in treatment being delayed or missed. If any doubt exists in this matter, advice may be sought from PTS Control.
Safety of Patients
Attention is drawn to the need for seat belts to be worn by the driver and all passengers.
Care of patients conveyed by the Volunteer Car Service
This service is for patients who are unable, for medical reasons to travel to or from treatment centres by public transport. They may be upset and therefore, should be treated with consideration and understanding at all times. Volunteers must help them to enter or alight from their cars and see them safely into hospital or settled in their own home on discharge. The sympathetic handling of patients is the prime responsibility of our service. You will be required to ensure that any discharged patient is seen safely into their house, preferably into the care of a relative or neighbour.
Ambulance PTS Control
It is the responsibility of all volunteers to notify PTS Control of any changes/alterations to planned work on the day.
Your voluntary activity is planned the previous day and where possible printed log sheets are transmitted to you by email during early evening.
PTS Control is available at all times. Should a problem arise "out of hours" they are there to assist you. Control staff may ask you to convey patients at short notice (depending upon your availability); this will usually be during the evening or at weekends.
Identification
Upon commencement as a volunteer, you will be provided with Ambulance Car Service signs for your car and an identification badge. These should be displayed at all times and only when transporting patients on behalf of the trust.
Unemployment and Volunteers registered as Unemployed
As previously stated the Ambulance Car Service is purely voluntary and reimbursement of expenses is paid to volunteers. Should you be registered as unemployed it is your responsibility to ensure that any effects on benefits being received by you are discussed with the relevant benefits provider.
AMBULANCE CAR SERVICE APPLICATION FORM
1. PERSONAL DETAILSTitle: Mr / Mrs / Ms or Other – please specify: ………………………………………………………………
Surname: ………………………………………………………………………………………………………..
Forename(s): ……………………………………………………………………………………………………
Address: ……………………………………………………………………………………………………
……………………………………………………………………………………………………
……………………………………………………………………………………………………
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Postcode: …………………………………………………….
Home Telephone Number: (inc. STD Code) …………………………Fax No......
Mobile Telephone Number: ………………………….…………….
Email Address: ………………………………………………………………………………………………..
Date of Birth: ………………………………National Insurance Number: …………………………………..
2. CAR DETAILS – CAR MUST BE LESS THAN 6 YEARS OLD
Car Reg Number: ………………………… Make & Model: ……………………………………………….
Cubic Capacity: ………………………….. Seating Capacity: …………………………………………….
Year of Registration: ……………………. Insurance Company: ………………………………………...
Policy Number: …………………………… Insurance Renewal Date: …………………………………...
MOT Certificate Date: ……………………………………………………………………………………….....
3. DRIVING DETAILS
Driver Number: ……………………………………… Issue Number: ……………………………………
Type of Licence : Full / Provisional
Valid from: …………………………………… to: ………………………………………………………......
Motor Vehicle Groups / Categories: ………………………………………………………………………...
Date First Passed UK Driving Test: ………………………………………………………………………...
Types of Vehicles Driven: ……………………………………………………………………………………
Endorsements: YES/NO Details if any: ……………………………………………………………………
Court Code: ………………………………. Date of Conviction: …………………………………………..
Offence Code: …………………………….. Date of Offence: ………………………………………………
Disqualification Period: ……………………………………………………………………………………….
Signature: ………………………………………………………………………………………………………..
4. AVAILABILITY
Please indicate below when you will normally be available:
Days / Before 8am / AM / PM / After 6pmMonday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Will you be able to take patients on Long Distance Journeys?YES/NO
Are you willing to accept journeys involving an overnight stay?YES/NO
Are you willing to do Bank Holidays andWeekends?YES / NO
5. WORK EXPERIENCEPlease list your work experience for the past five years beginning with your most recent job held.
If you were self-employed, give firm name. (Please use additional sheet if necessary).
Name of Employer:Address:
Phone Number: / Employment Dates From: / Employment Dates To:?
Your last job title:
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:
Reason for leaving (be specific):
Name of employer:
Address:
Phone Number: / Employment Dates From: / Employment Dates To:
Your last job title:
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:
company
Reason for leaving (be specific):
6. REHABILITATION OF OFFENDERS ACT 1974
Because of the nature of the Trusts business and the journeys you will be carrying out, this voluntary post is exempt from the Provision 4 (2) of the rehabilitation of Offenders Act 1974 (Exemptions) Order 1975. Applicants are therefore not entitled to withhold information about convictions which for other purposes are “spent” under the provisions of the Act.
In the event of acceptance as a voluntary driver, any failure to disclose such convictions will result in termination of use as a volunteer. Any information given will be completely confidential and will be considered only in relation to an n application for positions to which the Order applies.
Have you any previous cautions, convictions or any hearings pending? YES/NO
If yes, please give details:
7. DISCLOSURE – CRIMINAL RECORDS BUREAU (CRB)The North East Ambulance Service NHS Trust uses the Criminal Records Bureau (CRB) Disclosure service to help assess the suitability of applicants for positions of trust. As an organisation, we comply fully with the CRB Code of Practice regarding the correct handling, use, storage, retention and disposal of Disclosures and Disclosure information. It also complies fully with its obligations under the Data Protection Act and other relevant legislation pertaining to the safe handling, use, storage, retention and disposal of Disclosure information and has a written policy on these matters, which is available to those who wish to see it on request.
8. PROTECTION OF CHILDREN: DISCLOSURE OF CRIMINAL BACKGROUND OF THOSE WITH ACCESS TO CHILDRENI understand that the voluntary post for which I am applying is regarded as having access to children.
I understand that the CRB check on any convictions, bind over’s or cautions will be necessary.
I hereby give permission to this check being carried out.
I hereby understand that any information received from the CRB will be treated in absolute confidence.
Signed:......
Date:......
9. DECLARATION
- I have fully read and understood the information regarding the Ambulance Car Service and consider that I fulfil all the criteria therein.
- I accept that the North East Ambulance Service NHS Trust accepts no liability for damages or injuries to myself, the patients carried or my car, from accidents incurred whilst on duty, and confirm that I have fully comprehensive insurance against such claims or liabilities.
- I must notify the North East Ambulance Service NHS Trust of any change of car or insurance arrangements.
- I must notify the North East Ambulance Service of any Driving Licence endorsements obtained either prior or subsequent to my joining the service and report any pending prosecution at any time.
- I understand that this is a voluntary role and that there are no contractual arrangements or contract of employment stated or implied.
Signed:...... Date:......
Please give details of 1st Referee:-
Name......
Address......
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Telephone Number......
Please give details of 2nd Referee:-
Name......
Address......
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Telephone Number......
If you are receiving payment from the Trust for use of this vehicle for any service other than the Ambulance Car Service , kindly give details below:-
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Please give the name of any other Authority for whom Ambulance Car Service journeys are undertaken:-
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