What to do if…
you are told a critically ill relative must be transferred to another hospital quickly

What to do now

1. Get to the right person. Ask to speak to the consultant or senior doctor responsible. If they are not immediately available, ask for the duty registrar or senior clinician and the nurse in charge. Say: “I need the transfer details and the safety plan. Please talk me through where, why, when, and who is accepting them.”

2. Write down the four essentials.

   • Destination: hospital name, exact site, ward or unit.
   • Reason: specialist treatment, lack of a suitable bed, equipment, staffing, or another stated reason.
   • Timing: likely departure time and what might change it.
   • Receiving care: the accepting hospital team, unit, or doctor, and how handover will happen.

3. Ask what you are being asked to do. Say: “Are you asking for a decision from the patient or a legal decision-maker, or are you informing us about a clinical transfer decision?”

   • If your relative can understand and communicate the decision, ask staff to speak with them directly.
   • If your relative cannot decide right now, ask what capacity or best-interests process is being used and who is being consulted.

4. State any legal authority or known wishes clearly.

   • England and Wales: if there is a registered Health and Welfare LPA, the attorney can usually make relevant health and care decisions only when the person lacks capacity for that decision. Say: “I am the Health and Welfare attorney. I can send the registered LPA now.”
   • Scotland: if there is a welfare attorney or welfare guardian, say this and ask how to provide proof.
   • Northern Ireland: ask the team what legal authority, court appointment, or recorded consent arrangement they need to check.
   • If there is an advance decision, advance directive, written refusal of treatment, or clear written record of wishes, tell the clinical team and ask them to record that it has been raised.

5. Ask the transfer safety questions.

   • “What are the risks of staying compared with moving?”
   • “Who will travel with them, and what monitoring or treatment will continue during the journey?”
   • “What equipment, medicines, oxygen, or notes will travel with them?”
   • “Has the receiving unit accepted them and been told the expected arrival time?”
   • “Who should I call for an update during and after the move?”

6. Get the receiving contact details before the transfer. Ask for the receiving unit’s phone number, the hospital switchboard route if a direct number is not available, and when the first update after arrival is expected.

7. Use the hospital escalation route if communication is breaking down. In England, ask for PALS if it is available at that time. Elsewhere in the UK, ask for the hospital’s patient advice, liaison, complaints, or feedback service. If it is out of hours, ask for the on-call site manager, duty manager, or senior nurse and request a clear call-back time.

8. Protect practical essentials. Ask what will happen to personal belongings, medication, phone, glasses, hearing aids, dentures, or mobility aids. Keep any useful identifier to hand, such as the NHS or hospital number, CHI number in Scotland, or any local hospital identifier if known.

9. Keep one calm channel. Choose one person to speak to staff and one person to update family. If you are not the main caller, help with transport, childcare, chargers, food, or writing notes.

10. Correct contact mistakes quickly. If staff are consulting the wrong person, say plainly who the correct contact, attorney, guardian, or known decision-maker is and how to reach them now.