Patients have a right to an appropriate continuum of care. This continuum of care begins within the prehospital environment and extends right through to patient discharge and follow-up. In the emergency care domain, there are various levels of care that can be initiated depending on the patient’s injury/illness.
These various levels of care are related to the scopes of practice of the treating Emergency Care Provider. Once a level of care has been initiated, only in circumstances where the patient is deemed to be stable and not conceivably be any need for continued or further management, may the patient be handed over to a lesser qualified independent practitioner.
In deciding whether to handover to a lesser qualified individual, meticulous consideration should be given to the scope of practice of the receiving Emergency Care Provider.
When patients are handed over to lesser qualified individuals, medication side/adverse effects, equipment complexity, patient needs and potential patient adverse events should be carefully considered. In addition, the practice of upgrading levels of care for the purpose of financial gain is strongly condemned.
The decision to handover a patient to a lesser qualified individual lies with the treating Emergency Care Provider, and in the case of an adverse event, the responsibility lies with that individual who elected to handover the patient. At all times, patients should be transported to the nearest, most appropriate healthcare facility in compliance with the National Health Act, 2003 (61 of 2003).