top of page

These are suggested templates for documents and are by no means touted as the only solution. We are happy to add any templates from any department to aid other users in making choices that suit their needs

Individual Patient's Notes - Updated Version

Patient Specific Documentation - a method of capturing the contacts, interactions and notes involved in working with our patients

Initial Patient Consultation Document (including consent to share)

Full patient assessment document for Frequent Attenders

Patient Information Leaflet

Information about Frequent Attender Service for patients

Confidentiality Statement - Multi Agency Panel

Multi Agency Confidentiality Statement for signing

Consent to Share

Patient Consent

Behaviour Contract

For use with patients who need to access emergency care but whose behaviours cause problems with the smooth running of the department

​

To be used after capacity assessment has been undertaken

Alert Warning

Risk/warning alert for use with patients whose behaviour may cause harassment, alarm or distress, or who may be violent/aggressive

​

Also used for interhospital sharing for hospital hoppers

Information to assist patient care in the Emergency Department

Information sheet for use before full multi agency meeting is held and actions decided. This sheet enables the service to provide a quick synopsis of the patients needs and any known triggers/information whilst a full MDT is being called

Integrated Management Plan

Multi Agency Management Plan

Frequent Attender Letter 1 - Notification of Multi Attendance Trigger

First Notification of Multi Attendance Trigger

Frequent Attender Letter 2 - Notification of Lack of Change

Notification of Lack of Change

Frequent Attender Letter 3 - Notification of Further Action

Notification of Further Action

Please reload

bottom of page