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A comparison of handover communication in NHS and military emergency care

02 April 2020
Volume 12 · Issue 4



There is a gap in the literature comparing communication during handover between military and NHS emergency care settings.


This study aimed to explore differences in handover communication in the NHS and the military, and to understand how paramedics manage the transition between settings.


This was a qualitative study for which 13 paramedics were interviewed. It focused on handover communication in NHS emergency care settings and Camp Bastion Hospital, Afghanistan.


Interviews were conducted with regular and reservist paramedics serving in the Royal Air Force who had undertaken a deployment with the Medical Emergency Response Team. Semi-structured interviews were recorded, transcribed, coded and subjected to a thematic analysis.


Three principal themes were identified: differences between handover communication; standardisation; and the challenge of transition.


Participants were most concerned about standardisation. Transition theory and resilience may account for the difficulties encountered when transitioning between different care settings.

The aim of this study was to explore differences in handover communication between NHS and UK military emergency care settings, and understand how paramedics manage the transition between them. There is a growing body of international literature on handover communication between paramedics and hospital receiving staff, but little is known about handover communication in the UK military (Slope et al, 2019).

Handover communication in the UK military was governed by Clinical Guidelines for Operations: Joint Doctrine Publication (CGO) 999 published by the Ministry of Defence (MoD) in 2013. This publication mandated the use of the MIST (mechanism of injury, injuries or illness, signs and treatment, adult or child, time), which is often referred to as ATMIST to include patient age and time of incident (MoD, 2013: 41), as well as assigned trauma team roles.

Military practices evolved in response to the conflict in Afghanistan, when UK forces were in command of the hospital at Camp Bastion until they withdrew in 2013. Paramedics deployed to Camp Bastion as part of the Medical Emergency Response Team (MERT) and handed patients over to receiving staff at the emergency department (ED) at Camp Bastion Hospital (Thomas, 2014).

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