Our governance framework for service commencement

Calviora's Statement of Purpose will define the organisation, its aims and objectives, service location, regulated activity, service-user groups and management arrangements.

• Scope limited to planned, non-emergency patient transport — emergency response, 999 conveyance and unscheduled care are excluded
• Service-user group stated explicitly as adults aged 18 and over; children are not within the intended launch service scope
• Any change of scope, location or activity to be reviewed and notified before it takes effect
• The published scope and the registered scope to remain aligned at all times

The framework sets out named accountability at board and service level. A Nominated Individual and a Registered Manager will hold defined responsibilities under the regulations.

• Nominated Individual accountable for the way the regulated activity is managed and provided
• Registered Manager accountable for day-to-day delivery, competence of crews and regulatory compliance
• Fit and proper person requirements applied to directors and senior appointments
• A documented scheme of delegation, escalation route and governance meeting cycle
• Individuals will be named publicly only once appointments are confirmed

Safeguarding will be treated as everyone's responsibility, with a single, unambiguous route to raise and escalate a concern. Calviora's service users are adults aged 18 and over; child safeguarding awareness is retained as an organisational duty for staff rather than as a service offered to children.

• Adult safeguarding procedure with a named safeguarding lead, supported by organisational child safeguarding awareness for staff
• Role-appropriate safeguarding training levels, refreshed on a defined cycle
• Immediate escalation routes to local authority safeguarding teams and the police where required
• Recognition of neglect, exploitation, self-neglect and domestic abuse built into crew training
• Safeguarding concerns recorded, reviewed and reported to CQC where notifiable

Every person who attends a patient will be recruited safely and signed off as competent before working unsupervised.

• Safer recruitment process covering identity, right to work, references, employment history and DBS at the appropriate level
• A staffing structure defining role types, responsibilities, qualifications and supervision lines
• Structured induction, supervised practice and documented competency sign-off
• A training matrix covering safeguarding, moving and handling, basic life support, infection prevention, conflict resolution and mental health awareness
• Ongoing supervision, appraisal and refresher cycles with escalation where competency lapses

Care will be delivered with consent, and where capacity is in question the Mental Capacity Act framework will be applied and recorded.

• Consent sought, recorded and revisited throughout the journey
• Assumption of capacity, decision-specific assessment and best-interests decision making where capacity is lacking
• Recognition of advance decisions, lasting powers of attorney and Deprivation of Liberty safeguards where relevant
• Reasonable adjustments, communication support and accessible information as standard
• Dignity, privacy and equality obligations written into crew standards

Mental health transport is included only for appropriately assessed adult non-emergency journeys whose needs can be supported safely within Calviora's ordinary patient transport model. Secure conveyance, detained-patient transport and restraint-based transport are not part of the planned launch service.

• Individual pre-journey risk assessment agreed with the referring clinical team, with a clear decline route where needs fall outside the model
• Consent-led practice, with the Mental Capacity Act framework applied and recorded where capacity is in question
• Trauma-informed, calm and dignified crew practice as the default approach
• Crew training in de-escalation, communication, safeguarding adults and mental health awareness
• Defined escalation routes to the referring team, emergency services or safeguarding where a journey cannot safely continue
• Structured handover standards at collection and destination

Infection prevention will be applied consistently across crews, vehicles and equipment.

• Standard precautions, hand hygiene and personal protective equipment expectations for every journey
• Defined vehicle and equipment cleaning schedules, including enhanced decontamination after higher-risk transfers
• Safe management of clinical waste, sharps and linen
• Isolation and cohorting arrangements agreed with referring services where required
• IPC audit and monitoring built into the quality assurance cycle

Calviora does not provide treatment or clinically monitored transport. Where a patient's own medication travels with them, its handling and handover will be governed rather than left to individual judgement.

• Crews do not administer medication; patients' own medication travels with the patient or their escort
• Secure carriage, temperature considerations and documented handover of patients' own medication
• Clear boundaries on what crews may and may not do, with escalation to the referring clinical team
• Recording of any medicines-related incident, discrepancy or omission
• Any equipment carried on the vehicle checked, in date and logged

Vehicles and equipment will be governed by documented standards covering suitability, maintenance and daily readiness. No vehicle details are published until vehicles are secured and verified.

• Vehicle specification matched to intended patient need, including stretcher and wheelchair-accessible requirements
• Scheduled servicing, MOT, defect reporting and off-road procedures
• Daily vehicle and equipment checks recorded before first journey
• Equipment inventory, servicing, calibration and expiry monitoring
• Cleaning schedules, driver licensing checks and insurance held before any vehicle carries a patient

The framework treats risk and incidents as sources of learning, supported by an open and honest response to those affected.

• A maintained risk register with assessed likelihood, impact, controls and review dates
• Dynamic risk assessment at the point of care as well as documented journey risk assessment
• Incident reporting, grading, investigation and thematic review
• Duty of candour applied where a notifiable safety incident occurs, with a documented apology and explanation
• An accessible complaints procedure with defined response times and independent escalation routes
• Statutory notifications to CQC and other bodies where required

Patient information will be handled under UK GDPR and the Data Protection Act, with confidentiality treated as a clinical safety matter.

• Lawful basis, data minimisation and defined retention periods for patient records
• Role-based access control, secure devices and secure destruction
• Data protection impact assessments for new processing and information-sharing agreements with partners
• Personal data breach identification, containment and reporting procedures
• Records management standards ensuring journey records are accurate, contemporaneous and retrievable

The service will define in advance how it responds when demand, staffing, vehicles or systems are disrupted.

• Continuity arrangements for vehicle breakdown, staff absence, IT failure and severe weather
• Clinical deterioration protocol with immediate escalation to emergency services
• On-call and command arrangements with defined decision-making authority
• Communication plans for patients, referrers and commissioners during disruption
• Periodic testing and review of continuity arrangements

Appropriate cover will be in place and evidenced before any patient is carried. Insurers, policy numbers, limits and dates are not published.

• Motor insurance appropriate to patient-carrying use
• Public liability and employer's liability cover
• Medical malpractice or professional indemnity cover where the delivery model requires it
• Cover reviewed against scope, fleet and staffing whenever the service changes

Quality will be measured rather than assumed, with findings feeding a visible improvement cycle.

• A planned audit programme covering records, IPC, vehicles, safeguarding and journey quality
• Patient, family and referrer feedback captured and reviewed
• Performance and safety measures reviewed at governance meetings with actions tracked to closure
• Freedom to speak up arrangements so staff can raise concerns without detriment
• Learning shared across crews and reflected in updated policy and training

Every journey will be governed by assessment, equipment and staffing controls proportionate to the patient's mobility needs.

• Pre-journey assessment of mobility, skin integrity and access at both ends of the journey
• Equipment rated and verified for safe working load, including stretchers, ramps and transfer aids
• Crew numbers and moving-and-handling competency matched to the assessed need
• Dignity, privacy and communication standards applied throughout
• Declining or deferring a journey where safe handling cannot be assured