In reply to the above: TR did exactly the right thing. In London, we have a wide variety of "casualty" hospitals, many of which specialize in different types of thing - ie, specialists in burns, plastics, cardio-pulmonary, neuro etc, all the while still being casualty receiving hosps. LAS crews will frequently be aware/made aware that a particular patient is under a particular hosp for their condition. In certain circs, we will convey to their recognized treatment centre if we deem it appropriate (ie for sickle cell pats). In other cases, it may not be necessary if - as TR intimated - the patients CURRENT problem has little or nothing to do with their CHRONIC condition. It's really a case of "decide on scene, when you have all the facts to hand".