There are two reasons patients are transferred between intensive care units or to a different hospital. The first is that the patient needs the specialist care or treatment that can only be provided in the hospital they are going to, or that once treatment has been given they need to be transferred back to the hospital nearer home for their recovery. A good example of this is neurosurgery.
The second reason patients are transferred between intensive care units is called a "non clinical transfer" and this occurs because there are no available intensive care beds in the hospital they are at when they become unwell enough to need ICU. Sometimes the demand for an intensive care unit bed is so great that the consultant may have to make arrangements for a patient, already in intensive care, to be transferred to another intensive care unit in another hospital so that a more desperately ill patient, who is too ill to travel, can be admitted. This might occur very rarely.
The decisions on how to manage these awful situations rest ultimately with the intensive care consultant in discussion with the senior nurses and specialist teams, and with the intensive care consultant at the receiving hospital.
It is understood that this can be very distressing for patients and relatives, especially if someone has to be transferred further away from home, but these are not decisions that are taken lightly and they often have to be made very quickly.