Ambulance services are an integral part
of the health system. While quality of care provided by paramedics
is paramount, the outcome for a patient may also be affected by the
time taken to respond to an emergency.
The audit objective was to determine
whether ambulance services are sufficiently accessible and
appropriately responsive, focusing on:
- indicator data and
assessment of performance trends in response times
- distribution of
resources and impact on service responsiveness.
The audit also considered response time
performance in relation to the amalgamation of ambulance services
Ambulance Victoria (AV) has achieved
much since amalgamation, including improvements to call taking and
dispatch for the whole state, and strategic planning for rural
regions. However, some expected efficiencies have not been realised
and the trend of deteriorating ambulance response times evident
prior to amalgamation has not been arrested. Ambulances are taking
longer to respond to Code 1 emergencies, with the lowest
performance since 2004–05 recorded in 2009–10. Response times have
worsened more in rural regions than in the metropolitan area and
are worst in population centres less than 7 500. Communities of
similar population size do not necessarily get the same level of
responsiveness from AV.
It is likely that the significant
increase is demand for emergency services in the past six years has
caused most of the increase in response time. Increased funding of
$185.7 million over four years from 2008–09, and amalgamation, have
not succeeded in addressing this.
This points to unfinished work from the
amalgamation, particularly addressing cultural issues that have
persisted from Rural Ambulance Victoria, and in bedding down more
sophisticated resource allocation in regional and rural areas. New
funding provided by the Department of Health also needs to be
better aligned with AV operational priorities.
Greater transparency in reporting response time performance and
disclosing area specific targets, which take account of geography
and branch staffing, is needed to better inform the public about
the level of service it can realistically expect. The present
reporting of statewide measures omits the level of detail necessary
to give this understanding.