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 in 2008.
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.