1. Ambulance Services in Australasia 2013

2. Agenda Overview Who is CAA? Dimensions and Services Current Issues
Demand
Performance and Measurement
Regulation
Questions

3. Who is the CAA ? The Council of Ambulance Authorities Inc.
Established in 1962
Incorporated in 2002 (+ first staff member)
Charity (no income tax)
Ten members – public ambulance services
Governed by a Board of ten Directors
Small secretariat, headed by CEO
Australasia’s equivalent of AACE

4. International Links
AACE
Paramedic Chiefs of Canada

5. Dimensions Activity (Incidents): Population: www.caa.net.au
Australia 22.6m
New Zealand m
TOTAL m
(UK 62.7m)
Activity (Incidents):
Emergency 1.7m
Urgent m
Non-Urgent 1.2m
TOTAL m
Not Transported m (11% Patients)

6. CAA’s Member Services www.caa.net.au 8 Australian Services
ACT Ambulance Service
Ambulance Service New South Wales
Ambulance Tasmania
Ambulance Victoria
Queensland Ambulance Service
SA Ambulance Service
St John, Northern Territory
St John, Western Australia
2 New Zealand Services
St John, New Zealand
Wellington Free Ambulance
Australian Capital Territory
The UK would fit into Australia 31.6 times (into New Zealand 1.1 times)
Texas fits 11 times!
Note: NZ not to scale in this map

7. Governance www.caa.net.au Non-Government - Contract
State Government – Emergency Services Departments
State Government - Health Departments

8. Dimensions $2.5 billion 80% Operational Staff (=13,400 FTE)
8,900 Volunteers
30% of Response Locations
Covered only by Volunteers

9. www.caa.net.au PAID STAFF (FTE 000s) STATIONS VEHICLES INCIDENTS
St John, WA
1,126
189
597
230,000
St John, NT
167 9 58
N/A
SA Ambulance
1,210
114
399
256,000
Queensland Ambulance
3,895
266
1,244
833,000
AS New South Wales
4,360
267
1,574
973,000
ACT Ambulance
224 7 46
39,000
Ambulance Victoria
3,449
230
1,092
795,000
Tasmanian Ambulance
357 49
164
68,000
St John, NZ
1,705
913
416,000
Wellington Free
214 30
71,000
TOTAL
16,707
1,329
6,117
3,681,000
Annual Report Data
More on CAA web site

10. Current Issues Demand Performance Measurement Regulation
Emergency Management

11. Demand Continued increase
Incidents and patient numbers: 4.5%+ growth pa
(higher in NZ than Aus)
Reduce non-emergency load
Out-sourcing, secondary triage and referral
Community Paramedicine - ‘Urgent Community Care’
Better integration with health services - end ‘ramping’
Developing the value proposition – support future investment

12. Performance Measurement
From process measures to patient outcomes
Eg. ‘Response time’ to ‘Survival to discharge’; Pain…
Balanced suite of indicators
Would look familiar to you
Systems – EPRs - ‘Big Data’ for ambulance

13. Regulation Paramedics Registration or black list (Code of Conduct)?
Australia different to New Zealand?
Risk Management or cultural change ?
Paramedic practice
Clinical Governance
Third party providers
Event Medical Services
NEPT
Industrial

14. Emergency Management Floods, Fires, Cyclones, Earthquakes
Increased incidence - due to climate change
Increased exposure to risk
Including reputational risk
Greater Recognition of Ambulance Capability needed
Management of care and resources in the field
Delivery of health care in uncontrolled environments
Resourcing Ambulance Capacity
‘Surge’ resourcing

15. A strong voice for the sector Appreciation of the ambulance role
My Mission
A seat at the table
A strong voice for the sector
Appreciation of the ambulance role
Attention to our issues

16. Questions ?