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Report on Government Services 2020

PART E, SECTION 11: PRESENTATION REVISED ON 25 JUNE 2020

11 Ambulance services

The presentation of this section has been updated since its release on 31 January 2020. To access material in the original format please refer to the archived copy

This section is presented in a new online format. Dynamic data visualisations replace the static chapter format used in previous editions. Machine readable data are also available for download. A guide is available on accessing information in the new format.

The focus of performance reporting in this section is on ambulance service organisations, which are the primary agencies involved in providing emergency medical care, pre-hospital and out-of-hospital care, and transport services.

The Indicator Results tab uses data from the data tables to provide information on the performance for each indicator in the Indicator Framework. The same data in the data tables are also available in CSV format.

Skip to downloadable Ambulance services data tables and supporting material

  • Context
  • Indicator Framework
  • Indicator Results

Objectives for ambulance services

Ambulance services aim to promote health and reduce the adverse effects of emergency events on the community. Governments’ involvement in ambulance services is aimed at providing emergency medical care, pre-hospital and out-of-hospital care, and transport services that are:

  • accessible and timely
  • meet patients' needs through delivery of appropriate health care
  • high quality — safe, co-ordinated and responsive health care
  • sustainable.

Governments aim for ambulance services to meet these objectives in an equitable and efficient manner.

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Service overview

Ambulance services include preparing for, providing and enhancing:

  • emergency and non-emergency pre-hospital and out-of-hospital patient care and transport
  • inter-hospital patient transport including the movement of critical patients
  • specialised rescue services
  • the ambulance component of multi-casualty events
  • the community’s capacity to respond to emergencies.

Roles and responsibilities

Ambulance service organisations are the primary agencies involved in providing services for ambulance events. State and Territory governments provide ambulance services in most jurisdictions. In WA and the NT, St John Ambulance is under contract to the respective governments as the primary provider of ambulance services.

Across jurisdictions the role of ambulance service organisations serves as an integral part of the health system. The role of paramedics has expanded over the last decade to include the assessment and management of patients with minor illnesses and injuries to avoid transport to hospital.

On 1 December 2018, paramedicine became a nationally regulated profession with paramedics joining the National Registration and Accreditation Scheme (Paramedics Australasia, 2020). From this date, paramedics must be registered with the Paramedicine Board of Australia and meet the Board’s registration standards in order to practise in Australia (Paramedicine Board of Australia, 2018).

Funding

Total expenditure on ambulance services was $3.9 billion in 2018-19 (table 11A.10), which was funded from a mix of revenue sources. Total revenue of ambulance service organisations was $3.8 billion in 2018-19, representing an annual average growth rate of 5.6 per cent since 2014-15 (table 11.1).

Jurisdictions have different funding models to provide resourcing to ambulance service organisations. Nationally in 2018-19, State and Territory government grants and indirect government funding formed the greatest source of ambulance service organisations funding (73.2 per cent of total funding), followed by transport fees (from public hospitals, private citizens and insurance (21.3 per cent of total funding)) and subscriptions and other income (5.5 per cent) (table 11A.1).

Size and scope

Human resources

Nationally in 2018-19, for ambulance services reported in this section there were:

  • 18 445 FTE salaried personnel (81.5 per cent were ambulance operatives)
  • 6681 volunteer personnel (89.9 per cent were ambulance operatives)
  • 3144 paramedic community first responders. Community first responders are trained volunteers that provide an emergency response (with no transport capacity) and first aid care before ambulance arrival (table 11A.8).

Demand for ambulance services

Nationally in 2018-19, there were:

  • 3.8 million incidents reported to ambulance service organisations1 (152.9 incidents per 1000 people)
  • 4.8 million responses where an ambulance was sent to an incident (192.3 responses per 1000 people). There can be multiple responses sent to a single incident. There can also be responses to incidents that do not have people requiring treatment and/or transport
  • 1185 response locations (3712 first responder locations with an ambulance) and 3829 ambulance general transport and patient transport vehicles
  • 3.7 million patients assessed, treated or transported by ambulance service organisations (146.8 patients per 1000 people) (figure 11.1)
  • 96 air ambulance aircraft available. There are air ambulance (also called aero-medical) services in all jurisdictions, although arrangements vary across jurisdictions (table 11A.2).

Ambulance service organisations prioritise incidents as:

  • emergency — immediate response under lights and sirens required (code 1)
  • urgent — undelayed response required without lights and sirens (code 2)
  • non emergency — non urgent response required (codes 3, 4)
  • casualty room attendance.

Nationally in 2018-19, 37.5 per cent of the 3.8 million incidents ambulance service organisations attended were prioritised as emergency incidents, followed by 35.6 per cent prioritised as urgent and 26.9 per cent prioritised as non-emergency (table 11A.2). There were 209 casualty room attendance incidents (all of which occurred in Queensland).

  1. An incident is an event that resulted in a demand for ambulance services to respond. Locate Footnote 1 above

References

Paramedics Australasia, 2020, https://paramedics.org/professional-standards (accessed 4 May 2020).

Paramedicine Board of Australia, 2018, Registration standards, https://www.paramedicineboard.gov.au/Registration.aspx (accessed 22 October 2019).

The performance indicator framework provides information on equity, efficiency and effectiveness, and distinguishes the outputs and outcomes of ambulance services.

The performance indicator framework shows which data are complete and comparable in this Report. For data that are not considered directly comparable, text includes relevant caveats and supporting commentary. Section 1 discusses data comparability and completeness from a Report-wide perspective. In addition to the service area's Profile information, the Report’s statistical context (section 2) contains data that may assist in interpreting the performance indicators presented in this section.

Improvements to performance reporting for ambulance services are ongoing and include identifying data sources to fill gaps in reporting for performance indicators and measures, and improving the comparability and completeness of data.

Outputs

Outputs are the services delivered (while outcomes are the impact of these services on the status of an individual or group) (see section 1). Output information is also critical for equitable, efficient and effective management of government services.

Outcomes

Outcomes are the impact of services on the status of an individual or group (see section 1).

Indicator framework

An overview of the Ambulance services indicator results is presented. Different delivery contexts, locations and types of clients can affect the equity, effectiveness and efficiency of ambulance services.

Information to assist the interpretation of these data can be found in the Ambulance services interpretative material and data tables. Data tables are identified by a ‘11A’ prefix (for example, table 11A.1).

All data are available for download as an excel spreadsheet and as a CSV dataset — refer to Download supporting material. Specific data used in figures can be downloaded by clicking in the figure area, navigating to the bottom of the visualisation to the grey toolbar, clicking on the 'Download' icon and selecting 'Data' from the menu. Selecting 'PDF' or 'Powerpoint' from the 'Download' menu will download a static view of the performance indicator results.

Download supporting material

Note: an errata was released for section 11 Ambulance services.

Errata

The following data have changed for section 11 Ambulance services data tables:

  • Table 11A.5: Amended data for Proportion of patients who reported a clinically meaningful pain reduction for 2014-15, 2016-17 and 2017-18 for Aust, 2015-16 for Vic, Qld, NT and Aust and 2012-13 for Vic. Amended data for Total number of pain management patients for 2015-16 and 2017-18 for Aust and 2012-13 for Vic and Aust.
  • Table 11A.7: Amended data for Total operational workforce and Workforce attrition for 2016-17 for NSW.
  • Table 11A.11: Amended data for Paramedic witnessed adult cardiac arrest survival rate for 2015-16 for Tas, 2013-14 for NSW and 2011-12 for NT. Amended data for Adult cardiac arrests where resuscitation attempted (excluding paramedic witnessed) survival rate for 2013-14 for NSW and 2011-12 for NT. Amended data for Adult VF/VT cardiac arrests (excluding paramedic witnessed) survival rate for 2011-12 for NT.