Ms ROSOL – I have some more questions about the ambulance services. Minister, how many single response shifts were worked by paramedics in 2023-24?
Mr BARNETT – Thank you for that question which is clearly operational. I’ll just check if the chief executive can assist. We’ll get to the detail of that and come back to you. Do you think that’s possible today or on notice?
Mr EMERY – I think it would need to be on notice along with that other data.
Mr BARNETT – Yes. We’ll take that on notice.
Ms ROSOL – Thank you. A report on government services data shows that in 2018‑19, the 90th percentile response time for emergency incidents in the Hobart area was 21 minutes, but in 2022-23 it had increased to 31 minutes – a 10-minute, 48 per cent increase – in just five years and we’ve also seen our statewide results rapidly worsening over the same period. We know in an emergency, every single minute counts, but thousands of Tasmanians every year are waiting longer and longer for an ambulance when they need it the most. Has the department done any work to understand the impact that lengthening response times may have had on patient outcomes or to assess in any way the harm that’s being caused by these lengthening delays, so kind of following through after the delays and seeing the impact?
Mr BARNETT – The first thing I would say in response to that question is the increased funding support for the 78 new paramedics that we’re putting on over the next four years and the incredible improvements in the ambulance times and the incremental improvements we’re getting at all our emergency department outcomes in terms of ambulance and the 9000 hours that rather than being ramped, they’re now out on the street and in the communities doing the wonderful work that they do. That’s what I think I outlined in response to the member for Bass, Rob Fairs, earlier today, but in addition to that I’ll ask the chief executive to add to that answer.
Mr EMERY – Any delayed response that results in an adverse patient outcome is picked up through our clinical governance framework and is the subject of root cause analysis where that is a SAC1 incident, or severity assessment code 1 incident. Where they are what we call SAC2 incidents, we would undertake a London protocol and I’m just having the team pull that information now in terms of the number of incidents we’ve had in the last year. It is small. We closely monitor and have a number of processes in place for those delayed response cases, including procedure within the Ambulance Tasmania communication centre where we undertake call-backs and our secondary triage service can also undertake call-backs to monitor those patients whilst they’re awaiting emergency ambulance response.
Ms Rosol, I’ll just say that that more than 50 per cent of the 000 calls that come through to Ambulance Tasmania are not for priority zero or for priority one cases, and that’s not to be disparaging of those individuals calling 000 for ambulance assistance, it is to say that often engagements with Ambulance Tasmania are for assistance in navigating the healthcare system and the minister touched on some of the challenges accessing primary care already.
We’re working incredibly hard to increase the number of calls that we can manage through our secondary triage service where they can speak to specialist clinicians, including paramedics and nurses, as well as be referred to an emergency doctor. Since the inception of that program in 2021, more than 11,000 000 calls have gone through that secondary triage service and some 53 per cent of those calls are able to be managed in the community without requiring an emergency ambulance response.
On top of that, the funding of the Community Paramedic program has seen several thousand patients responded to in the community by our specialist community paramedics and in the order of 60 per cent of those patients don’t require transport to an emergency department, which is about three times higher than the non-conveyance rate of other emergency ambulances. And, of course, the significant investment in the Police, Ambulance, Clinician Early Response (PACER) model in southern Tasmania and the mental health co-response model in north-west Tasmania and in 2025 in northern Tasmania will continue to support us providing care to those lower acuity presentations outside of the emergency department.
I share that context with you, Ms Rosol, because achieving those things along with transfer–of-care performance is critical for us to be able to service those time-critical P0 and P1 cases as quickly as possible, which is why all of this additional work is taking place so we can support those patients in the community as quickly as possible.
Ms ROSOL – Thank you. I appreciate the bigger picture, but I also would love some information on those particular things.
CHAIR – Before I give the call to Mr O’Byrne, minister, you said there was an answer to one of those earlier questions.
Mr BARNETT – Yes, I did and we’re trying to cooperate with the committee to provide the answers as soon as possible. That’s why I’m indicating at the appropriate time when the answer is available, and it’s up to the committee when they’d like to hear the answer.
Mr EMERY – Ms Rosol, you asked about safety events associated with delayed responses. The information I’ve received from my team is that of the 193,985 incidents Ambulance Tasmania attended over the last two financial years, there have been eight SAC 1 or SAC 2 safety events over that period.
As I said, all SAC 1 incidents are the subject of a root cause analysis investigation, and all SAC 2 incidents are the subject of a London protocol investigation – just different investigative methodologies. Then we take those recommendations and work actively to implement those recommendations that are different for every circumstance. In some of those incidents it was about the activation of a helicopter emergency medical service. In other circumstances it might have been about the call-taking procedure. We look at those incidents holistically and do everything we can to learn from them and change our practice to prevent reoccurrence.
