Part C: Service Specification for emergency road ambulance services

Transcription

1 Prt C: Servie Speifition for emergeny rod mulne servies 1 Term This Agreement will strt on 1 April 2012 or when duly exeuted y the prties nd will, sujet to Prt 1, Shedule 2 luse 11 (Termintion) or luse 16 (Conflit), ontinue for period of 48 months to 31 Mrh 2016 with further right of renewl for 24 month term. The right of renewl is t the sole disretion of the Purhsers sujet to the stisftory performne of the Servies 2 Purpose Emergeny Amulne Providers (EAPs) provide Emergeny Amulne Servies (EAS) to the puli. EAS inludes timely, pproprite emergeny re nd where neessry, emergeny trnsport of ptients to ple of definitive re. 3 Servie Ojetives The ojetives for this Servie re: Tht it is essentil tht people get the right re, t the right time, in the right ple from the right person 1. Emergeny mulne servies ensure the re given filittes the est possile outomes, for ptients who ess emergeny mulne servies nd omplies with qulity requirements. Integrtion of EAS into the wider helth setor. 4 Priniples 4.1 The following re guiding priniples for primry retrievls / tretment / trnsport: Tretment delivered is neessry, pproprite nd of the required qulity. Tretment is delivered y the stff with the pproprite skill level nd support. Trnsport to tretment is undertken only when neessry nd pproprite nd is relted to ptient need. 5 Overview of Emergeny Amulne Servies 5.1 Emergeny Amulne Servies inludes Emergeny Amulne Communition Centres (EACCs) nd Emergeny Amulne Providers. 5.2 EACCs: provide the teleommunition interfe etween the ller nd the EAP; determine the ptient need through n greed telephone trige system; 1 Rodside to Bedside A 24-hour Clinilly Integrted Aute Mngement System for New Zelnd; ACC/Helth Funding Authority/Ministry of Helth nd Counil of Medil Colleges; Aville from 1

2 effetively mnge mulne resoures to ensure emergeny lls re ppropritely responded to. 5.3 The types of resoures ville to the EACC for dispth re: Emergeny Rod Amulnes inluding wter mulnes 2 ; Emergeny Air Amulnes; nd Primry Response in Medil Emergeny (PRIME) dotors nd nurses. 5.4 EAPs: provide rod mulne servies ross New Zelnd, with rnge of servies nd pility levels to meet the needs of their ommunities within ville resoures; re dispthed y the EACCs; respond in timely mnner to lls for ssistne mde through the EACCs in order to provide pproprite re nd, where neessry, emergeny trnsport of people requiring urgent tretment s result of one of the following medil emergenies: illness, injury or ostetri emergeny. 5.5 The Crown expets tht the resoure most pproprite to the ptient s triged needs will e utilised. This mens n mulne resoure will e dispthed nd/or referrl to n lterntive re pthwy. 5.6 It is expeted, tht if n mulne hs een dispthed nd it is deemed linilly pproprite, then the EAP shll refer the ptient to n lterntive re pthwy rther thn trnsport the ptient to ple of definitive re. 6 Bkground 6.1 Rodside to Bedside Rodside to Bedside outlines the frmework neessry to provide the est possile outomes for people who need to ess emergeny servies y ensuring tht people get the right re, t the right time, in the right ple, from the right person. EAPs must follow the Rodside to Bedside frmework. 6.2 The New Zelnd Amulne Servie Strtegy The New Zelnd Amulne Servie Strtegy 3 (the Strtegy) ws nnouned in June The Strtegy ws developed y the Aident Compenstion Corportion (ACC) nd the Ministry in onsulttion with the mulne setor nd other stkeholders. The Strtegy provides frmework for future development nd growth of emergeny mulne servies, nd ongoing ollortion etween Crown, setor nd stkeholders. The 10 inititives from the Strtegy were developed tking into onsidertion dvie nd reommendtions following severl reviews of the Amulne Setor. These inititives hve een prioritised nd re eing implemented over time. 2 Servies usully orgnised through EAPs nd provided y Cost Gurd servies 3 The New Zelnd Amulne Servie Strtegy The first line of moile emergeny intervention in the ontinuum of helth re. 4 June Aville from 2

3 6.3 Integrtion into the wider helth setor The integrtion of Emergeny Amulne Servies into the wider Helth Setor my ontriute to more servies eing delivered in lol ommunities. Therey potentilly reduing the demnd on seondry nd tertiry servies. This my led to providing etter re for ptients, loser to home. 6.4 Oligtions for response to mjor emergenies EAPs must omply with the following: The Ntionl Civil Defene Emergeny Mngement Pln Order The Amulne New Zelnd Amulne Ntionl Mjor Inident Pln (AMPLANZ) frmework. The New Zelnd Stndrd, Amulne nd prmedil servies stndrd (NZS 8156). 6.5 EAP nd EACC Interfe The EACCs dispth EAP resoures to the sene of the medil emergeny, s pproprite, sed upon informtion reeived from the ller. Allotion nd dispth of resoures is sed on ptient need, within ville resoures. EAPs re responsile for the supply of the EAS resoures. EAPs re required to hve forml, signed Servie Level Agreement (SLA) with EACCs tht desries the opertionl reltionship, inluding lotion finding responsiilities. Communition etween the EAP nd EACCs is prmount t ll times nd this will e refleted in the SLA. A opy of the signed SLA will e provided to the Ntionl Amulne Setor Offie (NASO). Any susequent hnges will e formlly greed nd signed y the EAP nd EACCs, nd then dvised to NASO. The EAP will e prtiipting memer of the Emergeny Amulne Communition Centre User Group. The Terms of Referene 4 should e revised t lest every two yers with EACCs leding the proess with involvement of ll EAPs nd NASO. 6.6 Emergeny Cre Coordintion Tems EAPs must e prtiipting memers of the pproprite regionl Emergeny Cre Coordintion Tem (ECCT), where they exist. 6.7 Interfe Between the Ministry nd ACC The NASO is joint ACC nd Ministry tem whih mnges ll EAS ontrts, inluding EACC nd EAP ontrts, on ehlf of the two Crown Agenies. ACC nd the Ministry hve different funding models for EAS; these will ontinue until suh time s joint funding model hs een greed nd pproved for implementtion. Any hnges to the funding model will e reorded in ontrt vrition. 4 EACC User Group Terms of Referene re pproved y NASO, Amulne New Zelnd nd the EACC Oversight Committee. Current ToR re ville from Amulne New Zelnd 3

4 6.8 ACC Responsiilities ACC is responsile for the funding of EAS for ertin eligile people 5 who hve suffered personl injury in terms of the At for whih lim for over hs een epted, or is likely (in the EAP s experiene) to e epted. Eligile people re those for whom the EAS strts within 24 hours of suffering personl injury or within 24 hours of eing found fter suffering personl injury (whihever is the lter), nd for whom the emergeny trnsport is neessry for the purpose of otining tretment urgently for the limnt s personl injury. Those eligile re ll those resident in New Zelnd nd visitors to New Zelnd. 6.9 Ministry Responsiilities d e The Ministry funds EAS for ll Eligile People 6 who hve need for emergeny medil ttention. For the purposes of this servie speifition emergeny medil ttention mens servies provided to ptient who requires medil ttention (not used y trum) from the time of the EAS eing notified (vi the EACC) of the need for servies; to the time the ptient rrives t ple of definitive re. Trnsport etween puli hospitl emergeny deprtments within three hours of rriving y mulne is inluded in the servie provided under this Agreement. In this speifition, emergeny mens those ses triged s life thretened or potentilly life thretened s determined y the Trige system used in the EACC. The EAS is pity funded to meet this urgent demnd nd my e used to respond to non emergeny situtions ut non emergeny volumes re not onsidered sis for hnge in funding levels. The use of funded pity to respond to non-emergeny situtions must not impt on the ility to respond to emergeny situtions. 7 Servie Desription 7.1 Generl The Emergeny Amulne Provider must: Comply with NZS 8156 (inluding ut not limited to linil governne) nd relevnt legisltion outlined in NZS Be memer of Amulne New Zelnd. Comply with Interntionl Orgnistion for Stndrdiztion 9001: 2001 (ISO 9001:2001). d Use est endevours to meet the required response time trgets (refer Appendix 2). e Respond nd supply n emergeny rod mulne servie for people requiring ssistne s result of medil emergeny when required nd dispthed y the EACC. 5 Refer to Prt Two, Servie Shedule Emergeny Rod Amulne Servies for the definition of Eligile Persons for ACC EAS Servies. 6 Refer to Prt Two, Servie Shedule Emergeny Rod Amulne Servies for the definition of Eligile Persons for Ministry EAS Servies. 4

5 f g Be ville 24 hours dy, 7 dys week inlusive of sttutory nd puli holidys, nd hve ontingeny servies in ple for k-up in the event of their inility to provide the Servies for ny reson. Respond to requests y the EACC to trnsport tretment provider(s) to the sene of n inident where it is linilly pproprite (eg where the ptient is not le to e moved), nd where it is resonle, to return tht tretment provider to town or residene, (e.g. emergeny physiin, nesthetist, led mternity rer). h Crew rod mulnes with ppropritely skilled stff (refer Appendix 1). i j Meet servie delivery requirements desried in this servie speifition. Send the most pproprite, losest/fstest resoure regrdless of geogrphil oundry. 7.2 Clinil Governne The EAP must hve n estlished Clinil Governne Frmework within their orgnistion, nd must e le to demonstrte oth the frmework, nd pplition of the frmework to dily usiness, if requested y NASO. The EAP will e prtiipting memer of the mulne setor s Ntionl Clinil Ledership Group (NCLG) 7. The EAP shll implement poliies nd proedures diretly relting to linil issues whih hve een promoted y the NCLG. 7.3 Trining nd Edution The EAP will hve ontinuing linil edution progrmme to ensure tht mulne personnel mintin linil ompetene nd urreny. 7.4 Stff nd Servie Cpility Levels The Servie Cpility Levels (refer Appendix 1) desries the rewing required of the EAP. If Amulne Personnel eome regulted nd registered helth professionls under the Helth Prtitioners Competene Assurne At (HPCA At) 2003, then eh Amulne rew memer/stff memer/offier will hold n nnul prtiing ertifite nd will work within their sope of prtie (if ny). The EAP will e responsile to ensure stff meet the registrtion requirements under the HPCA At, in timefrme greed y the EAP nd NASO (on ehlf of ACC nd the Ministry). 7.5 At the Sene of medil emergeny The EAP must: ensure Servies provided omply with NZS 8156; ensure ll Amulne Personnel re ppropritely trined nd work within the urrent uthorised ptient re protools issued y the responsile Medil Advisor/Medil Diretor; nd 7 The purpose of the NCLG is to provide onsistent pproh to ll linil issues ross the New Zelnd Amulne Setor. 5

6 o-ordinte with other emergeny servies present t the sene (e.g. Polie nd Fire). 7.6 Ptient Hndover The EAP must ensure ontinuity of re for the ptient is mintined y : The semless trnsfer of re to the epting tretment fility. Hndover y oth verl report, nd properly doumented opy of the Ptient Report Form (PRF), nd, where pproprite, the ACC45, to the reeiving tretment fility Where it is pproprite, the ACC45 must e signed y the ptient wherever possile; if the ptient is unle to sign, the reson for this must e doumented on the PRF. The responsiility remins with the EAP until n lterntive linil pthwy hs een greed nd epted y the other prty, nd wrm hndover hs een ompleted, s per the developed protools nd/or guidelines. 8 Mori Helth nd Culturl Requirements 8.1 EAPs will provide servies in ulturlly pproprite wy nd will omply with relevnt ulturl requirements s presried y the Ministry nd ACC from time to time. 9 Exlusions 9.1 EAS servies for the following inidents re exluded from this Agreement: for the Ministry: i ii the inter-hospitl trnsfer of ptients with the exeption of those medil ptients trnsferred etween filities within three hours of rrivl t tht fility; nd non emergeny ttendnes inluding ttendne t puli events, stndy in support of other emergeny servies nd ny trnsports privtely funded. for ACC: i ii iii ptients trnsferred more thn 24 hours fter suffering their personl injury; non-emergeny trnsport unless the trnsport meets the Plnned Non Emergeny Trnsport y Amulne (NETBA) servie desriptions. Prior pprovl must e otined for Plnned NETBA ny time spent in the serh for Climnt; nd osts inurred if the Climnt dies efore the EAS rrives; nd iv ptients, where the lotion of the ptient is outside New Zelnd s territoril wters. 8 8 Territoril Se, Contiguous Zone nd Exlusive Eonomi Zone At 1977 nd Injury Prevention, Rehilittion, nd Compenstion At

7 10 Servie Linkges 10.1 The purpose of key linkges is to mintin working reltionship of ommunition, onsulttion nd inlusion. Those orgnistions identified in luse 10.2 re not exlusive nd the EAP is enourged to explore opportunities to develop nd mintin key linkges with other orgnistions ntionlly, or within the region tht enle nd/or promote effetive servie delivery nd hievement of the ojetives of this servie speifition The EAP must mintin key linkges with the following orgnistions or entities in order to provide n effiient nd effetive emergeny mulne servie: d e f g h i j k other EAPs (rod nd ir) in the region nd neighouring regions; PRIME providers; EACCs; reeiving Distrit Helth Bords whih hve n involvement in emergeny re s well s DHBs whih provide speilist servies on ntionl or su ntionl sis (e.g urns, spinl injury); the ECCT for the region; the Ministry; ACC; NASO; other emergeny servies inluding New Zelnd Polie, Fire, Serh nd Resue; relevnt ntionl Setor nd Stkeholder groups eg Amulne New Zelnd; other lol orgnistions with diret interest in the provision of emergeny re inluding Primry Helth Orgnistions nd privte emergeny medil linis. 11 Qulity Requirements 11.1 Generl Qulity Requirements The EAP will: omply with the qulity requirements in the overrhing Agreement(s); nd e ertified s omplint with the urrent version of NZS Response time trgets re defined in Appendix 2 (Response Time Trgets) Dt Qulity The EAP must work with EACCs to ensure tht the dt stored y EACC is urte nd relile. The EAPs will work with EACCs to ensure tht the lssifitions (ie Urn, Rurl nd Remote) tht re pplied to eh Servie Are re ligned with the ltest Census dt ville. 7

8 Agreement is required y the EAP, the EACC nd NASO to pply lssifition to Servie Are(s) tht is not in line with the ltest ensus dt ville. The reson for the hnge must e doumented y the EACC nd reported in the next Qurterly Report. 12 Reporting 12.1 The EAP will provide reports eletronilly to NASO, in n greed formt The EAP will provide reports to NASO s per the following tle. Dt should e provided in Mirosoft Exel spredsheet formt where pproprite. Appendix 3 ontins inditive templtes for dt required. Reporting Requirement Frequeny/Period Due 1. Response Time Performne (Ltest month nd 24 months history) Performne ginst response time trgets s defined in ppendix 2 Monthly 20 th lendr dy of the following month 2. Volume Dt (Ltest month nd 24 months history). Volume of inidents ttended where there ws no ptient trnsported. Volume of inidents ttended where there ws t lest one ptient trnsported (y life thretening, potentilly life thretening nd non emergeny) 3. Frontline Stffing Stff estlishment Full Time Equivlent (FTE) numers y Skill level for. FTE pid estlishment. FTE vnies for pid positions. Hedount of Volunteers 4. Clinil outomes: The EAP will to report on linil outome mesures for t lest one medil ondition nd one trum relted ondition.. This report must lso e sent to the NCLG. The onditions nd reporting requirements re determined y the NCLG with NASO nd my e reviewed nnully. 5. Qulity. Copy of Annul Ptient Experiene Survey. Copy of the NZS8156 udit summry with ny orretive tions Monthly Six-monthly: July-Deemer Jnury to June Six-monthly: July-Deemer Jnury to June Annul 20 th lendr dy of the following month 20 th Jnury 20 th July 20 th Jnury 20 th July As ville 12.3 The EACC servie providers my provide dt to NASO. Where the dt represents n individul EAP the dt will first e sent to the EAP for the opportunity to verify the dt nd provide ommentry. 8

9 13 Inident reporting All inidents will e ssigned Severity Assessment Code (SAC) rting for the tul nd potentil outome of the inident. Rtings shll e in ordne with the New Zelnd Inident Mngement System (NZIMS). See Appendix 4 for detils Inident Reporting - Serious nd Sentinel Events Speifi Event Reporting Serious nd Sentinel events with SAC 1 or SAC 2 rting of the outome of the inident must e reported s per NZIMS. i NASO must e notified of SAC 1 nd SAC 2 events no lter thn five working dys from identifition of the event. The EAP will provide NASO with opy of the NZIMS report. The EAP will provide NASO with updtes of ny developments regrding the investigtion inluding: i ii iii iv Progress of investigtion Findings of the investigtion Medi releses/responses Mitigtion strtegies. Medi The EAP will immeditely dvise NASO if it eomes wre of serious or sentinel event whih in the EAP s opinion hs or my hve medi or puli interest. This my e provided orlly in the first instne, nd followed up in writing. d Qurterly Reporting i ii iii The EAP must provide NASO with qurterly reports summrising Serious nd Sentinel events. These reports should e from the sme dt soure s the NZIMS reports. The minimum dt required is shown in the templte in Appendix 5 (Serious nd sentinel events qurterly report). This dt my either e entered into the templte or in n lterntive formt Inident Reporting - Adverse Events nd Complints Medi The EAP will immeditely dvise NASO if it eomes wre of n dverse event or omplint whih in the EAP s opinion hs or my hve medi or puli interest. This my e provided orlly in the first instne, nd followed up in writing. NASO will e informed of the following informtion, following internl investigtion: i ii Cuse of inident Impt/Potentil Impt 9

10 iii iv Mitigtion Strtegies Outome. Qurterly Reporting The EAP must report to NASO, volumes of dverse event, using the templte in Appendix 6 (Volume Templte Adverse Events). This will e used to monitor trends Other Reporting NASO my mke resonle requests for d-ho informtion relting to the provision of EAS nd the EAPs must provide ny suh requested informtion within n greed timefrme tht is resonle for the informtion requested. 14 Monitoring nd Evlution 14.1 Representtives from NASO will meet qurterly with the representtive from the EAP to review nd disuss the reports reeived y NASO nd ny performne issues All reports tht re provided to NASO from oth the EAP nd EACCs will form the sis for quntittive mesurement of performne of tht EAP Prior to the regulr performne monitoring meetings s detiled in luse Error! Referene soure not found.4.1, the EAP will provide NASO with written ommentry/explntions regrding hnging trends nd exeptions identified in the reports regionl/distrit performne issues tivities plnned nd eing undertken to improve performne 14.4 The EAP will prtiipte in the EACC User Groups s per luse Upon resonle notie (not less thn 10 working dys), the EAP will ollte nd provide informtion for udit to the Ministry nd ACC NASO retins the right to evlute ny spet of the EAP s performne. At lest 10 dys notie will e given of ny evlution udit. 10

11 Appendix 1: Servie Cpility Levels s per NZS 8156 Servie Cpility Levels Bsi Life Support (BLS) Intermedite Life Support (ILS) Advned Life Support (ALS) Rod All emergeny Bsi Life Support ple mulnes must e rewed with t lest one rew memer who holds t minimum: the Amulne New Zelnd reognised Ntionl Diplom in Amulne Prtie (NZQA Level 5) or equivlent. All emergeny Intermedite Life Support ple mulnes must e rewed with t lest two rew memers who hold n Amulne New Zelnd reognised mulne qulifition. One must hold minimum: the Amulne New Zelnd reognised Bhelor of Helth Siene, ILS Pthwy (WFA/OSJ) or equivlent. All emergeny Advned Life Support ple mulnes must e rewed with t lest two rew memers who hold n Amulne New Zelnd reognised mulne qulifition. One must hold minimum of Post Grdute Certifite in Speility Cre Advne Prmedi Prtie or equivlent s reognised y Amulne New Zelnd. OTHER SERVICE CAPABILITY LEVELS Servie Cpility Levels First Responder Rpid Response Unit Urgent Community Cre (UCC)/Extended Cre Prmedis (ECP) PRIME Rod A response whih my hve qulifition of less thn BLS nd is the first resoure ville to respond to n inident. This my or my not e response in vehile with ptient rrying pility. This my inlude the fire servie. A response is non trnsport ple vehile. This response is designed for erly rrivl t ses where immedite intervention is required nd n lso e used for k up for lower skilled rew levels. A response with skill level of ECP/UCC who re trined to ssess ptients onditions to determine the est ptient re pthwy, whih my e typilly involve tretment t home or referrl to other re pthwys, rther thn diret trnsport to ED. PRIME is o-response with mulne servies, for medil emergenies in identified PRIME lotions. PRIME Prtitioners re Dotors nd Nurses who re PRIME trined. 11

12 Appendix 2: Response Time Trgets Response times will e reported for the following types of inident: 1 Immeditely Life Thretening Inidents 2 Potentilly Life Thretening Inidents, nd 3 Non Emergeny Inidents ProQA is n interntionlly reognised medil dispth system nd trige tool. The definitions for the vrious ProQA determinnt levels re in the Servie Shedule glossry. The determinnt level ssigned to eh inident will form the sis of lssifying the type of inident. Urn servie re Rurl servie re Remote rurl servie re Type of Inident (Min urn entres > 15,000 popultion responses (Rurl res surrounding urn ities, or non-remote (Very rurl nd remote lotions s speified on servie within ity oundry s speified on servie re mp) rurl res, or minor urn/provinil town entres < re mp) 15,000 popultion s speified on servie re mp) Immeditely Life Arrive t request point Arrive t request point Arrive t request point Arrive t request point Arrive t request point Arrive t request point Thretening within 8 minutes from time within 20 minutes from within 12 minutes from within 30 minutes from within 25 minutes from within 60 minutes from Emergeny of suffiient informtion time of suffiient time of suffiient time of suffiient time of suffiient time of suffiient Inidents olleted for the ll to e informtion olleted for informtion olleted for informtion olleted for informtion olleted for informtion olleted for entered into the queue for the ll to e entered into the ll to e entered into the ll to e entered into the ll to e entered into the ll to e entered into 50% of lls the queue for 95% of lls the queue for 50% of lls the queue for 95% of lls the queue for 50% of lls the queue for 95% of lls Potentilly Life Arrive t request point within 20 minutes from the time Arrive t request point within 30 minutes from the time Arrive t request point within 60 minutes from the time Thretening of suffiient informtion olleted for the ll to e of suffiient informtion olleted for the ll to e of suffiient informtion olleted for the ll to e Emergeny entered into the queue for 80% of lls entered into the queue for 80% of lls entered into the queue for 80% of lls Inidents Non Emergeny Time out s requested or speified y ontrol nd within Time out s requested or speified y ontrol nd within Time out s requested or speified y ontrol nd within Inidents norml rod restritions norml rod restritions norml rod restritions 12

13 Time intervls The following digrm shows the intervls tht re used for time sed reports Ativity nd Relted Performne Inditors for Communitions Centres nd Amulne T3 s per ontrt Performne Events Ativity Ringing Time T1 Phone Rings Answer Time Cll Answered s per ontrt T2 T3 T4 Phone Piked Up Cll Registered Time Keystroke fter Lotion nd Chief Complint s per ontrt Cll Registered System Pre Assigned no mesure ment Jo rrives t Dispth sreen Assign Time Pger messge trnsmitted from CAD s per ontrt T5 Pssed to rew on pger Ativtion Time Crew Book Moile s per ontrt T6 Crew Book Moile to Sene Journey or Response Time Crew Book Arrivl t Sene Priority or Ptient Ctegory Code s per ontrt (urn) s per ontrt (rurl) s per ontrt (remote) Priority or Ptient Ctegory Code s per ontrt (urn) s per ontrt (rurl) s per ontrt (remote) Priority or Ptient Ctegory Code (s per ontrt for ll res) T7 Crew Arrive t Sene Tret Time Crew ook deprt sene s per ontrt (ll res) T8 Crew Deprt Sene Trnsport Time Crew ook rrivl t destintion No KPI, lol irumstnes T9 Crew Arrive t Tretment Centre Hndover nd Rediness Crew ook ler t destintion s per ontrt T10 Crew Cler nd ville for work Overll Ativtion Stndrd CLOCK START Overll Response Stndrd 13

14 Appendix 3: Reporting Templtes Response Time Performne Provider Period Dte Jul-09 Aug-09 Sep-09 Ot-09 Nov-09 De-09 Jn-10 Fe-10 Mr-10 Apr-10 My-10 Jun-10 Jul-10 Aug-10 Sep-10 Ot-10 Nov-10 De-10 Jn-11 Fe-11 Mr-11 Apr-11 My-11 Jun-11 Jul-11 Immeditely Life thretening emergeny inidents Urn Rurl Remote Potentilly life thretening emergeny inidents Immeditely Life thretening emergeny inidents Potentilly life thretening emergeny inidents Immeditely Life thretening emergeny inidents Potentilly life thretening emergeny inidents 50% 95% 80% 50% 95% 80% 50% 95% 80% 8 minutes 20 minutes 20 mintues 12 minutes 30 minutes 30 minutes 25 minutes 60 minutes 60 minutes 14

15 Volume Reporting Provider Period Dte Volume of inidents ttended where there ws no ptient trnsported Volume of inidents ttended where there ws t lest one ptient trnsported Immeditely life thretening Potentilly life thretening Non-emergeny Jul-09 Aug-09 Sep-09 Ot-09 Nov-09 De-09 Jn-10 Fe-10 Mr-10 Apr-10 My-10 Jun-10 Jul-10 Aug-10 Sep-10 Ot-10 Nov-10 De-10 Jn-11 Fe-11 Mr-11 Apr-11 My-11 Jun-11 Jul-11 15

16 Front Line Stffing Provider Period Dte ALS ILS BLS Totl Full Time Equivlent Pid Estlishment Full time Equivlent vnies for pid positions Hedount of volunteers 16

17 Appendix 4: Alloting the Severity Assessment Code (SAC Sore) 17

18 Soure: 18

19 Appendix 5: Serious nd Sentinel Events Qurterly Reporting Templte Reported y: Opertor: Dte Reported: Yer: Qurter: (nme) (selet) (dte) 2010/11 (selet) Inidents - Qurterly Report Required fields Required for SAC1 nd SAC2 events (not required for SAC3 & SAC4) If known: Orgnistion Event Ref Dte Reported to NASO Type of Inident Dte of inident Region Serious, Sentinel or Adverse Atul / Potentil (Ner Miss) Atul Severity Assessment Code (SAC) Sore Inident Ctegory Desription of wht hppened nd immedite tions tken Finl SAC Sore (following investigtion / mitigtion) Findings/Outome of Investigtion Reommendtions Mitigtion (Investigtion / Response / Ations) Medi overge (if ny) Medi Story (if ny) Complint? Inident Numer (selet) (selet) (selet) (selet) (selet) (selet) (selet) 19

20 Appendix 6: Volume Templte Adverse Events This templte reltes to luse Reported y: Opertor: Dte Reported: Yer: Qurter: (nme) (selet) (dte) 2010/11 (selet) Attitude Lte Driving Pyment Refusl Equipment Injury Tretment Communition Culturl Privy Other The ttitude of the ttending memer(s) Lte rrivl Ctegories Any issues round the driving of the mulne Speifi issues involving pyment Refusl of ptient to trnsport or the memer elieves there is no need to trnsport Speifi equipment issues - mye sfety relted Where the ptient is injured s diret result of trnsporting to destintion Medil tretment - suitility thereof et. Whether there my hve een rekdown in Communition with rew nd RCC or even hospitl / ptient Any issues round ulturl mtters Issues involving privy onerns Where omplint does not netly fit into ny of the other tegories Totl Adverse Events 0 20