Saint John Ambulance, as we heard a little earlier this morning, will no longer be able to perform life saving but high risk procedures. After a directive from nt Health, high acuity, low occurrence procedures conducted by intensive care paramedics have been immediately suspended due to clinical governance concerns. The suspension is to remain in place until a Chief Medical Officer is appointed, which the Northern Territory hasn't had for two years reportedly. Now. We spoke to doctor John Zorbis about this a little earlier this morning, and joining me in the studio right now is Saint John Ambulance Director of Ambulance Services, Andrew Thomas. Good morning to you.

Saint John Ambulance, as we heard a little earlier this morning, will no longer be able to perform life saving but high risk procedures. After a directive from nt Health, high acuity, low occurrence procedures conducted by intensive care paramedics have been immediately suspended due to clinical governance concerns. The suspension is to remain in place until a Chief Medical Officer is appointed, which the Northern Territory hasn't had for two years reportedly. Now. We spoke to doctor John Zorbis about this a little earlier this morning, and joining me in the studio right now is Saint John Ambulance Director of Ambulance Services, Andrew Thomas. Good morning to you.

Good morning, Catie. It's pleasure to be here.

Good morning, Catie. It's pleasure to be here.

Thank you so much for your time this morning. Now, Andrew, tell me why was this directive made.

Thank you so much for your time this morning. Now, Andrew, tell me why was this directive made.

Yeah, Look, and as doctor Zorbis put before, obviously we had nt government brought in a review as we know, early last year, and there was some issues that the reviewer had around some of the governance of those procedures and we've been doing a number of a lot of work to be able to work through those processes and there's now been established a Road Amulance Service Clinical Governance Committee which has senior members of in T Health and Saint John and we're working through those recommendations INT Health have taken from there. We've been doing a lot of work through that. Out of that committee, the decision was made and we were advised by the CE of Health that we were to suspend those procedures until we could continue to work through and improve those governant aspects that they have identified and we're working through with n T Health on what that is. And one of the ones obviously they've highlighted and there's been a big push as from the AMA and other people within health, is around having a medical director or an ambulance service medical officer to provide some oversight.

Yeah, Look, and as doctor Zorbis put before, obviously we had nt government brought in a review as we know, early last year, and there was some issues that the reviewer had around some of the governance of those procedures and we've been doing a number of a lot of work to be able to work through those processes and there's now been established a Road Amulance Service Clinical Governance Committee which has senior members of in T Health and Saint John and we're working through those recommendations INT Health have taken from there. We've been doing a lot of work through that. Out of that committee, the decision was made and we were advised by the CE of Health that we were to suspend those procedures until we could continue to work through and improve those governant aspects that they have identified and we're working through with n T Health on what that is. And one of the ones obviously they've highlighted and there's been a big push as from the AMA and other people within health, is around having a medical director or an ambulance service medical officer to provide some oversight.

On that and so where is the recruitment at for a medical services officer or the other description that you'd just given Ash.

On that and so where is the recruitment at for a medical services officer or the other description that you'd just given Ash.

Yeah, So in terms of that, as I said, it was one of the recommendations and after the report was received by Health last year and then the Road Animal Service Clinical Governments Committee was set up in February of this year. We've been speaking at the first meeting in fact was greed and between both NT Health and s John that we would look at about having a medical officer, and NT Health had agreed to provide us with medical officers.

Yeah, So in terms of that, as I said, it was one of the recommendations and after the report was received by Health last year and then the Road Animal Service Clinical Governments Committee was set up in February of this year. We've been speaking at the first meeting in fact was greed and between both NT Health and s John that we would look at about having a medical officer, and NT Health had agreed to provide us with medical officers.

Since so you're waiting for MT Health now to provide.

Since so you're waiting for MT Health now to provide.

Since that we've been working through a process, okay, and there are there will be two positions due to the fact that they're still negotiating some of the contracts within In terms of those people, I can't advise about who those positions are, but there will be one in our springs and there will be one in Darwin, and they will be specifically sort of through their job description, focusing on training, clinical review of cases, credentialing of our staff, particularly in those high end skills, and then also look you know, being having the ongoing review of our clinical guidelines and and providing that clinical advice to our staff when needed in those processes. So, you know, we hope to very shortly that NT Health have got those contracts sorted out with those people and then we can announce exactly who those people are and then you know, engage with them. At this stage, it looks as though it's probably not going to be in place until you know, because of their current commitments until August, which we would rather see that sooner.

Since that we've been working through a process, okay, and there are there will be two positions due to the fact that they're still negotiating some of the contracts within In terms of those people, I can't advise about who those positions are, but there will be one in our springs and there will be one in Darwin, and they will be specifically sort of through their job description, focusing on training, clinical review of cases, credentialing of our staff, particularly in those high end skills, and then also look you know, being having the ongoing review of our clinical guidelines and and providing that clinical advice to our staff when needed in those processes. So, you know, we hope to very shortly that NT Health have got those contracts sorted out with those people and then we can announce exactly who those people are and then you know, engage with them. At this stage, it looks as though it's probably not going to be in place until you know, because of their current commitments until August, which we would rather see that sooner.

But look, I suppose I'm just trying to get to the bottom of it from you know, a territorian perspective or from a from a patient perspective if I was a patient, because you want to make sure that paramedics have got every tool in their belt to be able to save your life if required. So I suppose what I'm hearing following on from doctor's orbis speaking to us earlier this morning, and what you are saying is that now these two procedures are off the table and they're not going to be back on the table until we have an Ambulance Service medical officer. Is there any concern here that lives could be lost because paramedics are not able to use these two procedures as a result of not having this officer in place. Yeah.

But look, I suppose I'm just trying to get to the bottom of it from you know, a territorian perspective or from a from a patient perspective if I was a patient, because you want to make sure that paramedics have got every tool in their belt to be able to save your life if required. So I suppose what I'm hearing following on from doctor's orbis speaking to us earlier this morning, and what you are saying is that now these two procedures are off the table and they're not going to be back on the table until we have an Ambulance Service medical officer. Is there any concern here that lives could be lost because paramedics are not able to use these two procedures as a result of not having this officer in place. Yeah.

Look, I mean, you know, these skills were brought in as part of a clinical upgrade, and in two thousand and twenty two we underwent a upskilling of specific intensive care paramedics, which is already our highest level of clinician in the organization and quite an intensive training program, and that court included the previous medical officer and int health medical officers and specialists and retrievalists and our staff went through a really rigorous project program on training as well as then assessment and endorsement.

Look, I mean, you know, these skills were brought in as part of a clinical upgrade, and in two thousand and twenty two we underwent a upskilling of specific intensive care paramedics, which is already our highest level of clinician in the organization and quite an intensive training program, and that court included the previous medical officer and int health medical officers and specialists and retrievalists and our staff went through a really rigorous project program on training as well as then assessment and endorsement.

So is effectively in TE health saying that they don't deem that as enough.

So is effectively in TE health saying that they don't deem that as enough.

I look, as I said, we've been doing through work and we've been asked to provide evidence to NT Health on where we're at, what those processes, those systems, those structures that we've put in place, and we have, through a continuous improvement process, been working on increasing those processes, you know, since that was implemented and even in the last eighteen months working through improvement processes. So obviously we've provided the information INT Health, they've made a direction that's that's there. I suppose their prerogative, and we're working with them and that committee to understand exactly the areas that we need to improve on and will do had.

I look, as I said, we've been doing through work and we've been asked to provide evidence to NT Health on where we're at, what those processes, those systems, those structures that we've put in place, and we have, through a continuous improvement process, been working on increasing those processes, you know, since that was implemented and even in the last eighteen months working through improvement processes. So obviously we've provided the information INT Health, they've made a direction that's that's there. I suppose their prerogative, and we're working with them and that committee to understand exactly the areas that we need to improve on and will do had.

Something happened, had there been a bad patient outcome, had there been I don't know in appropriate use of it.

Something happened, had there been a bad patient outcome, had there been I don't know in appropriate use of it.

So I think Doctor's orbis from the Amama comment before that there were some concerns raised that triggered off the ALIS review, so that those concerns and most of those cases that occurred were occurred when we actually had a medical chief medical officer, and so in terms of and that's that nothing about the process. But I'm just saying where we've gone along is that there was concerns raised as identified and he mentioned all of those cases were reviewed. If there were any changes or processes or learnings from those reviews, obviously we've put them in place and to always make sure and that's how we respond. And we know that within healthcare, and we've discussed before that you know, at times sometimes things will occur that may not be the best delivery of care. But you know, part of good governance is about be able to identify, review them, and then make changes to stop them happening in the future.

So I think Doctor's orbis from the Amama comment before that there were some concerns raised that triggered off the ALIS review, so that those concerns and most of those cases that occurred were occurred when we actually had a medical chief medical officer, and so in terms of and that's that nothing about the process. But I'm just saying where we've gone along is that there was concerns raised as identified and he mentioned all of those cases were reviewed. If there were any changes or processes or learnings from those reviews, obviously we've put them in place and to always make sure and that's how we respond. And we know that within healthcare, and we've discussed before that you know, at times sometimes things will occur that may not be the best delivery of care. But you know, part of good governance is about be able to identify, review them, and then make changes to stop them happening in the future.

And look, I guess for a lot of people listening this morning, the thing that they're going to want to know is that if their life is at risk, that paramedics are able to do what is required to save them, to get them to the emergency department.

And look, I guess for a lot of people listening this morning, the thing that they're going to want to know is that if their life is at risk, that paramedics are able to do what is required to save them, to get them to the emergency department.

Look, our paramedics are highly qualified, and you know, I can't speak highly and as we had before about the amazing work that all of our paramedics and all of our emergency communications and our intensive care paramedics. This has been I'll say a bit of a blow for some of our staff and particularly those intensive care paramixs who have gone through a lot of training, regular training outside of their own ails to maintain and keep those high skill levels up and what else, and so you know, they're really feeling it and what else. But I can reassure that the public that absolutely the quality of care that our staff will deliver and that it is these two procedures only that are impacted, and they are a very very small component in a very high end of what we do and the care that we deliver. And so care starts right from the basic care that can be provided before people get right through the whole continuum for our staff to deliver that quality care and then take the patient to hospital.

Look, our paramedics are highly qualified, and you know, I can't speak highly and as we had before about the amazing work that all of our paramedics and all of our emergency communications and our intensive care paramedics. This has been I'll say a bit of a blow for some of our staff and particularly those intensive care paramixs who have gone through a lot of training, regular training outside of their own ails to maintain and keep those high skill levels up and what else, and so you know, they're really feeling it and what else. But I can reassure that the public that absolutely the quality of care that our staff will deliver and that it is these two procedures only that are impacted, and they are a very very small component in a very high end of what we do and the care that we deliver. And so care starts right from the basic care that can be provided before people get right through the whole continuum for our staff to deliver that quality care and then take the patient to hospital.

Look, if you have just joined us, I am in this studio with Sin John Ambulance Director of Ambulance Services Andrew Thomas. Now I do want to ask, we know the Territories Ullance Service contract, it's been reported, is going to be up for grabs for the first time in over a century after Saint John was of course banned from performing these two life saving high risk procedures. The NT News is reporting that the Northern Territory Health Minister, Steve Edgington said that the Saint John ambulance contract was due to expire in early twenty twenty six, with a procurement process for a new contract to begin shortly. Has there been any indication that Saint John is going to lose that contract? What is the situation from your perspective at the moment, Andrew.

Look, if you have just joined us, I am in this studio with Sin John Ambulance Director of Ambulance Services Andrew Thomas. Now I do want to ask, we know the Territories Ullance Service contract, it's been reported, is going to be up for grabs for the first time in over a century after Saint John was of course banned from performing these two life saving high risk procedures. The NT News is reporting that the Northern Territory Health Minister, Steve Edgington said that the Saint John ambulance contract was due to expire in early twenty twenty six, with a procurement process for a new contract to begin shortly. Has there been any indication that Saint John is going to lose that contract? What is the situation from your perspective at the moment, Andrew.

Yeah, So look, just to let you know, Katie, is that and we've spoken before us. We know that the ambulance contract was coming up in twenty twenty six, and we've been doing a lot of work for a significant period of time now working through with NT government around the ongoing process. And we knew that there was going to be a procurement process for the ambulance service and we've had those discussions with our staff. So that's surprised you, that's sort of surprise at all. And we actually look forward to a process because we don't want to roll over a contract that we've already identified leaves the territory under resourced for staff and ambulances. We know that currently we're twenty five percent underresourced in our springs and we're about forty percent underresourced in terms of emergency ambulances in Darwin, so we're absolutely keen to engage in a process. We did get notified on Friday via a letter from the Sea of Health that through that procurement process, which is well defined by nt Health, that we will be in sole discussions with nt Health for the emergency component of the road ambulance contract. So that's to deliver emergency ambulances across the Northern Terrace.

Yeah, So look, just to let you know, Katie, is that and we've spoken before us. We know that the ambulance contract was coming up in twenty twenty six, and we've been doing a lot of work for a significant period of time now working through with NT government around the ongoing process. And we knew that there was going to be a procurement process for the ambulance service and we've had those discussions with our staff. So that's surprised you, that's sort of surprise at all. And we actually look forward to a process because we don't want to roll over a contract that we've already identified leaves the territory under resourced for staff and ambulances. We know that currently we're twenty five percent underresourced in our springs and we're about forty percent underresourced in terms of emergency ambulances in Darwin, so we're absolutely keen to engage in a process. We did get notified on Friday via a letter from the Sea of Health that through that procurement process, which is well defined by nt Health, that we will be in sole discussions with nt Health for the emergency component of the road ambulance contract. So that's to deliver emergency ambulances across the Northern Terrace.

So it does look ause that's going to continue if indeed those discussions go well, but you're the in sole discussion with them at this point in time.

So it does look ause that's going to continue if indeed those discussions go well, but you're the in sole discussion with them at this point in time.

That's correct, yes, and so that's that we know and we're also advised at that point in time, is that the the low acuity services or the patient transport services and so that a lot of that is related to the movement of people from aero medical facilities, you know, from you know, in transfers from across the territory, so from the airport to the hospital and return or from low from residential age care facilities to hospitals in return those type of cases, and that we know that that was going to come out and go to a tender process and that will be as highlighted probably today, that will be open for other people and that's what occurs in every other state and territory. So those sort of private providers are in terms of ambulance for patient transport and as you know, we know that already across the territory we have care flight that undertake some patient transport work. R fts do as long as us now we've been doing that patient transport work for a long period of time and we will be actively involved in that process and we believe that we will be you know, a quality person to put in for the tender.

That's correct, yes, and so that's that we know and we're also advised at that point in time, is that the the low acuity services or the patient transport services and so that a lot of that is related to the movement of people from aero medical facilities, you know, from you know, in transfers from across the territory, so from the airport to the hospital and return or from low from residential age care facilities to hospitals in return those type of cases, and that we know that that was going to come out and go to a tender process and that will be as highlighted probably today, that will be open for other people and that's what occurs in every other state and territory. So those sort of private providers are in terms of ambulance for patient transport and as you know, we know that already across the territory we have care flight that undertake some patient transport work. R fts do as long as us now we've been doing that patient transport work for a long period of time and we will be actively involved in that process and we believe that we will be you know, a quality person to put in for the tender.

So just in terms of that notification from the Chief Executive of the Health Department around Saint John being in sole discussion for the emergency care isnt. So in terms of that, is that going to mean then if like let's say for example, that you no longer then have the low acuity transfer service, would that mean job losses for Saint John.

So just in terms of that notification from the Chief Executive of the Health Department around Saint John being in sole discussion for the emergency care isnt. So in terms of that, is that going to mean then if like let's say for example, that you no longer then have the low acuity transfer service, would that mean job losses for Saint John.

No, Well, we need to look at and part of that is, as we said before, we need to look about our resourcing. And we know that and we've already highlighted that the resourcing that we have at the moment doesn't cover what we have in terms of our workload. Our capacity is regularly over the years right by the workload, so we you know, we'll need to look at that. As A said, in terms of the patient transport services, we will be actively pushing that and we believe that having a patient transport service that links into our emergency service, you know, adds a lot of benefit in terms of being able to provide some surge capacity and rather than relying on independent providers. So you know, as I said, that will form part of our case going forward. In terms of the patient transport, we will be actively looking and making sure that the appropriate resourcing for the delivery of emergency animals and so that's not just numbers. That's as highlighted before and then highlighted in the Alis review and a number of the other reviews that have been quoted around the services, is that resourcing is not up to a standard where it meets in other services. So we want to make sure that and that's across the board. We know that we are under resourced in our triple zero call center and our amazing e m ds there work under incredible pressure. We've seen call volumes in the emergency call center double in the last five years and so, and we haven't seen that corresponding increase in staffing. We know that clinical governance and all of the concerns that have been raised around that in education and training, we need more staff to be able to deliver that.

No, Well, we need to look at and part of that is, as we said before, we need to look about our resourcing. And we know that and we've already highlighted that the resourcing that we have at the moment doesn't cover what we have in terms of our workload. Our capacity is regularly over the years right by the workload, so we you know, we'll need to look at that. As A said, in terms of the patient transport services, we will be actively pushing that and we believe that having a patient transport service that links into our emergency service, you know, adds a lot of benefit in terms of being able to provide some surge capacity and rather than relying on independent providers. So you know, as I said, that will form part of our case going forward. In terms of the patient transport, we will be actively looking and making sure that the appropriate resourcing for the delivery of emergency animals and so that's not just numbers. That's as highlighted before and then highlighted in the Alis review and a number of the other reviews that have been quoted around the services, is that resourcing is not up to a standard where it meets in other services. So we want to make sure that and that's across the board. We know that we are under resourced in our triple zero call center and our amazing e m ds there work under incredible pressure. We've seen call volumes in the emergency call center double in the last five years and so, and we haven't seen that corresponding increase in staffing. We know that clinical governance and all of the concerns that have been raised around that in education and training, we need more staff to be able to deliver that.

Andrew, just in terms of the emergency ambulance contract and that notification that you are in soul discussions on that contract. When do you reckon you'll know whether Saint John is going to be maintaining it, keeping it or not.

Andrew, just in terms of the emergency ambulance contract and that notification that you are in soul discussions on that contract. When do you reckon you'll know whether Saint John is going to be maintaining it, keeping it or not.

Well look at it. You know, as I said, we've got notified on Friday. We've already established the first meeting with NT Health as part of looking at that process. And you know, like any form of procurement process and discussions, we'll need to work through and make sure have those concerns met that we've raised around the recruitment. Obviously, I know that obviously Health are keen to make sure that they want the best service they can they can get, but you know, obviously wanting to make sure that that fits with in their constraints that they've got as well. So as I said, we're starting those meetings and once we know it will be putting you know, like notifying people about where they give with the contract.

Well look at it. You know, as I said, we've got notified on Friday. We've already established the first meeting with NT Health as part of looking at that process. And you know, like any form of procurement process and discussions, we'll need to work through and make sure have those concerns met that we've raised around the recruitment. Obviously, I know that obviously Health are keen to make sure that they want the best service they can they can get, but you know, obviously wanting to make sure that that fits with in their constraints that they've got as well. So as I said, we're starting those meetings and once we know it will be putting you know, like notifying people about where they give with the contract.

Well, Sir John Ambulance, Director of Ambulance Services, Andrew Thomas, we are going to have to leave it there. Good to catch up with you this morning. Thanks so much for your time.

Well, Sir John Ambulance, Director of Ambulance Services, Andrew Thomas, we are going to have to leave it there. Good to catch up with you this morning. Thanks so much for your time.

No, thanks very much, Cadie.

No, thanks very much, Cadie.

Thank you

Thank you