Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
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
(00:21):
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.
Speaker 2 (00:41):
Good morning, Catie. It's pleasure to be here.
Speaker 1 (00:43):
Thank you so much for your time this morning. Now, Andrew,
tell me why was this directive made.
Speaker 2 (00:49):
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
(01:09):
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
(01:33):
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
(01:55):
having a medical director or an ambulance service medical officer
to provide some oversight.
Speaker 1 (02:01):
On that and so where is the recruitment at for
a medical services officer or the other description that you'd
just given Ash.
Speaker 2 (02:10):
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
(02:33):
John that we would look at about having a medical officer,
and NT Health had agreed to provide us with medical officers.
Speaker 1 (02:42):
Since so you're waiting for MT Health now to provide.
Speaker 2 (02:45):
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
(03:07):
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
(03:29):
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.
Speaker 1 (03:43):
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
(04:05):
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.
Speaker 2 (04:27):
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
(04:51):
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.
Speaker 1 (05:02):
So is effectively in TE health saying that they don't
deem that as enough.
Speaker 2 (05:06):
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
(05:27):
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.
Speaker 1 (05:43):
Something happened, had there been a bad patient outcome, had
there been I don't know in appropriate use of it.
Speaker 2 (05:51):
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
(06:11):
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,
(06:31):
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.
Speaker 1 (06:42):
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.
Speaker 2 (06:55):
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
(07:17):
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
(07:40):
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.
Speaker 1 (07:51):
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
(08:12):
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
(08:33):
lose that contract? What is the situation from your perspective
at the moment, Andrew.
Speaker 2 (08:38):
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
(08:59):
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
(09:20):
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
(09:42):
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.
Speaker 1 (09:53):
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.
Speaker 2 (10:01):
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
(10:22):
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
(10:42):
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
(11:04):
and we believe that we will be you know, a
quality person to put in for the tender.
Speaker 1 (11:10):
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
(11:31):
the low acuity transfer service, would that mean job losses
for Saint John.
Speaker 2 (11:37):
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.
(11:59):
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,
(12:20):
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
(12:42):
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
(13:03):
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.
Speaker 1 (13:18):
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.
Speaker 2 (13:32):
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
(13:53):
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.
Speaker 1 (14:10):
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.
Speaker 2 (14:17):
No, thanks very much, Cadie.
Speaker 1 (14:18):
Thank 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
(00:21):
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.
Speaker 2 (00:41):
Good morning, Catie. It's pleasure to be here.
Speaker 1 (00:43):
Thank you so much for your time this morning. Now, Andrew,
tell me why was this directive made.
Speaker 2 (00:49):
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
(01:09):
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
(01:33):
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
(01:55):
having a medical director or an ambulance service medical officer
to provide some oversight.
Speaker 1 (02:01):
On that and so where is the recruitment at for
a medical services officer or the other description that you'd
just given Ash.
Speaker 2 (02:10):
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
(02:33):
John that we would look at about having a medical officer,
and NT Health had agreed to provide us with medical officers.
Speaker 1 (02:42):
Since so you're waiting for MT Health now to provide.
Speaker 2 (02:45):
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
(03:07):
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
(03:29):
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.
Speaker 1 (03:43):
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
(04:05):
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.
Speaker 2 (04:27):
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
(04:51):
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.
Speaker 1 (05:02):
So is effectively in TE health saying that they don't
deem that as enough.
Speaker 2 (05:06):
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
(05:27):
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.
Speaker 1 (05:43):
Something happened, had there been a bad patient outcome, had
there been I don't know in appropriate use of it.
Speaker 2 (05:51):
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
(06:11):
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,
(06:31):
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.
Speaker 1 (06:42):
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.
Speaker 2 (06:55):
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
(07:17):
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
(07:40):
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.
Speaker 1 (07:51):
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
(08:12):
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
(08:33):
lose that contract? What is the situation from your perspective
at the moment, Andrew.
Speaker 2 (08:38):
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
(08:59):
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
(09:20):
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
(09:42):
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.
Speaker 1 (09:53):
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.
Speaker 2 (10:01):
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
(10:22):
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
(10:42):
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
(11:04):
and we believe that we will be you know, a
quality person to put in for the tender.
Speaker 1 (11:10):
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
(11:31):
the low acuity transfer service, would that mean job losses
for Saint John.
Speaker 2 (11:37):
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.
(11:59):
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,
(12:20):
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
(12:42):
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
(13:03):
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.
Speaker 1 (13:18):
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.
Speaker 2 (13:32):
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
(13:53):
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.
Speaker 1 (14:10):
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.
Speaker 2 (14:17):
No, thanks very much, Cadie.
Speaker 1 (14:18):
Thank you
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I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
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Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
Ridiculous History
History is beautiful, brutal and, often, ridiculous. Join Ben Bowlin and Noel Brown as they dive into some of the weirdest stories from across the span of human civilization in Ridiculous History, a podcast by iHeartRadio.