Leading the Way for Non Emergency Patient Transport

G4S Health Services

Indeed, Victoria’s non emergency patient transport privatisation plan was driven by the need for greater efficiency and cost savings –and both of these goals have been met since the service was first contracted out twenty years ago. “Providing non-urgent patient transport using emergency ambulances is a very expensive way of going about it,” Ms Berry explains. Outsourcing non emergency patient transport to private organisations like G4S leaves public ambulances free to respond to emergencies. In fact, G4S’ business model has been so beneficial to Victoria’s healthcare system that the company has grown from a four ambulance start-up in 1993, to operating 57 ambulances responsible for transporting more than 80,000 patients a year.

The vast majority of the company’s work comes from Ambulance Victoria. In fact, G4S holds Ambulance Victoria’s largest non emergency transportation contract – and has just been granted an even greater portion of the organisation’s workload.

G4S is a private operator, but the standards and regulations that the company follows are every bit as stringent as those kept by government run patient transport services – if not more so. First of all, G4S must adhere to the Non Emergency Patient Transport Act, an overarching regulation and licencing regime for any operator providing non emergency transport in Victoria. This act carefully covers everything from accreditation requirements and quality standards to drug licencing and Department of Health audits. “These are the minimum standards,” Ms Berry points out. “Our customers still regularly set higher standards beyond that. Some of them are clinical standards; some of them are performance standards.”

Timeliness is an issue that garners particular focus when it comes to performance standards. In fact, timeliness “is one of the big reasons why nonemergency transport works so well,” Ms Berry reports. She explains that, in traditional ambulance service, emergency response time must be given strict priority, and non-emergency patients can experience significant delays for transportation. Private operators, on the other hand, are “very much governed by key performance indicators in their contracts.” As a result, G4S’s customers can expect the company’s response time to be much shorter – in many cases its ambulances will arrive in as little as 30 minutes. “And that has a big impact on the customer,” Ms Berry explains, “particularly if the customer is a hospital.”

Efficient patient flow is crucial in a busy health care setting, she points out, because “if you can’t get patients out you can’t get new ones in.” In fact, as government introduces new incentives to help hospitals improve their patient flow, “they very much depend on us to assist them in making that happen,” Ms Berry says.

G4S also maintains its own internal standards and policies that go beyond what is required by government or customers. “G4S is incredibly conscientious in that area,” Ms Berry reports. The company adheres to strict, self-imposed regulations to ensure that “we meet our customer expectations and that we exceed them in most cases.” Internal policies cover everything from training, both in terms of safety and clinical care, all the way through to financial principles.

Some internal policies are specifically designed to “reward effort and reward productivity.” Rewarding productivity and efficiency is crucial because these attributes are the secret to maintaining the highest quality service while simultaneously offering competitive prices. To ensure ongoing efficiency and competency, G4S puts a tremendous amount of time and energy into the development of its 200 employees. Ironically, the ambulances themselves, along with their high-tech medical equipment, represent a much smaller investment. “The investment really is in our staff,” Ms Berry explains. “Training is the big issue. To enter the industry you have to already have the tertiary qualifications. But we see that very much as the entry level qualification so we provide ongoing training and skills maintenance. Some of that is in the care of the patient, some of that is in the care of the staff themselves.”

The company also supports its staff with career path assistance – not just for the benefit of G4S, but also to bolster and improve ambulance service in general. “A lot of younger people entering this industry do it with the specific intention of building up their credentials toward entering emergency ambulance services in the future,” Ms Berry reports. “And we recognise that is going to happen, so we… prepare them for that sort of work in the future. And in the twilight of their emergency career, some of them drift back again.”

Traditionally, non emergency patient transport has been used to transfer ill or injured patients from one health care facility or nursing home to another, but G4S broke new ground in 1995 by providing standby services at high risk sporting events, just in case urgent medical assistance is needed, Ms Berry reports. This has included thoroughbred and harness racing, and major sporting events.

Non emergency patient transport providers are generally not set up to deal with acute trauma situations, but G4S requires its employees to carry special equipment and undergo training specifically tailored for sports injuries. The company also works closely with the Newborn Emergency Transport Service by providing the transportation for medical teams transferring critically ill infants from one hospital to another.

G4S has successfully led Victoria’s non emergency patient transport market for years, and the team now has its sights set on expanding into other locations. This goal will require more states to recognise the benefit of private patient transportation, however. “Victoria now has a well-established, nearly twenty year old history of non emergency patient transport,” Ms Berry says. But, “[in] the other states it is still embryonic,” or simply non-existent. “And the challenge is to get the other states to see the advantages – both economic and quality wise – that we can deliver.”

Ms Berry believes that New South Wales and South Australia will be the first states (after Victoria) to deregulate and open patient transport to private enterprise. Queensland, she adds, will likely not be far behind. But she points out that certain commonly held assumptions must be set aside before this can successfully occur. “There are challenges in overcoming perceptions that there is a degradation of service rather than an improvement,” she explains. “People tend to think that if you take public health out of public hands that it [will] result in a degradation of service and we need to demonstrate that we can do better, not worse.”

To this end, G4S is actively promoting the benefits of private non emergency transport. And people are listening. “We know that some of the other states are now looking at the Victorian model and seeing it as an example of success,” Ms Berry reports. “We need to be there in the forefront showing them how we participated in that success and how we can help translate it for them as well.” The company has recently won a number of large, prestigious contracts, one of which is for St Vincent’s Health, a private organisation providing public health. Only time will tell if the non emergency patient transport business model will take hold across Australia. But, if it does, G4S will surely be leading the way.

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October 20, 2018, 11:42 AM AEDT

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